"It was the best of times, it was the worst of times, it was the age of wisdom, it was the age of foolishness…"
Resident Training. The center of gravity of the Glen Cove Family Medicine Residency program starting shifting to Huntington in 2014, and last year in-patient education for these trainees became fully integrated into our Departments of Medicine, Obstetrics, Pediatrics and Surgery. Dr. Kraydman led the FM Medicine teaching service while Drs. Fred Diblasio, Bob Zingale, Bob Scanlon, Adriana Garrite and others provided oversight for experiences in Critical Care, Surgery, Obstetrics and Palliative Medicine respectively. Residents achieved exceptional scores this year in the ABFM In-training exams, outperforming the national mean and, for third year residents, doing so by an impressive 77 points. The residents and faculty are grateful to the many other members of our medical staff for all you do to make them better doctors.
The CMS Joint Replacement Bundled Payment project gained momentum with Orthopaedics Chair James Gurtowsky at the helm. This federal program seeks to encourage innovation to improve quality and efficiency across a number of conditions and treatments. Our orthopedic surgeons collaborated with their hospitalist colleagues and many other disciplines to achieve better outcomes at lower cost by standardizing care, improving care coordination, emphasizing patient engagement and reducing avoidable complications.Emergency Medicine. To address serious staffing deficiencies in Emergency Medicine, we cross-credentialed dozens of these physicians across sites, while bringing in new Nursing leadership to ensure that our ED was staffed to meet the community's needs while creating a practice environment to attract and retain the best practitioners. We also recruited a full time, board-certified Director of Pediatric Emergency Medicine, Adam Litroff, to support the care of almost 10,000 children who visit our facility each year. Meanwhile, construction on a facility that will more than double the size of our current ED is on or ahead of schedule.
ICD-10. After multiple mis-fires, the federal effort to launch the 10th Edition of the International Classification of Diseases came to fruition on October 1st. Hundreds of you complied with our Health System's mandate that you receive education to prepare you for the enhanced documentation requirements, and we thank you for that. (More to follow, as our clinical documentation initiatives ramp up in 2016…)
Electronic Health Records. You continued functioning in the era of the EMR. Congratulations! Dr. Robert Wachter (the individual who coined the term "hospitalist" and stands among the most articulate observers of the patient safety movement) did "a 175 degree turn about" on electronic records: previously a dewey eyed apologist for the digital revolution, Watcher catalogued the serious defects of EMRs in a Times Op-Ed piece this past year. Rather than a being a "disruptive technology" in the trendy, positive sense of "game-changer," he acknowledged that up to now, electronic records have been just "disruptive." Fortunately, many of you are contributing to the ongoing improvement of our EMR and will be helping with the migration to a new platform in 2017. Together, we will achieve a state in which electronic charting is an indispensable tool and not an obstacle to practice.
School of Medicine. In May, the Hofstra - NSLIJ School of Medicine graduated its first class. More than 60 of you serve as active faculty, mostly as community preceptors to these medical students as part of the their Introductory Clinical Experience, a "doctoring" course that not only serves as a practice space for physical diagnosis, but also as a mentoring experience, where students can learn through seeing and doing what it means to be a caring, patient-centered, and personally accountable Physician.
Awards and recognition. With your help, Huntington continued to be recognized by quality organizations as a leader in providing safe and effective care to our patients. The national LeapFrog Group assigned the hospital an "A" rating for patient safety. US News ranked Huntington in the top 10% of centers in the state. The AHA and American Stroke Association conferred "Gold Plus" recognition for quality of care for patients with stroke and cerebrovascular disease. Other designations include Center of Excellence designation for Minimally-invasive gynecological surgery, breast surgery and Bariatrics, and the Joint Commission's Disease Specific Certification "Gold Seal" for Hip and Knee replacement and Advanced Palliative Care.
End of Life Care. There is no aspect of medical care that requires more professionalism, skill or wisdom than decision-making at the end of life. Improvement efforts are underway, with your help, locally and System-wide. At Huntington, we revitalized our Bioethics Committee this year, committing to a three part agenda of education, consultation and systematic policy review. Some of you are also involved with the NSLIJ Advanced Illness Collaborative project, which seeks to improve our collective ability to engage patients and families compassionately and effectively in thinking about how we die. Based partly on the ACP "Conversation Project," the Collaborative aims to improve the quality of dialogue between caregivers and families about end-of-life options, acknowledging that supporting autonomy, promoting the patient's best interest and avoiding harm are important but sometimes conflictual aims and values.
End of Life Care. There is no aspect of medical care that requires more professionalism, skill or wisdom than decision-making at the end of life. Improvement efforts are underway, with your help, locally and System-wide. At Huntington, we revitalized our Bioethics Committee this year, committing to a three part agenda of education, consultation and systematic policy review. Some of you are also involved with the NSLIJ Advanced Illness Collaborative project, which seeks to improve our collective ability to engage patients and families compassionately and effectively in thinking about how we die. Based partly on the ACP "Conversation Project," the Collaborative aims to improve the quality of dialogue between caregivers and families about end-of-life options, acknowledging that supporting autonomy, promoting the patient's best interest and avoiding harm are important but sometimes conflictual aims and values.
It remains a great source of honor and personal satisfaction for me to serve the Huntington Hospital medical staff. I thank you for your efforts on behalf of patients, for your devotion, your intelligence and your forbearance, and I look forward to what we can achieve together in 2016.
