The BMC Brief
March 28, 2013 Volume 2, Issue 6
- New Observation Unit, Retail Pharmacy Will Provide Enhanced Services to Patients
- BMC Rolls Out eMERGE; Kicks Off Project
- NICU Celebrates One Year Central Line Infection-Free
- Second Annual Multicultural Week a Global Success
- What’s for Dinner? Turkey Vegetable Lasagna
- What Do You Do, Stephanie Sharp?
- News of Note
- Awards and Accolades
This month BMC opened a new, 12-bed observation unit on Menino Pavilion 2 dedicated to “observing” patients who are expected to be discharged with 24 hours. Patients are admitted to the unit from the Emergency Department with the expectation that they may need additional testing, imaging or observation before they can be safely discharged.
New observation unit on Menino 2
The new unit is part of BMC’s strategic plan work to provide the right care to every patient by providing high-quality care to short-stay patients. The goal of the unit is to reduce patients’ length of stay from a day or more to the national benchmark of 15-16 hours.
“The observation unit model is one that more hospitals are moving toward nationwide,” says George Barth, MM, RN, CCRN, Clinical Director, Emergency Department. “They have been shown to be effective in ensuring high-quality, expedited care and that is our goal at BMC.”
The unit is staffed by the hospitalist team and by July 1, will be managed by the Department of Emergency Medicine.
On April 2, BMC will open its first retail pharmacy, located in the Shapiro Ambulatory Care Center. Similar to a CVS or Walgreens pharmacy, the Shapiro pharmacy will provide prescriptions to patients and non-BMC patients, such as families, visitors, staff and the public. The 2,500-square-foot space located on Shapiro 1 will feature kiosk-based check-in for customers, a warm and welcoming waiting space and a private counseling room. It will be one of the most technologically advanced pharmacies in the region, featuring two robotic medication fill systems that will fill prescriptions 10-20 times faster and advanced computer systems designed to make the process of filling a prescription safer.
“More than half of the prescriptions BMC providers prescribe are to patients who are cared for in the Shapiro building, and this new location will make it more convenient for them to obtain the medications they need,” says David Twitchell, PharmD, MBA, Senior Director, Pharmacy. “We know this pharmacy will deliver shorter wait times and a high-quality experience to our patients.”
Twitchell notes that BMC's other two outpatient pharmacies, located in Yawkey and Doctor's Office Building (DOB), are not closing.
“Our focus is on providing high-quality, exceptional care to our patients and these two new services will do exactly that,” says Lisa O’Connor, RN, BSN, MS, NEAA-BC, Senior Vice President, Clinical Operations and Chief Nursing Officer.
The Shapiro pharmacy will be open seven days a week: 7 a.m.-7 p.m. Monday-Friday, 7 a.m.-5 p.m. Saturday and 10 a.m.-3 p.m. Sunday.
Shapiro Pharmacy By the Numbers:
- Almost 90 percent of medication fills will be done through automated systems, which are faster, more efficient and accurate than traditional fill systems.
- 90 percent of inventory (more than 1,900 unique items) will be stored in two machines that take up only 80 square feet of space.
- The Innovations Robotx system is 20-40 times faster than a technician manually filling prescriptions, and 5-10 times faster than BMC’s current robotic fill system.
- Customers can receive text alerts when their prescriptions are ready and refill them online.
On March 26, President and CEO Kate Walsh joined members of the BMC executive team and approximately 300 employees in the Bakst Auditorium to officially kick off BMC’s transition to eMERGE, the hospital’s new electronic health record (EHR) system. eMERGE stands for Electronic Medical Records Generating Excellence and is the name chosen by hospital staff for the new system in a contest last month. eMERGE, an Epic system, will strengthen the quality of care delivered to patients and improve the integration of services across the organization.
“This is a great opportunity for us to take even better care of our patients,” said Walsh. “This new system will enhance our ability to provide safe and effective care, while placing BMC among the top medical institutions in the country which also have this advanced Epic EHR system.”
Representatives from Epic provided a demonstration of the new electronic health record, which included one fictitious patient’s journey through an inpatient setting with a diagnosis of acute appendicitis. The patient’s complete medical record was electronically transferred with the patient as he traveled from the emergency department to surgery and then post-op recovery on a medical/surgical floor. By enabling full integration between departments, eMERGE will enable providers to view the “whole patient,” including his medical history, allergies, labs, orders, and complete medication administration record to ensure that care is coordinated and safe.
eMERGE will also help solve one of the longstanding challenges at BMC – systems that don’t talk to each other.
“As an integrated system, eMERGE is going to allow the safe and seamless transfer of information, while making care as efficient and effective as possible, because information will be at our fingertips,” said Eric Poon, Chief Medical Information Officer. “We’re going to transform ourselves into an integrated health care delivery network that supports the notion of one patient – one record.”
Representatives from Epic are on site this week to visit with departments across BMC to learn about current workflows and practices. The Epic team will use what they learn during the site visits to help design the best possible system for BMC and will return in April to test the site with key groups.
In a unit where germs can mean the difference between life and death for the tiniest of human beings, the Neonatal Intensive Care Unit (NICU) has a big reason to celebrate: one year of no central line infections.
The NICU team
Central lines tubes are used by the NICU to deliver medications and nutrition to preterm babies via their umbilical cords or veins. Infections can occur when bacteria and other germs travel down the central line and into the baby’s blood, spreading quickly throughout the body and creating dangerous complications.
After focusing efforts on reducing central line infections in the unit, the NICU hit its one-year anniversary of being infection-free March 17. The decrease is dramatic; in 2006, BMC had the highest rate of central line infections among all Level 3 NICUs in the city.
“Currently we are the best in Boston,” says Neonatologist Meg Parker, MD, MPH. “No other Level 3 NICU has gone infection-free as long as us right now.”
The NICU achieved its success by focusing efforts on a staff hand washing campaign, equipment sterilization techniques, line insertion and maintenance checklists, and close supervision of medical trainees learning to put in central lines. It also joined a national hospital collaborative to ensure performance of best-practice techniques to reduce central line infections for preterm infants.
“When we instituted changes on the unit, staff embraced them with the belief we could improve and we are now celebrating the success of that enormous level of commitment,” says Stacy Dow, RN, NICU Nurse Educator. “While I am proud of our achievement, I am more honored to be a part of such a dedicated team of NICU professionals.”
“We have worked hard to deliver better, safer care to our patients and we are all very proud of this achievement,” says Alan Fujii, MD, Medical Director, NICU.
“This is an example of great, multi-disciplinary teamwork,” says James Moses, MD, MPH, Director, Pediatric Patient Safety and Quality. “It demonstrates that through a willingness to do things better, great patient outcomes can be achieved.”
With representation from more than 25 countries, BMC’s second annual Multicultural Week honored diversity with music, dance and traditional cuisine. Performances from a variety of countries peppered the lobbies throughout campus during the week of March 18, and culminated in the signature Multicultural Fair where staff displayed mementos, turning the Shapiro lobby into a cultural epicenter.
Sonali Sengupta, Development
“BMC has a unique and global patient and employee population,” says Barbara Catchings, co-chair of the Multicultural Week Committee and Director, Community Outreach and Student Internships, Human Resources. “Multicultural Week celebrates this diversity and allows our workforce to share their wide-ranging cultures with one another in a way that is fulfilling and inclusive.”
During the week-long celebration, the Menino, Newton and Shapiro cafeterias featured ethnic cuisines from Caribbean jerk pork to Persian lamb stew, each day highlighting a different culture. Live musical performances also were held in the lobbies, with musicians performing Latin, Asian, European and North American songs.
The Multicultural Fair showcased items including art, jewelry, cookware, musical instruments, and clothing from Africa, Asia, Europe and North and South America. Tables boasted a sparkling pink children’s garment from Sierra Leone, a hand-carved fiddle from Ireland, Russian nesting dolls, a lamp made from seashells from the Phillipines, a large conch shell from Bermuda and much more. Visitors also were treated to three performances during the exhibition.
Sonali Sengupta, a member of BMC’s Development Department, was first to take the stage and wow the crowd with a classical Indian dance pairing intricate footwork with graceful movement. Next, Kevin Muldoon, an Information Services field technician, was joined by his roommate Eric Norris to play a selection of Irish music, ranging from traditional Celtic tunes all the way up to modern-day Irish pop, on the guitar and mandolin. The last performer, Sidi “Joh” Camara, immersed the crowd in African culture with dance lessons to accompany the beat of his African drums.
“This year’s Multicultural Week was a tremendous success,” says Anna Chun, co-chair of the Multicultural Week Committee and the Recognition Events Coordinator in Human Resources. “We already have employees telling us they would love to bring in items that represent their culture and countries for next year.”
Summer is fast approaching, but a balanced diet should be a year-round staple on your quest to be healthy. You can start by trying this delicious recipe from BMC Demonstration Kitchen Chef Tracey Burg.
This new twist on an old favorite replaces carb-heavy pasta with zucchini, which increases the veggie servings you get in one meal. This meal serves eight people at 230 calories per serving, which is perfect for a healthy dinner party for friends and family.
Turkey Vegetable Lasagna
- 1 lb lean ground turkey
- 1 cup diced onion
- 3 garlic cloves
- 28 oz crushed tomatoes, no salt added
- 7 oz ricotta cheese, part skim
- 8 oz cottage Cheese, 1% fat
- 1/4 pound of sliced mushrooms
- 1 can (15–ounce) can diced tomatoes, no salt added
- 1/2 pound eggplant, sliced lengthwise
- 1/4 lb summer squash, sliced lengthwise
- 1/2 zucchini, sliced lengthwise
- 1 cup shredded mozzarella cheese, part skim
- Dried or fresh herbs to taste
- Preheat oven to 400 degrees.
- In a medium sauté pan, sauté garlic and onions until translucent.
- Add the onion, garlic, green pepper and mushroom and sauté for 3 minutes.
- Add ground turkey and cook until browned and cooked through.
- Add crushed tomatoes and simmer for 15-20 minutes. Add herbs to taste.
- Roast or grill vegetables for 2-4 minutes. Set aside.
- Combine cottage cheese and ricotta cheese. Season with herbs to taste.
- Layer sauce, vegetable and cheese mixture. Finish lasagna with shredded mozzarella cheese.
- Bake for 25-30 minutes or until cheese is melted.
Nutritional Information per serving:
- Calories: 209
- Total Fat: 9 g
- Sodium: 300 mg
- Carbohydrates: 10 g
- Cholesterol: 60 mg
- Dietary Fiber: 3 g
- Protein: 22 g
Name: Stephanie Sharp
Title: Child Life Specialist
Department: Pediatric Emergency Department
Years at BMC: 5 months
What brought you to BMC?
Before coming to BMC I worked at Winchester and Shriners hospitals and completed internships at Massachusetts General and Newton-Wellesley hospitals. The population at BMC is diverse so I knew I would get to experience a child life perspective that is different from other medical centers. I love the emergency department setting, so when a child life specialist position opened in the pediatric emergency department, I knew it was a perfect fit.
What is a Child Life Specialist?
Child Life Specialists use play and education to facilitate understanding and effective coping, and to ensure that life remains as normal as possible for pediatric patients during hospital stays. We have undergraduate or graduate degrees in child development (or similar fields), have completed an internship and passed a national certification exam. This position is very collaborative, as we work with physicians, nurses and social workers to address all the needs of each child.
What do you do here?
I assess the coping level of children and families when they come into the pediatric emergency department and determine what support they need from me during their stay. This could mean: providing developmentally appropriate preparation prior to and distraction during procedures; helping them practice deep breathing and relaxation techniques to lower anxiety; advocating for the use of family centered care, comfort positioning and pain reduction techniques; or engaging a patient in play to normalize the environment and promote effective coping. Along with providing the best support for patients, my role often allows pediatricians and other staff to do their job more efficiently as the child is typically more cooperative with exams and procedures. We have two other child life specialists at BMC; one in the pediatric intensive care unit and another in the pediatric primary care clinic.
March is Child Life Month. Why is this so important?
Many people are not familiar with the child life role, so Child Life Month brings awareness to our profession. We are available to consult in other departments, as well as when someone is concerned about how a child is coping with an adult’s illness or death. The more people understand our role, the better equipped we are to be utilized more effectively throughout the hospital, not just in our primary departments.
Do you know a staff member who should be profiled? Send your suggestions to firstname.lastname@example.org.
Robert Vinci, MD
Robert Vinci, MD named Chief/Chair of Pediatrics
Robert Vinci, MD, has been appointed Chief of Pediatrics at BMC and the Joel and Barbara Alpert Professor and Chair of the Department of Pediatrics at BU School of Medicine (BUSM). For the past 20 years, Vinci has served as Vice Chair and Clinical Chief of the Department, providing leadership for the significant expansion of pediatric clinical services. He received his medical degree from the College of Medicine and Dentistry-Rutgers Medical School, now known as the Robert Wood Johnson Medical School and completed his pediatric residency at the former Boston City Hospital (now BMC), serving as chief resident, in 1983. Vinci joined the Department of Pediatrics at BUSM in 1984 and two years later he established the Division of Pediatric Emergency Medicine at Boston City Hospital. He is a member of the National Board of Directors for the Association of Pediatric Program Directors, the American Academy of Pediatrics, the Academic Pediatric Association and the Academic Pediatric Society.
BUSM students match to BMC
This month, 15 medical students from Boston University School of Medicine’s class of 2013 “matched” to BMC for their residencies. Match Day is a nation-wide event at medical schools where students in their final year of medical school find out where they will conduct their postgraduate training.
Health journalists visit BMC
BMC recently hosted a group of 30 health and science journalists who traveled to Boston to attend the annual meeting of the Association of Health Care Journalists (AHCJ). The educational field trip highlighted BMC’s award-winning Preventive Food Pantry and Demonstration Kitchen as well as its innovative Solomont Center for Clinical Simulation and Nursing.
Domenic Ciraulo, MD, Psychiatrist-in-Chief, BMC, is the first co-recipient of the Massachusetts Association for Mental Health (MAMH) Drew-Foley Award. The newest award from MAMH is named in honor of two former MAMH board members, Paul Drew and Jim Foley, who were compassionate advocates for mental health. Ciraulo will be presented with the award at the 100th Annual Friend and Leader/Spirit of Compassion reception.