Welcome to the Physician Resource Center

Click here to view the February edition (Annual Physician Notice) of the Microscoop Newsletter.  For more information or questions, please contact Beverly McAllister, MS, MT(ASCP)SC, Laboratory Administrative Director, at 717-738-6527 or email beverlymcallister@ephratahospital.org.

CDC - Vaccines - Adult Immunization Schedules and Tools for Providers

http://www.cdc.gov/vaccines/schedules/hcp/adult.html

Please review and share this link.

Peg Holland, R.N., CIC

I wanted to inform everyone of a nationwide shortage of furosemide (Lasix) IV. It is expected to be resolved within 1 to 2 weeks. Recommendations are to use bumetanide (Bumex) IV or furosemide oral in lieu of the IV formulation. If necessary, pharmacy will write automatic substitution orders for furosemide IV. I will inform the hospital staff when this shortage is over. Thank you for your cooperation.

Gregory M. Pochan, Pharm.D.
Director of Pharmacy
Ephrata Community Hospital
717-721-5885
gregpochan@ephratahospital.org

Click here to read the latest information about the statue of influenza in our area.

To view memo, click here.

To view memo, click here.

To view this article, click here.

To view this article, click here.

Effective Monday, November 12, the Lab switched to a new lot of coagulation reagents.  For more info, click here.

To view a copy of the fact sheet, click here.

TOPIC:  DOCUMENTATION OF PALLIATIVE CARE WILL NOT EXCLUDE A PATIENT FROM THE PUBLICLY REPORTED MEDICARE (CMS) QUALITY IMPROVEMENT CORE MEASURES

Rationale:  Palliative Care is increasingly being offered as a care program provided with ongoing treatment.  Patients should not be excluded from quality improvement measures because they enter a palliative care program.

When: July 1, 2012

What:  CMS is changing the documentation requirements for a patient to be excluded from quality measures in the Acute Myocardial, Heart Failure, Pneumonia, Stroke, and VTE measure sets.  Documentation of Palliative Care or Palliative Measures will no longer exclude the patient from the measure population.  Documentation of Comfort Measures   will continue to exclude the patient from the measure requirements. 

Examples of documentation that would be considered Comfort Measures include: 

• Comfort measures only recommendation
• Order for consultation or evaluation by a hospice care service
• Patient or family request for comfort measures only
• Plan for comfort measures only
• A referral to hospice care service

Documentation of Do Not Resuscitate (DNR), living will, no code, no heroic measures, Palliative Care or Palliative Measures will not exclude a patient from inclusion in the core measure requirements. 

Thank you for your efforts to provide the best evidence based care to our patients and assist Ephrata Community Hospital to accomplish our performance goals.

Please contact the Quality Improvement Department at 738-6594 or email Kim Gross at KimGross@Ephratahospital.org if you have questions or would like additional information regarding the measure requirements.  

To view memo, click here.

Click here to download the Annual Compliance Meeting presentation.

From Greg Pochan, Director of Pharmacy:

We have NO ketorolac injection due to a nationwide manufacturing shortage. Alternatives include oral NSAIDs and narcotics if injections are required. According to the wholesaler this shortage may last until the end of February.

In addition, there is a limited supply of Zofran MDV in stock.  If ODT tablets can be used, all the better, BTW no Zofran 2 ml vials.

For the most current on information on Drug Shortages go to the Hospital INTRANET; click on The Pharmacy icon; click on Drug Shortages icon.

Click here to view the October edition (Annual Physician Notice) of the Microscoop Newsletter.  For more information or questions, please contact Beverly McAllister, MS, MT(ASCP)SC, Laboratory Administrative Director, at 717-738-6527 or email beverlymcallister@ephratahospital.org.

To access the Provider Order Sets, click here.

Effective, December 1,2011, the Laboratory will be changing the test method of the serum carcinoembryonic antigen
(CEA) assay. The test will now be performed in-house. CEA is one assay that can vary significantly by test method.
Serial evaluations should be performed by the same laboratory to ensure comparability of test results in a single
patient.  For more information, click here.

Effective 11/15/11, the Laboratory will be switching to a new lot of coagulation reagents. Essentially, all ranges will remain the same. The Heparin Protocol will not change. Please click here to review the memo. Contact Janis Eppley, Hematology Supervisor, at x6415 with any questions or concerns.

Ordering/Following Orders for Diagnostic Tests

 For more information or questions, contact Susan Parker, Corporate Compliance Officer, at 738-6772 or susanparker@ephratahospital.org.

Order: 

• A communication from the treating physician/practitioner requesting a diagnostic test be performed. 
• Treating physician/treating practitioner is defined as the physician/practitioner who treats the patient for a specific medical problem and who uses the results of a diagnostic test in the management of the patient’s medical problem.
• Order may conditionally request an additional diagnostic test if the result of the initial test yields a certain value.

Interpreting physician determined a different diagnostic test is appropriate:

• If originally ordered test is clinically inappropriate or suboptimal.
• Interpreting physician must obtain a new order from the treating physician/practitioner
• If treating physician/practitioner cannot be reached for a new order, testing facility may furnish additional diagnostic tests if ALL of the following apply:

1.     The originally ordered test is performed;

2.     The interpreting physician at the testing facility documents that, because of abnormal results on the originally ordered test, additional testing is medically necessary;

3.     Delaying the additional testing would have an adverse effect on the care of the patient;

4.     The result of the additional test is communicated to, and used by the treating physician/practitioner; and

5.     The interpreting physician documents at the testing facility why additional testing was done AND that unsuccessful attempt(s) were made to reach the ordering physician/practitioner.

• Unless specified in the order, the interpreting physician may determine, without notifying the treating physician/practitioner, the parameters of the diagnostic test.

Every year, chronic wounds caused by diabetes, poor circulation or other conditions keep three to five million Americans from doing the things they love. The Center for Wound Healing & Hyperbaric Services at Ephrata Community Hospital applies proven wound care practices and advanced clinical approaches, including Hyperbaric Oxygen Therapy, to help patients who suffer from such chronic wounds.  To learn more about how this service may benefit your patients, click here.

The goal of the Medical Surgical Unit is to create an individualized plan of care that will provide high quality nursing care and establish an emotional connection with the patient and his/her family.

Over the last three months we were developing the reorganization of the Medical Surgical Units Leadership. The purpose of this reorganization is to increase clinical support, increase overall staff education, provide 1:1 mentoring of staff, and provide Unit Manager support. Since nursing is the heart of the healthcare team, the goal in implementing the Unit Leads is to:

• Improve patient outcomes
• Improve the customer experience
• Improve communication between patients, families, physicians and other members of the healthcare team.

The Unit Leads responsibilities involve overseeing daily operations of the unit with the patient at the center of all activities. These responsibilities of communication and coordination of nursing care on their respective units include, but are not limited to:

• Daily evaluation of the number and complexity of the patients in coordinating care
• Responsible for orientation, training programs and ongoing educational opportunities
• Daily staff mentoring and coaching related to patient care issues
• Oversight of the ancillary staff in assuring all aspects of the patient’s ADLs are being completed
• Assist with patient care as needed
• Perform daily rounds on the patients to ensure nursing is communicating and meeting the emotional and physical needs of the patients
• Facilitate nurse/physician rounding and assure the nurses are prepared to discuss the patient’s plan of care

Investigate concerns and make changes that will improve patient care.Please congratulate and continue to support the following Unit Leads:

Emma Mentz-Unit Lead MS3
She has been with the hospital since 1989. Previously she was the Clinical Educator. She has now assumed the responsibilities of Unit Lead on MS3. Emma shares her extensive nursing knowledge and skills with the staff and facilitates the overall orientation process. She has an interest in developing the Palliative Care Program for the hospital.

Laura Alexander-Unit Lead MS2
She has returned to the Medical Surgical Unit in 2009 after working in Virginia for two and half years on a cardiac unit. She is respected by her peers and has been able to share her past cardiac knowledge and skills with our telemetry unit nurses. Laura is an active member of the Heart Failure Committee and Readmission Task Force.

Christine Gehris De-Jesus- Unit Lead MS1
She has been with the hospital since November of 2008. She has been instrumental in the organization of the Bariatric Program. In addition, she is a member of the Stroke Committee and Chairperson of the Medical Surgical Unit Council.

Carolyn Wheeler-Surgical Telemetry
She has moved to the Surgical Telemetry Unit after working on MS3 since 1989. Carolyn demonstrates knowledge, excellent nursing skills and leadership in her role.

If you have any questions or concerns, please contact Kathy Musser, BSN, RN (Unit Manager Medical Surgical Unit) at 738-6352 or click here.

You can learn more about POLST through an online Physician Orders for Life-Sustaining Treatment (POLST): Respecting Patient Choices across the Continuum of Care training module. For more information, click here.

• POLST Brochure
• POLST Form Sample
• POLST Power Point Presentation

Interested in socializing with your colleagues on the golf course? Dr. Camerino has secured an 8:00 AM tee time at Iron Valley Golf Club on the third Saturday of each month (at a reduced rate).  Please contact Dr. Camerino at egcmd@hotmail.com or at (717) 940-4926.  He will need your email address and a cell phone number to add you to his roster.   Click here to view Dr. Camerino's invitation.

Please click here to download information about Face to Face Encounter, a new requirement that will affect physicians that order and the patients they refer for home health services.