Aloha, and welcome to the June issue of Pali Momi`s Physician

June 2015
IN THIS ISSUE
A Message From Jen
Art Gladstone Named New Pali Momi CEO
Aloha From Your CMO: My Swan Song
A Welcome From Your New CMO
The Joint Commission's Prescription for Health
Epic Update: Electronic Media for Our Patients
Aloha, and welcome to
the June issue of Pali
Momi's Physician
Enews Brief for medical
staff.
Hawaii Pacific Health among Top
Organizations in Employee Engagement
Pali Momi Awarded Advanced Certification for
Primary Stroke Center
Pali Momi Women's Center Earns National
Breast Center Accreditation
Healthy Pursuits: A Monthly Patient
Enewsletter
Be Prepared
Pali Momi Celebrates 25 Years
In the News
Upcoming Events
Welcome New Members and Allied Health
Professionals
A Message From Jen
As I take on this new challenge in my career, I am honored
and humbled by all the well wishes from our medical staff
and physician leaders. Many of you have shared your
thoughts on my time at Pali Momi and what we have all
accomplished together. Those are the memories I take with
me. It's what makes my 11 years at the hospital so
meaningful.
Jen H. Chahanovich, CEO
I have been privileged to work with a medical team that I hold in the highest esteem. You
have my sincerest gratitude for the work you do with patients, their families and our
community. The true commitment that has been made by all of you – to provide quality
care for West Oahu – has made all the difference to the people we serve.
Because of your efforts, in an ever-increasing number of areas, Pali Momi has been
recognized, certified or accredited among the top providers in the country. Our patient
experience ratings for four years in a row are among the top 10 percent. Our quality
results continually improve, and our cardiac, breast imaging, stroke care and bariatric
programs have achieved designations that place these programs with the nation's finest.
In families, even if members move away, the closeness and ties remain, and they do
come together again. I believe that is true, especially within the Hawaii Pacific Health
ohana, where our work extends throughout the system.
And so I extend my heartfelt mahalo to you, and for now, say aloha.
Art Gladstone Named New Pali Momi CEO
The following announcement was made by Hawaii Pacific
Health President & CEO Ray Vara on June 24, 2015:
"With Jen Chahanovich's upcoming move to Wilcox
Memorial Hospital and Kauai Medical Clinic, Hawaii Pacific
Health will be restructuring our senior leadership team.
As part of the restructuring, I am pleased to announce that
Art Gladstone will expand his CEO role to include
responsibility for both Pali Momi Medical Center and Straub
Clinic & Hospital effective July 1, 2015. Given Art’s long
history of operational and administrative leadership at both
Pali Momi and Straub, he is the ideal executive to oversee
both facilities. During his time at Pali Momi, Art held both
the vice president operations as well as chief operating
officer positions.
Art Gladstone, CEO
In 2004, Art assumed responsibility at Straub as its chief operating officer and was
promoted to CEO for Straub in 2013.
Art will also be restructuring his leadership team and will have chief operating officers for
Pali Momi and Straub reporting directly to him. He is currently looking at internal
candidates for the chief operating officer positions."
Ray Vara
President & CEO
Aloha From Your CMO: My Swan Song
Hugh N. Hazenfield, MD, FACS, outgoing Chief Medical
Officer
On June 30, I am making my third attempt at retirement –
and this time, I may get it right!
I have had the privilege to work with many of you as
colleagues not only at Pali Momi, but also at other Oahu
hospitals since my arrival in Hawaii in 1989. I have been
honored to be the recipient of your trust in caring for your
patients, your encouragement and your friendship.
I accepted the position as your chief medical officer and
started in this role on July 13, 2009. I promised Jen two
years of service, but somehow – as I stated to her – I forgot
to retire because I was enjoying this job.
Hugh N. Hazenfield, MD
Chief Medical Officer
The main reason for my accepting and remaining in this position was because of what I
viewed as your unique collegiality, as well as your dedication to quality care for your
patients and your willingness to serve in leadership roles and on committees to strive for
an even better medical center.
Because of your participation, Pali Momi is truly an unusual and outstanding hospital,
having won national recognition for quality.
It also includes:
The administration, which is very supportive of the providers, and each individual in
this hospital;
The employees, who not only see themselves as members of "the team," but smile
and greet us every morning;
The unselfish volunteers; and
The dedicated board members.
Being the first CMO, I have attempted to develop the chief medical officer position as a
resource and support for you, the physicians, in these rapidly changing times in the
practice of medicine. I hope that I have succeeded.
I am leaving the CMO responsibilities in the good hands of Dr. James Kakuda. He is an
outstanding physician. He has proven himself as an administrator as chief of staff and in
other leadership roles. He has quality care at heart, and he will serve you well.
Treasure what you have here at Pali Momi. Maintain your collegiality, and enjoy your
friendships. Continue to strive for the best quality care possible for your patients. Look
forward to each new day and its challenges and triumphs.
You are what makes and keeps this place such a great place in which to practice.
Aloha,
Hugh
A Welcome From Your New CMO
James T. Kakuda, MD, incoming Chief Medical Officer
It is with great excitement that I write this column as Pali
Momi's incoming chief medical officer.
For the past quarter-century, Pali Momi has grown to be an
important part of the West Oahu community. Through the
work of many, the medical center has brought to West
Oahu new technology, improved access, better service and
top-tier quality.
I view my new position as an opportunity to facilitate the
continuance of this good work.
The coming years will be difficult, as there are many
challenges that face us. The transition to ICD-10 in only a
few months is but one example of impending disruption.
James T. Kakuda, MD
Chief Medical Officer
Pali Momi recently hosted a CME on this topic. Our speaker estimated private practices
should have 60 days cash on hand to weather the transition! On top of this, more stresses
arise from the changing landscape of health care providers in our region, ongoing
changes with health care reform, and the ever-increasing administrative burden borne by
physicians.
While there are many challenges, there are also many things to look forward to:
construction of a comprehensive oncology treatment center, development of a new
cardiac catheterization lab and recruitment of new physicians – both private practice and
employed – are but a few examples of work that will allow us to better fulfill our mission.
I look forward to sharing these challenges and opportunities with you.
The Joint Commission's Prescription for Health
Mark Baker, MD, Chief of Staff
Pali Momi Medical Center is now in its time window of a
Joint Commission survey that extends until October! This
means that between now and then, a team of surveyors
can show up essentially unannounced and have access to
hospital areas and patient information that would otherwise
be considered confidential.
The Joint Commission is well-intentioned. From its website,
I read the following:
"For more than 60 years, The Joint Commission has been a
champion of patient safety by helping health care
organizations to improve the quality and safety of the care
they provide. Our many patient safety-focused initiatives
encourage and support organizations in their efforts to
make patient safety a continuous priority."
Mark Baker, MD
Chief of Staff
Sometimes, I am a skeptic. I scoured the literature, looking for an answer to some
questions. Has The Joint Commission improved health or health care? Has The Joint
Commission overstepped its boundaries? Is The Joint Commission good for patient care?
As with any question, the answer is, it depends.
Glassman provides evidence that The Joint Commission's "Do Not Use" abbreviation list
has decreased medication errors.1 These were announced in 2003 and include
abbreviations such as MS and MSO4, both of which had been confused with morphine.
At that time, I thought the inability to abbreviate morphine was silly because nobody could
confuse a pain medication with magnesium sulfate. I stand corrected. The article
documents that 10 percent of medication abbreviation errors were attributed to confusion
between these two. The electronic health record has made some of these areas of
confusion obsolete; thank you, Epic.
Has The Joint Commission overstepped its bounds? On The Health Care Blog, Karen
Sibert describes how the standards are a moving target:
The Joint Commission decrees that syringes containing medications should be labeled
with the name of the drug. No, that's not good enough. All syringes should be labeled with
the exact concentration in mg/cc as well as the name of the drug. That's not good enough
either. All syringes should be labeled with the drug name, the concentration of the drug,
and the date and time they were drawn up. No, wait. They should be labeled also with the
initials of the person who drew them up. And some medications should be labeled not with
the time the drug was drawn up, but with the time it expires.
Certainly, The Joint Commission is motivated to continue its effort to improve health care,
essentially ratcheting down on the providing organizations to the point where we wonder
what their purpose is.
If health care organizations could be trusted to maintain a defined level of quality, The
Joint Commission would be out of business. Unfortunately, that is not likely to happen;
health care may never be safe enough from a reviewer's point of view.
Pali Momi Medical Center truly has a culture of safety. So, if you have the opportunity to
meet one of the inspectors between now and October, smile, and tell them you are happy
to show them what you do and how you take the best possible care of patients.
1
Glassman P. The Joint Commission's "Do Not Use" List: Brief Review (NEW) In: Making
Health Care Safer II: An Updated Critical Analysis of the Evidence for Patient Safety
Practices. Rockville (MD): Agency for Healthcare Research and Quality (US); 2013 Mar.
(Evidence Reports/Technology Assessments, No. 211.) Chapter 5. Available from:
http://www.ncbi.nlm.nih.gov/books/NBK133373/
Epic Update: Electronic Media for Our Patients
Submitted by Mark Baker, MD
Epic has matured, and we are now using the 2014 version of Epic.
As with all upgrades, there were problems, but all things considered, the transition was
smooth. Future versions allow increased efficiency for the providers with better
documentation. I don't have a timeline for implementation.
Up until this point, most of the focus of the electronic health record is on providers and
delivering care. My focus with this newsletter is patient education. This is traditionally
outside of the scope of the electronic health record, but it is one of the most important
aspects to patient care.
Epic allows access to prepared aftercare instructions. Patients receive pages of printed
information (too many in my opinion). What do a lot of them do when they get home? They
look things up on the Internet. Do they find a reputable source? Do they find a blog that
indicates that we did the wrong thing? Do you know how to tell if a source is reputable?
Do you know how to guide your patients related to use of the Internet?
Health care providers typically have not promoted, encouraged or taught effective use of
the Internet to obtain medical information. Care is not delivered by the Internet!
Teaching patients home care and dissemination of information to the patient or caregivers
has traditionally been verbal with written instructions. Saidinajad et. al. found that ED
patients and families were interested in access to Internet-based patient care information.1
Internet-based medical content is increasing and may aid with patient understanding of
their injury or illness. Bloch et. al. describe improved understanding when patients used
video presentations for aftercare instructions.2 I look forward to this in the future!
How do you know what is reliable? There are medical content certification sites like
HONcode or URAC.
HONcode stands for Health On The Net Foundation. As stated on its website:
The Health On the Net Foundation (HON) promotes and guides the deployment of useful
and reliable online health information, and its appropriate and efficient use. Created in
1995, HON is a nonprofit, non-governmental organization, accredited to the Economic and
Social Council of the United Nations.
URAC is an independent nonprofit organization. Both WebMD and the Mayo Clinic Site
are certified and believed to have good patient information. UpToDate has recently been
increasing its supply of patient-related information, but it does not display any
accreditation.
You and your patients can look for the logos below, typically found at the bottom of the
website.
Technology is changing health care providers, our patients and the way we deliver care. In
spite of this, we will still need to focus on human-to-human interaction, compassion and
understanding of patients' wants, needs and fears.
Digital media for patient should be considered a supplement to and not a replacement of
that human interaction.
1
M. Saidinejad and J. Zorc. "Mobile and web-based education: delivering emergency
department discharge and aftercare instructions." Pediatric emergency care 30.3 (2014):
211-6. Print.
2
S. A. Bloch and A. J. Bloch. "Using video discharge instructions as an adjunct to
standard written instructions improved caregivers' understanding of their child's
emergency department visit, plan, and follow-up: a randomized controlled trial." Pediatric
emergency care 29.6 (2013): 699-704. Print.
Hawaii Pacific Health among Top Organizations in Employee
Engagement
Hawaii Pacific Health has been recognized with the prestigious Gallup Great Workplace
Award for the fourth year in a row.
The award recognizes HPH as one of 40 organizations leading the world in employee
engagement with winners based in a wide range of countries including Canada, China,
India, Indonesia, Netherlands, Singapore, Thailand, the United Arab Emirates, the United
Kingdom and the United States.
A team from HPH accepted the award on behalf of our organization earlier this month at
the Gallup Workplace Summit in Omaha, Nebraska.
HPH is currently ranked in the 86th percentile when benchmarked to a Gallup database of
more than 1.3 million health care employees, and averages nine engaged employees for
every one actively disengaged employee, which is five times the rate in the U.S. and more
than 16 times the rate for workforces globally.
All of the companies honored with the award are recognized for the business impact
achieved by integrating engagement into four areas that Gallup has identified as vital to
cultivating a workplace culture of engagement: strategy and leadership, accountability and
performance, communication and knowledge management, and development and
ongoing learning.
Pali Momi Awarded Advanced Certification for Primary Stroke
Center
Pali Momi Medical Center recently earned The Joint
Commission's Gold Seal of Approval® and the American Heart
Association/American Stroke Association's (AHA/ASA) HeartCheck mark for Advanced Certification for Primary Stroke
Centers. The Gold Seal of Approval® and the Heart-Check mark
represent symbols of quality from their respective organizations.
Pali Momi underwent a rigorous onsite review by Joint Commission experts who evaluated
the hospital's compliance with stroke-related standards and requirements, including
program management, the delivery of clinical care and performance improvement.
"We are honored to be certified as a Primary Stroke Center and to be acknowledged for
the quality, coordinated care we provide patients in the event of a stroke emergency," said
Pali Momi CEO Jen H. Chahanovich. "Time is a crucial factor in treating a stroke and
ensuring a successful outcome, so we are especially proud that we can provide access to
nationally-recognized stroke care close to home for the residents of Central and West
Oahu."
The Primary Stroke Center certification recognizes centers that follow the best practices
for stroke care. Certified primary stroke centers:
Use a standardized method of delivering care.
Support patient self-management activities.
Tailor treatment and intervention to individual needs.
Promote the flow of patient information across settings and providers, while
protecting patient rights, security and privacy.
Analyze and use standardized performance measure data to continually improve
treatment plans.
Demonstrate their application of and compliance with clinical practice guidelines
published by the AHA/ASA or equivalent evidence-based guidelines.
Established in 2003, Advanced Certification for Primary Stroke Centers is awarded for a
two-year period to Joint Commission-accredited acute care hospitals. The certification was
derived from the Brain Attack Coalition's "Recommendations for the Establishment of
Primary Stroke Centers" (JAMA, 2000) and the "Revised and Updated Recommendations
for the Establishment of Primary Stroke Centers" (Stroke, 2011).
Pali Momi Women's Center Earns National Breast Center
Accreditation
The Women's Center at Pali Momi Medical Center has been granted a full, three-year
accreditation designation by the National Accreditation Program for Breast Centers
(NAPBC), a program administered by the American College of Surgeons. Accreditation by
the NAPBC is given only to centers that have voluntarily committed to provide the highest
level of quality breast care and that undergo a rigorous evaluation process and review of
their performance.
"We're extremely proud of the quality of care and service provided to our patients at the
Pali Momi Women's Center," said Pali Momi CEO Jen H. Chahanovich. "This designation
validates the efforts of our Women's Center physicians, nurses and staff to maintain the
highest standards of care and our commitment to ensure access to quality breast health
services, particularly for residents of Central and West Oahu."
During the NAPBC survey process, the center was required to demonstrate compliance
with standards established by the NAPBC for treating women who are diagnosed with the
full spectrum of breast disease. The standards include proficiency in the areas of center
leadership, clinical management, research, community outreach, professional education
and quality improvement. A breast center that achieves NAPBC accreditation has
demonstrated a firm commitment to offer its patients every significant advantage in their
battle against breast disease.
The NAPBC is a consortium of professional organizations dedicated to the improvement
of the quality of care and monitoring of outcomes of patients with diseases of the breast.
This mission is pursued through standard-setting, scientific validation, and patient and
professional education. Its board membership includes professionals from 20 national
organizations that reflect the full spectrum of breast care.
Healthy Pursuits: A Monthly Patient Enewsletter
Pali Momi launched a monthly patient enewsletter earlier this year, and we want all
employees and physicians to have the opportunity to receive it too.
By subscribing to our patient enewsletter, you will have access to useful health and
wellness information to share with your patients. You also can stay informed of the topics
patients are interested in learning more about.
You can opt-in via the website link here to subscribe to receive the enewsletter via your
personal email address at home.
We have similar e-newsletters for each HPH hospital that you may also want to receive.
For questions or feedback, please send an email to [email protected].
Be Prepared
Hurricane season began on June 1 and will last through Nov. 30. Please see the 2015
Hurricane Season memos for employees and managers for preparation instructions.
Contact your Safety Officer for questions or more information.
Pali Momi Celebrates 25 Years
In observance of Pali Momi's silver anniversary, a celebratory gala was held May 2 at
Aulani at Ko Olina.
Presented under the theme "By the Light of the Silvery Moon," the gala included music, a
silent auction, dinner under the stars and a look back at 25 years of providing the highest
quality medical care to West and Central Oahu.
Click here to view more photos.
In the News
Here is a look at some of our physicians and specialists who have been featured in the
news recently:
Dr. Maria Ver – surgeon
Hawaii News Now, March 12: Ver highlights some of the activities and the
purpose behind Pali Momi's newest community event to promote health and
wellness.
See the video – Pali Momi launches Girls Night Out event for women's health
Dr. Huidy Shu – neurologist
KITV, May 31: The Doctor is in: Shu talks stroke awareness.
See the video – Warning signs of a stroke
KITV, May 31: Shu talks about the warning signs and treatment for stroke,
and his patient shares how getting to the hospital fast enough helped him
recover fully from a stroke.
See the video – Quick thinking helped save a man from a stroke
Dr. John Kao – cardiologist
KITV, June 3: Kao talks about the new technology available at Pali Momi
Medical Center to prevent and detect heart failure in patients.
See the video – Pali Momi Medical Center first in Hawaii to offer
CardioMEMS HF System
Hawaii News Now, June 4: Kao talks about the new technology available at
Pali Momi Medical Center to prevent and detect heart failure in patients.
See the video – Pali Momi implants new heart disease monitor
Upcoming Events
CATCH Conference
Congenital heart disease (CHD) is the most common defect in the United States,
occurring in one out of every 110 births.
Currently, there are more than 1 million adults in the U.S. living with congenital heart
disease, and this number continues to rise.
To address this growing need, Hawaii Pacific Health will host CATCH: Caring for Adults
and Teens with Congenital Heart Disease Aug. 22 at the Hilton Hawaiian Village, Coral
Ballroom 1 and 2.
Adolescents and adults with CHD face unique challenges that require a specialized team
of clinicians that includes primary care physicians, cardiologists, internists, nurses and
other health professionals.
At CATCH, an expert faculty from Hawaii and California will provide a comprehensive
overview of research-based, cutting-edge care by medical professionals with special
expertise in the complexities of CHD.
By the end of the conference, participants will be able to:
Identify potential comorbid conditions and complications in adults and teens with
CHD.
Review diagnostic and treatment options for adults and teens with CHD.
HPH is accredited by the Hawaii Medical Association to provide continuing medical
education for physicians.
HPH designates this live activity for a maximum of 6.0 AMA PRA Category 1 Credit(s).
Physicians should claim only the credit commensurate with the extent of their participation
in the activity.
The HPH Continuing Education Department is accredited as a provider of continuing
nursing education by the American Nurses Credentialing Center’s Commission on
Accreditation. HPH designates this live activity for a maximum of 6.0 ANNC contact hours.
Early registration by June 30 costs $95 for physicians and $75 other health professionals.
Regular registration costs $125 for physicians and $105 other health professionals.
To register, please complete the form found in the brochure here and return to Hawaii
Pacific Health Conference Services, or call 522-3469 for more information.
Department & Committee Meetings
All meetings will be held in the Executive Conference Room unless noted otherwise.
Operative & Other Procedures: July 1, 12:20 p.m.
Emergency Medicine Peer Review: July 6, 7 a.m.
Cancer Committee: July 14, 12:30 p.m.
Division of Radiology: July 14, 6 p.m.
Division of Emergency Medicine: July 27, 12:30 p.m.
Department of Medicine: July 27, 12:30 p.m., PMMC Conference Center
Division of Anesthesia: July 29, 7 a.m.
Metabolic and Bariatric Surgery: July 30, noon
Alapono Committee: Aug. 7, 12:30 p.m.
Medical Records Committee: Aug. 13, 12:30 p.m.
ED Peer Review: Sept. 28, 7 a.m.
Continuing Medical Education (CME)
Pali Momi Medical Center is accredited by the Hawaii Medical Association to provide
continuing medical education for physicians. This live activity is designated for a maximum
of 1 AMA PRA Category 1 Credit(s)TM. Physicians should only claim credit
commensurate with the extent of their participation in the activity.
All CMEs will be held at 12:30 p.m. in the PMMC Conference Center unless noted
otherwise.
"Hypothermia Protocol" by Yash Trivedi, MD: July 13
"Current and Emerging Therapies for the Treatment of Congestive Heart Failure" by
John Kao, MD: July 20
"Hand Hygiene" by Krist Pottorff, MPH, BSN, RN: Aug. 17
"Enhanced Recovery" by James Kakuda, MD: Aug. 24
Cancer Conference: Sept. 14
"Health Information Systems and Technology Safety" by Steve Robertson: Sept. 28
CMEs are subject to change. Please check the MSO Intranet calendar for updates, or call
485-4209 to confirm a meeting.
Holidays & Observances
Independence Day – Saturday, July 4 (Observance Friday, July 3)
Admission Day – Friday, Aug. 21
Labor Day – Monday, Sept. 7
Welcome New Members and Allied Health Professionals
Eddie S. Fiore, MD
Susan L. Tan, MD
Joseph Varcadipane, MD
Diagnostic Radiology
Otolaryngology
Orthopedic Surgery
Provisional Consulting Staff
Provisional Active Staff
Provisional Active Staff
Questions? Contact James T. Kakuda, MD, Chief Medical Officer at 485-4544 or
[email protected].
Pali Momi
Medical Center
The Pali Momi Physician enews brief is produced quarterly to keep the
98-1079 Moanalua Road
Aiea, HI 96701
Pali Momi is part of the not-for-profit Hawaii Pacific Health network.
medical staff informed of the latest news at our hospital. This enewsletter
replaces the printed version of the Pali Momi Physicians News Bulletin.