Issue 2, 2013 St. Elizabeth Health Center • St. Elizabeth Boardman Health Center HMpartners.org

medical staffU p d at e

A new patient care coordination modelwas implemented at St. Elizabeth HealthCenter on May 6 and will be phased in atthe other two hospitals over the next severalmonths. Through new functions andstandard operating procedures, the newmodel allows for:

• Clinical screening of patients prior to admission to make sure the appropriate patient status order (inpatient or observation) is obtained and the patient is placed in the unit that best meets their medical needs

• Managing the clinical progression of the patient while in the hospital

• Proactive discharge planning

The new care coordinationmodel is: Patient-Centered – the model willensure that information and throughputprocesses empower an excellent patientexperience, with active patient and familyengagement in managing their care andhealth. It will maximize evidence-basedholistic outcomes and deliver optimal carein the most efficient and effective location. High Quality – the model will ensurethat care across the continuum meets orexceeds top decile quality, outcome, safety,and mortality goals.

New Patient CareCoordination Modelat HMHP Hospitals

Continued on page 2

HMHP is creating a scholarship thatwill fund two years of medical school forup to five eligible medical students,$50,000 per student for each of the lasttwo years of medical school. Studentswould then enter residency according tothe medical education "match" system,after which they would return and establishmedical practices in the Mahoning Valley,joining the staff of an HMHP facility. After5 years of medical staff membership, theamount of the scholarship would beforgiven. "This initiative will help ensure asupply of talented medical professionals inthe Valley for the future,” says RobertShroder, CEO of Humility of Mary HealthPartners. "The Mahoning Valley hasexperienced shortages of physicians fordecades; many current area physicians areoriginally from the area. By funding thesescholarships, HMHP is contributing to themedical education of students and bringingthem back to the area to care for thecommunity."

How it works HMHP's hospitals, St. ElizabethHealth Center and St. Joseph HealthCenter, have medical residency programsand are affiliated with NEOMED,LECOM, and OUHCOM for the trainingof medical students. The scholarship is

open to medical students who graduatedfrom a high school in Mahoning,Trumbull, and Columbiana Counties inOhio and Lawrence and Mercer Countiesin Western Pennsylvania. Students must bein the last two years of medical school atNEOMED, LECOM, or OUHCOM.Scholarship recipients will be selected basedon objective criteria. Interested medical students shouldsubmit a letter of interest that highlights:

• Why the applicant would like to practice in the Mahoning Valley

• Their commitment to provide care consistent with the mission of HMHP

• A description of academic accomplishments

Applicants should also submit anundergraduate and graduate transcript,three letters of recommendation,curriculum vitae or resume, a dean’s letter,and evidence of graduation from a highschool in the region. All materials shouldbe sent to:

David Gemmel, PhD Department of Medical Education St. Elizabeth Health Center 1044 Belmont Avenue Youngstown, OH 44501

HMHPEstablishes

$1 MillionMedicalStudent

Scholarships

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New Treatment for Severe Asthma Introducedat St. Elizabeth

Agile – the model will allow quickresponse to changing demands andcommunity needs for health care servicesto provide health benefits that meetcommunity needs and ensure effectivestewardship of limited ministry resources. Proactive – the model will allowHMHP to accurately predict and projectpatient demand and staffing needs toprovide the right staff at the right time andplace to ensure high quality care via highlyreliable systems of integrated care across thecontinuum. The model will exhibit aworkforce with cross-continuumcompetency that can transition betweensites. Integrated – the model allows HMHPto provide high quality clinical care anddocumentation through standardizedoperational processes that ensure cliniciansacross the care continuum provide optimalcare in the appropriate setting. It also willensure that HMHP can generate accurate,appropriate, and compliant claims forreimbursement in a timely manner.

New Patient CareCoordination Modelat HMHP Hospitals

Continued from page 1 St. Elizabeth Health Center is among the first in the United States to offer a newprocedure for severe asthma patients, known as bronchial thermoplasty. The Alair®

Bronchial Thermoplasty System was recently approved by the U.S. Food and DrugAdministration (FDA). Patients who are 18 years and older and suffer from severepersistent asthma that is not well controlled with inhaled corticosteroids and long actingbeta agonists, the current standard-of-care treatments, will be eligible for the procedure.

“Bronchial Thermoplasty is an exciting, new advancement in the treatment of severeasthma,” says Timothy Barreiro, DO, director of the St. Elizabeth Pulmonary Health andResearch Center. “It has the potential to greatly improve the quality of life for manypatients suffering from constant asthma symptoms and we’re proud to offer it here atSt. Elizabeth.” Millions of patients with asthma struggle to keep their disease under control. Asthmaaccounts for 2 million emergency room visits in the US each year. Each day, roughly40,000 unscheduled physician office visits, 5,000 emergency room visits, and 1,000hospitalizations occur due to asthma. The Alair® Bronchial Thermoplasty System helpspatients with severe asthma gain substantially better control over their disease. Bronchial thermoplasty is performed through the working channel of a bronchoscopethat is introduced through a patient’s nose or mouth, and into their lungs. The tip of thesmall diameter Alair® catheter is expanded to contact the walls of targeted airways. Thisdevice then delivers controlled thermal energy to the airway walls to reduce the presence ofexcess smooth muscle that narrows the airways in patients with asthma. The minimally invasive procedure, like many other endoscopy procedures, is doneunder moderate sedation, allowing the patient to return home the same day. For more information, visit HMpartners.org/PHRC or contact the St. ElizabethPulmonary Health and Research center at 330-480-3258.

Brief Statement of Relevant Indications for Use, Contraindications, Warnings,and Adverse Events: The Alair® Bronchial Thermoplasty System is indicated for the treatment of severe persistentasthma in patients 18 years and older whose asthma is not well controlled with inhaled corticosteroidsand long acting beta agonists. The Alair® System is not for use in patients with an active implantableelectronic device or known sensitivity to medications used in bronchoscopy. Previously treated airwaysof the lung should not be retreated with the Alair® System. Patients should be stable and suitable toundergo bronchoscopy. The most common side effect of BT is an expected transient increase in thefrequency and worsening of respiratory-related symptoms.

Timothy J. BarreiroDO, FCCP, FACOI, FACP

St. Elizabeth PulmonaryHealth and Research Center

Orders and Titration, Taper, Wean IntravenousInfusion Orders – Provide Specific Instructions forSafe Administration

Duplicate Medication Orders - please bealert to the provision of specific ADMININSTRUCTIONS for DUPLICATEPRN Medication therapy (such as paintherapy or nausea/vomiting therapy). i.e. Ibuprofen 600mg every 4 hour prn pain, “HEADACHE OR MILD PAIN” in ADMIN INSTRUC Oxycodone/Acetaminophen 5/325 tablet 1 tabs every 3 hrs prn pain, “MODERATE PAIN” in ADMIN INSTRUC Oxycodone/Acetaminophen 5/325 tablet 2 tabs every 3 hours prn pain, “SEVERE PAIN” in ADMIN INSTRUCTitration, Taper, Weaning or IntravenousInfusions - please provide specific ADMININSTRUCTIONS with parameters toguide nurses in rate adjustments. i.e. norepinephrine (Levophed) titration order – norepinephrine 16mg/250ml start at 12mcg/min, titrate every 10 minutes, “KEEP MAP > 65” in ADMIN INSTRUC.

Pharmacy Update:2013 Patient SafetyInitiative

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Dr. Adam D. Cash is proud to announce cutting-edgeSciton® Laser technology in the division of Plastic andReconstructive Surgery at HMHP. This state of the artinstrument introduces exciting new capabilities in facialand body rejuvenation. Facial aging occurs with the passage of time and effectsof gravity. It is exhibited on the face through loss offullness specifically in the cheek area, loss of skin glowwith increase in red and brown pigment to the skin, aswell as both deep and fine wrinkles. Our combination ofLaser procedures can help diminish these signs, and aresignificantly more affordable than surgery with little orno downtime.

State of the Art CosmeticLaser Technologyat HMHP

With the introduction of our Erbium YAG Ablative Laser as well as BroadBand Lightwavelengths, women and men of all ages can improve appearance and turn back the hands oftime. The Sciton Joule Laser platform can effectively improve any of the following conditions: • Tighten fine lines and wrinkles of the face • Improve facial fullness • Vertical lines around the mouth • Facial scars caused by injury or accident • Scars caused by acne • Areas of uneven pigmentation, such as age spots • Lines on the cheeks caused by sun damage • Vascular lesions/Rosacea • Acne

Patients are treated in the office with minimal pain and without the need for a trip to theoperating room. Recovery generally occurs over a long weekend. To learn more visitHMpartners.org/plasticsurgery. Dr. Cash can help choose a treatment plan best for each individual in a privateconsultation at either his Howland or Boardman location.

The newest member of the HMHPfamily is HMHP Care Network, a clinicallyintegrated organization. The purpose of theentity is to enhance quality and reduce thecost of health care. HMHP Care Network is a physician ledorganization that enables physicians andthe HMHP hospitals to collaborate andshare accountability to create better healthoutcomes for the community. The networkincludes employed and independentphysicians who collectively commit toholding one another accountable for bestpractices to achieve quality and efficiencygoals. HMHP Care Network is aphysician-driven and physician-lednetwork. The board of managers includeseight physicians: Dr. John Baker, chair Dr. Bryan Veynovich, vice chair Dr. Hiba Abdel-Aziz, secretary Dr. Albert J. Cook II Dr. Jared Bunevich Dr. Chander Kohli Dr. Howard Dickey-White Dr. Ned Underwood.

Bob Shroder, Dr. Nick Kreatsoulasand Paul Olivier are board membersrepresenting HMHP. Physicians who apply to join HMHPCare Network agree to adhere tophysician-developed standards to improvequality and efficiency. This will allowHMHP Care Network to contractcollectively. It will be able to negotiatewith commercial payers and local,self-insured employers for improvement inreimbursement based on the ability toachieve quality benchmarks.

HMHP Care Network:Enhancing Quality,Reducing Cost

Adam D. Cash, MDPlastic and Reconstructive

Surgery

MicroLaserPeel TM

Howland1950 Niles-Cortland Rd., NESuite 9Warren, OH 44484Phone: 330-856-2545

Boardman Medical Pavilion8423 Market Str.Suite 205Boardman, OH 44512Phone: 330-729-3128

Daniel Fitzpatrick, DOReturns to the WoundCare Center Dr. Daniel Fitzpatrick is returning toSt. Joseph Wound Care Center. Upon hisreturn, he will assume the role of MedicalDirector for St. Joseph Wound CareCenter and Hyperbaric Medicine.Dr. Fitzpatrick will be seeing patients inthe center on Thursdays.

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Surgery Update

St. Joseph Surgical Serviceswelcomes Dr. Parisa Khavari. TheOhio State University College of Medicinegraduate is Obstetrics and Gynecologyboard certified and is currently performingrobotic-assisted procedure at St. Joseph.She has special expertise in disorders of thefemale lower genital tract and female lowergenital tract diseases.

St. Joseph Robotic SurgicalServices celebrated its one- yearanniversary in April. Over 250 roboticprocedures have been performed since theprogram’s start. Today, gynecological aswell as general and bariatric procedures arebeing performed robotically. Highlights ofthe first year include upgrading to theSI Model of the daVinci robot as well asDr. Woodruff performing the first singlesite robotic procedure in the area. Surgeonscurrently performing robotic proceduresare Drs. Amine Abdul-Aal, Emad Baky,Anthony DeSalvo, Parisa Khavari, PareshMehta, Mohammad Rashid, Tara Shipmanand Robert Woodruff.

Applause!Statewide Recognition Congratulations to Theresa Sheridan, DO, 3rd year Family Medicine Resident atSt. Joseph Health Center. Dr. Sheridan's paper on the Autism Spectrum placed third inthe Ohio State Society of the American College of Osteopathic Family Physicians(Ohio ACOFP)/CORE FP-RPAC paper competition. This is the third year in a rowthat a St. Joseph Resident has placed in the top three.

Resident of the Year Kim Jackson, DO, second year Family Medicine Resident from St. Joseph HealthCenter, was named 2013 Ohio ACOFP Family Medicine Resident of the year. Thisaward recognizes a FM resident in an AOA-approved Ohio program who exhibitsexemplary characteristics of an osteopathic family physician. These include compassion,leadership, and demonstrated commitment to osteopathic philosophy, patient care,community involvement and education.

Research on the National Stage Congratulations to the following residents and their physician advisors who will bepresenting research at national conferences this year:

National American College of Physicians, San Franciso, CA

• Farhad Fakhrejahani, Radiation Exposure from Diagnostic Procedures in Allogeneic Stem Cell Transplantation – How Much is Acceptable?

• Christian Ghattas, Cherry Valino, Tim Barreiro, Iatrogenic Tracheal Stenosis Presenting as Peristent Asthma (selected for presentation but not presented due to notification of acceptance in peer-reviewed journal before meeting)

American Thoracic Society, San Diego, CA

• Christian Ghattas, Amit Arbune, Basem Yacoub, Digvijay Singh, Inadequate Evaluation of Lung Volume Reduction Surgery Candidates

• Christian Ghattas, A Dai, David Gemmel, Misdiagnosis and Mistreatment of Chronic Obstructive Pulmonary Disease in an Underserved Population

• Christian Ghattas, Unique Radiologic Findings in Erionite Comparing to Asbestos Related Malignant Pleural Mesothelioma

American Federation for Medical Research, San Francisco, CA

• Rodjawan Supakul, Trends in Alcoholic Hepatitis Related Hospitalizations, Cost, and Mortality in the United States: 2002-2007

One of the most critical roles of aSpeech/Language Pathologist (SLP) ismaking decisions from a swallowingassessment about the ability to continueto eat and drink. The optimal swallowingassessment requires recognizing subtlevariations in the physiologic componentsand events that comprise an intact, healthyswallow mechanism. The MBSImp is an evidence-based,standardization of the Modified BariumSwallow Study (MBSS) in adults. It assesses17 critical components of swallowingand provides an objective profile of thephysiologic impairment affecting adultswallowing function. Technicians basetheir recommendations for eating on theMBS results. Kimberly Marchetto, MS, CCC/SLP(SEHC, Acute Rehab) and Lisa Yanak,MS, CCC SLP (SJHC) recently receivedtheir MBSImp Registered ClinicianCertification. Kimberly and Lisa share thisdistinction with 15 SLPs in the state ofOhio and just 540 SLPs worldwide.

Speech PathologistsCertified in SwallowEvaluations

Core Measures of Quality: March 2013

St. Elizabeth 95% 100% 100% 82%

St. Elizabeth Boardman 100% 100% 86% 94%

St. Joseph 70% 100% 87% 90%

AMI Heart Failure Pneumonia SCIP

Medical Staff Update and Board Approvalsavailable online at issuu.com/myhmhp

Board ApprovalsSt. Elizabeth Health CenterRequest for Active ProvisionalStaff Status

Darleen Abadco, DPM, Department ofSurgery, Section of Podiatry

Charles Cammock, MD, Department ofAnesthesiology

Raymundo Castillejo, MD, Department ofAnesthesiology

Ramy Fahim, DPM, Department ofSurgery, Section of Podiatry

Kathy McNutt, DO, Department ofEmergency Medicine

Alison Protain, DO, Department ofPediatrics, Section of Neonatology

Sameera Rahman, MD, Department ofFamily Medicine

Louis Salib, MD, Department ofAnesthesiology

Bradley Vargo, DO, Department ofAnesthesiology

Resignations

William Bartels, MD, Department ofFamily Medicine

Paula Brant, PA-C, Department ofEmergency Medicine

Lisa Elliott, RN, Department of InternalMedicine, Section of Cardiology

Debra Hilty, CNP, Department of InternalMedicine, Section of General Internal

Shelli Jackson, CNP, Department ofSurgery, Section of General Surgery

David Levy, DO, Department ofEmergency Medicine

Diane Pantelis, CNP, Department ofInternal Medicine, Section of Cardiology

Paul Rich, MD, Department ofFamily Medicine

Homer Skinner, DO, Department ofFamily Medicine

Raymond Wawrowski, PA-C, Departmentof Emergency

St. Elizabeth BoardmanHealth CenterRequest for Active ProvisionalStaff Status

Darleen Abadco, DPM, Department ofSurgery, Section of Podiatry

Charles Cammock, MD, Department ofHospital Based Specialists, Section ofAnesthesiology

Raymundo Castillejo, MD, Department ofHospital Based Specialists, Section ofAnesthesiology

Ramy Fahim, DPM, Department ofSurgery, Section of Podiatry

Michael Koprucki, MD, Department ofMedical Specialists, Section of Nephrology

Ronald Prizant, MD, Department ofHospital Based Specialists, Section ofAnesthesiology

Sameera Rahman, MD, Department ofPrimary Care, Section of Family Medicine

Louis Salib, MD, Department of HospitalBased Specialists, Section of Anesthesiology

Bradley Vargo, DO, Department ofHospital Based Specialists, Section ofAnesthesiology

Resignations

William Bartels, MD, Department ofPrimary Care, Section of Family Medicine

Paula N. Brant, PA-C, Department ofHospital Based Specialists, Section ofEmergency Medicine

Terry Lloyd, RN, Department of Surgery

Diane Pantelis, CNP, Department ofMedical Specialists, Section of Cardiology

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