Medical Staff e-Update
Andrew Caughey, MD
Medical Director, Henry Ford Allegiance Anesthesia Clinical Service & Chief of Staff
Mark Smith, MD
Senior Vice President, Medical Affairs and Chief Medical Officer
Issue 28 - February 2018
In honor of Henry Ford Allegiance Heath’s 100th Anniversary, we invite you to visit 100.HenryFordAllegiance.com to view a specially designed website with historical highlights and photos, serving as reminders of the unique connections the Jackson community shares. An expanded historic photo timeline showcasing Henry Ford Allegiance Health’s evolution will also be on display at the hospital later this year, bringing to mind memories of the health system’s role in the lives of area families across generations.
Henry Ford Allegiance Health is the first in Michigan to offer patients the advantages of the ExcelciusGPSTM surgical system. Innovative designs like the ExcelciusGPS are revolutionizing minimally invasive spine surgery and optimizing patient care by combining the benefits of navigation and robotics into one technology. This technology is designed to increase safety for patients and accuracy for their surgeons.“Robot-assisted surgery is a new, emerging area that will become the standard in care,” said Henry Ford Allegiance Health neurosurgeon Frank La Marca, MD. “At Henry Ford Allegiance Health, we are committed to providing the highest quality of care for our spine surgery patients. We are excited to offer our patients the advantages of the Excelcius system, which allows us to perform minimally invasive procedures which may result in less blood loss, less muscle damage and a potentially faster recovery.”One of the advantages of the ExcelciusGPS system is the inclusion of a GPS 3-D guidance system, designed to improve accuracy and optimize patient care by combining robotics with navigation, much like the GPS in a car. This advanced technology allows a neurosurgeon to place screws and implants in a very precise fashion while seeing exactly where to place their instruments in real-time.Henry Ford Allegiance neurosurgeon Azam Basheer, MD, said, “The GPS navigation gives me continuous feedback and allows me to see everything in real time. Now, my colleagues and I can preprogram coordinates, so the robotic arm can assist in guiding us to precise locations in the patient’s spine. The result is safer, faster surgery with less radiation exposure and less need to reposition my patient.”“Another advantage of ExcelciusGPS is that it allows us to make even safer, more consistent and smaller incisions,” said Henry Ford Allegiance neurosurgeon Amritraj Loganathan, MD. “This is valuable because it promotes healing and lessens scarring.”
Henry Ford Allegiance Health and thoracic surgeon Mohan Kulkarni, MD, have earned international recognition in the field of robotic surgery. On Wednesday, December 6, 2017, Yei-san Hsieh, MD—a thoracic surgeon from Taiwan—observed Dr. Kulkarni and his surgical team as they performed a three-hour lung biopsy using their newest surgical robot, the da Vinci Xi.Last spring, Henry Ford Allegiance Health was designated as a Mentor Site for Robotic Thoracic Surgery by Intuitive Surgical Inc., the manufacturer of the da Vinci robot. The manufacturer also recognized Dr. Kulkarni as a leader in the field of thoracic robotic surgery, inviting him to share his expertise with other thoracic surgeons from across the United States.“It is a great honor to be able to share the expertise of Dr. Kulkarni and his Surgery Services team with others, not only in our country but now internationally,” said Ondrea Bates, Senior Vice President, Operations & Continuum of Care.Dr. Hsieh, who has experience with robotic surgery, hopes to expand the use of this technology at Taoyuan General Hospital in Taiwan. He particularly wants to observe Dr. Kulkarni’s technique with the latest da Vinci equipment.Dr. Kulkarni is equally proud and excited to teach other surgeons. “Such an opportunity would not be possible,” he said, “without the concerted effort of the entire Henry Ford Allegiance Health robotic team, as well as strong administrative vision and support.”
Following a multi-year process, Henry Ford Allegiance Health joined the ranks of the 22 hospitals in Michigan verified as a Level II Trauma Center to provide comprehensive trauma care to severely injured patients, including those who have had major automobile accidents, sporting accidents, falls, head injuries and spinal injuries. The American College of Surgeons, the organization that oversees Trauma Center verification nationally, has four Trauma Center designation levels. To be designated as a Level II Trauma Center, a hospital must demonstrate an organized and coordinated approach to treating serious injury across the continuum of care. Requirements include the around the clock availability of all necessary trauma personnel, equipment, supplies, education and guidelines for care. Verified Trauma Centers must meet the essential criteria that ensure trauma care capability and institutional performance, as outlined by the American College of Surgeons' Committee on Trauma in its current Resources for Optimal Care of the Injured Patient manual. To ensure strict adherence to standards, Henry Ford Allegiance Health will then be required to re-verify every three years. These standards emphasize quality, community education, injury prevention, response time and staffing.Although Henry Ford Allegiance Health has been recognized by independent organizations as one of the best hospitals in Michigan for emergency care, being officially verified assures the community, health care providers and regulatory bodies that the health system has met the rigorous requirements necessary to care for critically injured patients across the entire continuum of care.“Now, very few patients will have to experience the 40-minute ambulance ride or helicopter transport ride to another facility. They will be cared for here in Jackson,” said Trauma Program Medical Director Lawrence Narkiewicz, MD. “For the most severely injured, eliminating that transport time can mean the difference between surviving or not. Meeting the rigorous verification quality standards was challenging, however, when lives are at stake – nothing less than excellent quality is acceptable.”
Changes at the Henry Ford Allegiance Specialty Hospital (formerly CareLink) will be effective on March 1. These changes will affect the patients who will be cared for at the Specialty Hospital and as well as our staff there.The Specialty Hospital is a designated Long-term Acute Care Hospital (LTACH in Medicare terms) and was established to provide long-term acute care, therapy and treatment for stabilized patients with complex medical issues. The physicians and staff have been providing this care since 2003 with excellent outcomes, including a higher percentage of patients discharged home than most comparable facilities. We are extremely proud of the team of caregivers at the Specialty Hospital, particularly since they have worked in a constrained environment with a succession of Medicare payment reductions which we believe were short-sighted given the potential to return patients to a better state of health and well-being that reduces further institutional care. Over the years, we have admitted to the Specialty Hospital, patients who met some but not all criteria for LTACH admission. We were able to do so with marginal reimbursement that allowed us to operate relatively close to breakeven. This reimbursement has now been further reduced, and to continue admitting “non-qualified” patients threatens the viability of the Specialty Hospital as a whole. We will work, through our case managers, with our patients (and families of patients) who do not meet Specialty Hospital criteria to determine the best place for care once the patient is ready for discharge from Henry Ford Allegiance Health (the Hospital). Sites of care include local skilled nursing facilities or nearby acute rehabilitation facilities. As we have learned time and again over the years, patients prefer to receive care close to home where the support of family and friends can be part of their recovery. Our goal is to work with local facilities to assure that this transition will provide options that are appropriate for patient care needs given this change at the Specialty Hospital. In addition, we will evaluate the services that Henry Ford Allegiance Health might provide as part of our post-acute care continuum. This change will reduce the volume at the Specialty Hospital by about 50% and will of course affect our staff. As we have done in similar situations, we will work with Human Resources to place these staff with the least disruption to their positions as we can. We know this change has a significant impact on the people who have served our patients and their families with such dedication, and we are committed to supporting them in the best way possible.We realize that changes in service such as this can create concerns among our staff and physicians. Your feedback and support are valued and most welcomed.
The Center for Health Innovation & Education began its operational phase as of January 22, 2018, with Dr. Kevin Durell as the Medical Director, Denise Johnson-Cooney as the Manager, and Sean Murphy as the Simulation Technician. Priority is being placed on operationalizing two high-fidelity mannequins, as well as assessing the needs of our stakeholders.
Currently, we are in need of people who are interested in assisting as standardized patient scenarios focused on patient interactions.