Medical Staff e-Update

Mark Smith, MD

Mark Smith, MD

Clinical Service Chief and Medical Director of Emergency Services, Executive Medical Director of Adult Hospitalist Services & Chief of Staff

Ray King, MD

Senior Vice President, Medical Affairs & CMO

Issue 20 - September 4, 2015

The Allegiance Health open-heart surgery program celebrated its seventh anniversary in February 2015. Just one month later, the open-heart team reached another milestone by operating on its 1000th patient—66-year-old Harry Adams of Grass Lake.

Harry is a health-conscious man who loves the outdoors, grows much of his own food and has had very few medical issues. Caring for the acreage around his home, cutting wood and gardening provides Harry with plenty of exercise, and he loves to hunt, fish and ride his motorcycle with his sons, Stephen and Jason.

Although he has a family history of heart disease, Harry was surprised when he recently experienced “pain that felt like I had a bulldozer on my chest.”

When he and his wife, Clara, arrived at the Allegiance Emergency Department, Harry mentioned chest pain, “and everything moved quickly from there,” he said. A series of tests confirmed that Harry was having a heart attack and would need open-heart surgery.

Cardiothoracic surgeon Mahender Macha, MD, came in to talk with Harry and his family. “I was really scared, but Dr. Macha was wonderful and explained everything to us,” Harry said. “I felt more confident after talking with him.”

Looking back, Harry said, “It was a really good experience. I was impressed with the Allegiance medical team.”

Harry’s recovery has gone smoothly and, with the help of the Allegiance Cardiac Rehabilitation program, he is back to his active life. He planted a huge vegetable garden and has been turkey hunting several times since his surgery. “It feels a little like I have been reborn,” he said. “I don’t take life for granted like I used to.” 

The Allegiance Construction Crew, in coordination with the Allegiance Safety Department, has developed a plan for removing the carpet from the 1st Floor of the Anderson Building hallways. Under the carpet is tile with adhesive that has the potential to contain asbestos. In its current state, asbestos poses no risk to our patients, visitors or staff members. However, as a precaution, the removal of the carpet in these areas will be treated as “containing asbestos,” which means certain areas of the hallway will need to be blocked off while a contracted asbestos abatement company does the removal.

Removing the carpet/tile and installing new carpet will take place in phases. During this time staff can expect to see the hallways blocked with barrier plastic, signs stating “no admittance,” alternative emergency exits posted, temporary way finding signs, bare concrete floors (after the carpet and tile have been removed), and grinding sounds (as they remove the tile).

  • Phase 1 - Friday, September 11 at 5 p.m. – Monday, September 14 6 a.m.
  • Phase 2 - Friday, September 18 at 7 p.m. – Monday, September 21 at 6 a.m.
  • Phase 3 - Friday, September 25 at 5 p.m. – Monday, September 28 at 6 a.m.
  • Phase 4 - Friday, October 2 – Monday, October 5 (day shift)

Please assure any concerned patients or visitors that we are taking every precaution to protect their safety and well-being during this necessary facility update. 

Allegiance President and CEO Georgia Fojtasek was recently honored with the highest achievement award of the Michigan Health and Hospital Association (MHA). The 2015 Meritorious Service Award recognizes Georgia for influencing health care across the state. She was specifically commended for her work to help shape policy on the national, state and regional levels that would improve access and quality of care for residents of Jackson and the surrounding counties, including the underserved.

“Georgia has always understood that improving the health and well-being of the people of the Jackson region required her service locally, regionally and nationally,” said MHA Board of Trustees Chairman Tom DeFauw.

“I am honored to receive the award on behalf of Allegiance Health,” Georgia said. “Our accomplishments are the direct result of decades of commitment by staff, physicians and governance members, including volunteer community trustees. Many of our achievements are also the result of partnerships formed between Allegiance and other community organizations that shared our vision for supporting residents of this region in becoming the healthiest in Michigan.”

In March 2018, McKesson will stop supporting Series Registration/Financials and Horizon Clinicals. In preparation, Allegiance Health leaders and the Information Systems department have been reviewing potential replacements for these products over the last six months. After thoughtful consideration, the leadership team has decided on the Epic system to provide a fully integrated EHR solution for Allegiance.

Through the selection process, three vendors were considered: Epic, Cerner and McKesson Paragon. It became clear that, in order to provide an efficient, integrated and cost-effective solution, we needed a system-wide EHR that includes as many applications and departments as possible.

We would like to thank everyone for their participation in the Epic deep dive demos. The Epic system received overwhelmingly positive feedback from our staff and leaders, and it has the highest ratings in all categories from KLAS, a respected information systems organization. Epic is also in use or is being implemented by all the organizations Allegiance is currently considering for potential affiliation. With these factors in mind, plus time and cost to the organization, we decided not to perform deep dive demos of the Cerner system.

Our transition to Epic will be done in several phases over the next few years and requires a large investment in time and resource collaboration across the entire health system. Now that the evaluation and selection processes are complete, the next steps will be planning and implementation. We are beginning the hiring process for the project team with the EHR Trainer positions that are posted. Later this year, the rest of the new implementation team will be selected.

In January 2016, all project team members will begin training on the Epic system. We are excited to embark on this monumental journey for Allegiance and look forward to enhancing care across the organization.

As our community continues to diversify, Allegiance Health recognizes the importance of being able to communicate effectively with patients in different languages. Qualified health care interpreters are available 24 hours a day, 7 days a week for our patients with Limited English Proficiency (LEP) and those who are hearing-impaired patients (as well as their family members). This service is available at no cost to the patient.

Allegiance Health currently uses on-site qualified health care interpreters for our Spanish-speaking and hearing-impaired patient population.  We also offer telephonic interpretation which provides access to more than 200 language types.  We are proud to announce that we have recently implemented video remote interpretation services to better assist our LEP and sensory impaired patients.

The video remote interpretation (VRI) services are provided via iPad and can be accessed throughout our health system, regardless of the location.  Video remote interpretation allows providers to access 12 language types via video chat to a qualified health care interpreter, as well as audio only connection to more than languages.  All 200 languages are available around the clock using the audio option from the same video interpreting application.

For a video demonstration, please visit the Interpreter Resources link on Ida.  For questions, please contact Patient Safety and Advocacy Services at 788-4703.

Allegiance Health recently installed new, highly advanced equipment to provide even more exacting precision in neurosurgery: the Medtronic StealthStation S7 for neurosurgery navigation and the O-Arm MultiDimensional Surgical Imaging System. The technology is designed for use in spine, orthopaedic and trauma-related surgeries. It provides real-time imaging of a patient’s anatomy during surgery with high-quality images and a large field of view in both two and three dimensions.

The improved visualization allows surgeons to complete complex minimally invasive procedures and confirm surgical accuracy—including the precise placement of screws and rods—before the patient leaves the operating room. The equipment also greatly reduces radiation exposure to staff.

“Allegiance is one of the few health systems between Detroit, Chicago and Indianapolis to offer this new technology. Our community is extremely fortunate to have access to this precision equipment, which is sure to improve patient outcomes,” said neurosurgeon Amritraj Loganathan, MD.

In an effort to standardize the content of paging messages while avoiding transmission of protected health information, we have created ‘predefined messages’ within the paging system.  Consequently, you will begin seeing a new phone exchange (517-205-xxxx) in the messages.

In order to comply with the privacy provisions of HIPAA staff have been instructed to not include patient names or room number in non-secure paging messages.  This has resulted in nurse and physician frustration as the content of the message may not be sufficient to assess the situation or in some cases know whom to call back.  An attempt has been made to provide scripting on the proper form and content of the messages.  This approach has had limited success.  As such we have created a series of ‘predefined messages’ or templates in the paging system.  The messages are as follows:

  • STAT, 517 205-xxxx, ContactNameRole, Unit, LastName3-FirstInitial, MRN xxxxxx, Reason
  • URGENT, 517 205-xxxx, ContactNameRole, Unit, LastName3-FirstInitial, MRN xxxxxx, Reason
  • ROUTINE, 517 205-xxxx, ContactNameRole, Unit, LastName3-FirstInitial, MRN xxxxxx, Reason
  • Please call ED 517-205-4844, Dr xxx, MRN xxxxxx

The content of the ‘prompts’ are replaced with the relevant information.  An example of a message is as follows:

  • ROUTINE, 517 205-4804, Julie RN, 7NW, Smi-J, MRN 123456, Consult for heart failure

A new exchange (205) has been created that allows all current extensions to be dialed directly from an outside line including direct to nurses (Ascom) phone as well as all numbers in other legacy phone exchanges including 788, 780, 817.  In addition, you will be able to dial the 10-digit number from a smart phone by tapping the number in the message.

In the near future, we will be upgrading the paging system to provide secure messaging within a smart phone application.

Beginning on the week of September 8, 2015 through the early November, we will be deploying Tap-On-Workstations to clinical devices in the Med-Surg, Critical Care and Maternal-Child Inpatient Units and in the Emergency Department. Two devices in the physician lounge will be converted to TOW on July 20.  The devices in the physician lounge will allow you to enroll in and become familiar with TOW in advance of the September deployment. Once enrolled, you will also be able to use TOW in the CUB.  Once a unit has been converted to TOW, you must be enrolled to use devices on that unit.

Tap-On Workstation (TOW) is a virtual desktop solution that is designed for clinical users and provides the following features:

  • Log-in and log-out of devices using your badge; after the first log-in of the day no need to type a password.
  • Consistent Desktop – the application icons on your desktop remain the same and in the same location on every device you access.
  • Single sign-on (SSO) – automatically enters you user name and password when you open most clinical applications including Physician Portal, PACS, SolCom …
  • Roaming Desktop – your active desktop follows you from device to device; for example you are in the physician lounge using a TOW device with Physician Portal open to a specific patient and you ‘tap out’, then you go to the CUB and ‘tap in’ on a device you will be right back where you left off.  In addition you don’t need to worry about logging someone off since their session will be saved if you ‘tap in’ on the workstation they stepped away from.

Enrollment is required to start using TOW. To enroll do the following:

  1. Tap your badge on the badge reader attached to any TOW device.
  2. Answer five (5) security questions.
  3. Generally takes less than 5 minutes.
  4. There will be step-by-step instructions placed next to each device.
  5. We will have trainers in the Physician Lounge during the week of July 20 and on inpatient units during the deployment.

Deployment Schedule

  • July 20, 2015: Physician Lounge
  • Sep. 8 thru mid-Nov. 2015: Inpatient Units (Med/Surgery, CCU, Maternal-Child) and ED
  • Feb. 2016: Behavioral Health, Surgery, Cath Lab

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