RFID Go-Live for Main Line Health Begins January 13, 2020

After many months of planning Main Line Heath will begin using Stryker Surgi-Count Radio Frequency Identification (RFID) in the Operating Rooms, Labor and Delivery, and C-Section Rooms commencing January 13, 2020. This technology will take our sponge tracking process to a higher level of safety as all sponges used during a case must be scanned in and out to ensure no sponge is left behind.

The timeline and staff education are outlined in the table below.

Bryn Mawr Go-Live: Jan 13th Lankenau Go-Live: January 15th
Morning In-Service:   December 17th Morning In-Service:   December 6th
Hands-on training: January 3, 6, 8, 9 Hands-on training: January 6, 8, 9, 14
Paoli Go-Live: Jan 20th Riddle Go-Live: January 22nd
Morning In-Service:   January 8th Morning In-Service:   December 11th
Hands-on training: January 9, 14, 15, 17 Hands-on training: January 16, 17, 20, 21

Staff education via in servicing has begun and hands on training will begin January 3rd as outlined above. In addition, clinical resources from Stryker will be on site in all areas impacted throughout go-live and for follow-up support post go-live.

One key workflow change is that all sponges need to be removed from the surgical field and counted into SurgiCount prior to patients leaving the room. This means all sponges must come off of the field versus being thrown away in drapes that may occur in some instances at this time.

We ask your support and patience and we transition to this new technology to improve patient safety.

Patrick Ross, Jr., MD PhD – Chair, Department of Surgery

Joseph M. Gobern, MD, MBA, FACOG – Chair, Department of Obstetrics & Gynecology

Sean M. Rowland, CRNA, MS, MBA – Surgical Services Director, Health System

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SBAR for Medical Staff Immunity

By Bindu Kumar MD, System Director, Employee Health and Safety

Situation:

 The MEC has approved the requirement that all members of the medical staff provide proof of immunity to Measles, Mumps, Varicella etc., in alignment with CDC guidance.  Having this information will help facilitate exposure management, minimize disruptions in service lines and patient care due to furlough and maximize the safety of the clinical care environment.

 Background:

  • Currently MLH does not have the immunity status on record for existing medical staff as it relates to Measles, Mumps, Rubella, Varicella, Pertussis and Hepatitis B.
  • MLH has had to furlough providers in the past during times of exposures to Varicella, Mumps etc. based on CDC best practices and DOH recommendations.   This has caused disruptions in medical staff scheduling and service delivery.
  • Other large local health systems (i.e. Penn, Jefferson and Temple) have such requirements in place.

Assessment:

As part of MLH’s ongoing commitment to staff and patient safety, a policy has been approved by the MEC and Senior Leadership requiring existing medical staff and newly credentialing medical staff to comply with the immunity requirements as above.

Recommendations:

  • By February 1, 2021 all members of the medical staff are expected to comply by demonstrating immunity to Measles, Mumps, Rubella, Varicella and MLH’s pertussis requirements.  Independent members of the medical staff are encouraged to know their Hepatitis B immunity status and comply with CDC guidelines in this regard. (see attached message map)
  • Medical staff who fail to meet this requirement by the deadline above will be subject to administrative suspension and referral to the Medical Executive Committee.
  • In the interim, administrative suspension can be recommended for non-immune medical staff by the Occupational Health Medical Director or System Medical Director of Infection Prevention in the case of significant exposure or clinical outbreak
  • New independent members of the medical staff seeking credentialing will also need to comply with the above.
  • The attached message map is informational and provides guidance regarding obtaining titers/vaccines and coverage options.

If you have any questions or concerns, please contact your Chair or email Dr. Kumar at kumarb@mlhs.org.

More information is attached here.

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Insertable monitors shown to detect atrial fibrillation more reliably than short-term strategies

By Donna Loyle, communications specialist, LIMR

An increasing variety of short-term cardiac monitoring techniques have been introduced in recent years, including skin patches, mobile outpatient devices and smartwatch apps. But can such strategies detect atrial fibrillation (AF) as reliably as an insertable cardiac monitor? That was the question a group of researchers, including Peter Kowey, MD, set out to answer.

The researchers used data from the REVEAL AF study, a multicenter clinical trial in which Main Line Health participated. They reviewed clinical information from 385 trial participants who were not previously diagnosed with AF but who had risk factors for the disorder and had cardiac monitors inserted.

“Our analysis one year after cardiac-monitor insertion showed the incidence of AF of six minutes or longer was 27 percent in this patient population, which was significantly greater than the short-term continuous monitoring strategies we studied,” said Dr. Kowey,  a world-renowned cardiologist at Lankenau Medical Center and the William Wikoff Smith Chair in Cardiovascular Research at Lankenau Institute for Medical Research.

“We concluded that most AF episodes that were detected by insertable cardiac monitors would go undetected by conventional short-term monitoring tactics,” Dr. Kowey continued. “That is problematic, because we know that diagnosing AF in a timely fashion means a patient can start appropriate treatment that is likely to prevent long-term harm or even death.”

Because all data in the comparative analysis was from patients who had cardiac monitors already inserted, the researchers used an ingenious modeling strategy. For example, one-time monitoring (meant to simulate short-term monitoring techniques) was assessed by computing AF incidence in the patient cohort at one, two, seven, 14 and 30 days post-insertion. Similarly, repeated short-term monitoring was simulated by assessing results on randomly selected days within a 30-day cycle over a one-year period.

The results showed the incidence of AF with insertable cardiac monitoring (ICM) at 12 months was more than eight times higher than the incidence of AF with 14-day monitoring (simulating 14-day cardiac monitoring skin patches). And it was more than four times higher than the incidence of AF with 30-day monitoring (simulating 30-day loop devices or mobile outpatient monitoring services).

The authors concluded that a significant portion of high-risk patients with previously unknown AF who have AF detected by ICMs would go undetected using routine or other ambulatory short-term monitoring strategies. This, in turn, would inhibit clinicians’ opportunities for prophylactic anticoagulation to prevent strokes and other negative outcomes.

“It’s important to note that in many patients, the symptoms of AF are silent or minor,” said Dr. Kowey. “So while we welcome the introduction of numerous new technologies to track heart rates for short periods of time, the results of this study compel us to caution patients that those techniques may not be fail-safe methods to detect AF. In short, these technologies cannot replace your doctor.”

The results from this comparative analysis were included in the manuscript “Rhythm monitoring strategies in patients at high risk for atrial fibrillation and stroke: A comparative analysis from the REVEAL AF study” published in American Heart Journal.

This study was funded by the medical device maker Medtronic, Inc.

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Provost Tykocinski visits Main Line Health for First Annual Provost Rounds

On Monday December 16, 2019 Dean Mark Tykocinski MD visited Lankenau Medical Center to meet with students and faculty of the Jefferson-Main Line Health Core Clinical Campus. Dean Tykocinski is the Provost and Executive Vice President for Academic Affairs at Thomas Jefferson University and the Anthony F. and Gertrude M. DePalma Dean of Sidney Kimmel Medical College at Thomas Jefferson University. Four medical students (Caroline Komlo, Abby Schmucker, Cole Gillian, and Vivek Bilolikar) of the MLH-Jefferson Core Clinical Campuses presented patient cases for discussion.

Dean Tykocinski has had a prolific career as a research pathologist, an academic dean, and as adviser to international research programs.  Using the cases presented as a basis, Dr. Tykocinski provided insight into several evolving arenas of medical research and demonstrated the impact of research on today’s practice in a variety of clinical fields. The event provided students and faculty an opportunity to see the impact of research on the patients that we treat.

Student case preparation for the event was mentored by Jefferson graduate Kaitlyn Kennard, a senior resident in the Lankenau Surgical Residency, and by Marie Weber, PhD, a researcher at the Lankenau Institute for Medical Research.

At its close, the students and faculty suggested that the very successful Provost Lecture become an annual event celebrating the Main Line Health-Jefferson Core Clinical Campus.

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Remote Access Multi-Factor Authentication Upgrade Coming January 18th

 

Main Line Health Information Services will be upgrading our Multi-Factor Authentication process that is used to verify users who are attempting to remotely access our systems. Multi-factor authentication sends a random 6-digit code to your registered mobile device when you remotely access MLH systems. The upgrade provides MLH with enhanced security features that support the protection of sensitive MLH data such as clinical, financial, personal and other business information.

The Multi-Factor Authentication upgrade will occur on Saturday, January 18th between 2:00 AM and 6:00 AM.  Remote access will not be available during this time.

After the upgrade, ALL users will be required to re-register their mobile phone number BEFORE their next attempt at getting remote access.  This will impact ALL remote users including employees, physicians, 3rd parties with access including non-MLHC physician practices, and vendors.

Please remember, Mobile phones are the only option supported for communication with multi-factor authentication.

More information, including instructions on how to re-register your phone number will be shared closer to the upgrade date.

Thank you for your attention as we work to keep our network secure.

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STEEEP Huddle: S for Safety

This week’s STEEEP Huddle, Contributed by Eileen Sherman, Director of Infection Prevention, focuses on MRSA isolation. In order to provide safe patient care, Main Line Health places those patients infected or colonized with MRSA in Contact Isolation. Avoiding unnecessary isolation enhances patient experience without compromising the safety of our staff and patients. As MLH Employees, your contribution to promote culture safety by adhering to the Standard Precautions and compliances with MLH Hand Hygiene Policy is important.

The STEEEP Huddle topics are posted every Monday on MLH To Go.

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Clinical Trial of the Week: Radiotherapy trial for patients with certain types of breast cancer

By Donna Loyle, communications specialist, LIMR

Tailor RT is a multicenter, randomized, non-inferiority phase III trial evaluating outcomes among certain breast cancer patients treated with regional radiotherapy (RT), that is, RT to regional nodes following breast-conserving surgery (BCS) or RT to the chest wall and regional nodes following mastectomy.

Each patient is grouped into one of four study arms:

  • Arm 1A: receives whole breast irradiation following BCS
  • Arm 1B: no radiotherapy following mastectomy
  • Arm 2A: receives whole breast irradiation plus regional RT following BCS
  • Arm 2B: radiotherapy to the chest wall and regional nodes following mastectomy

Inclusion criteria:

  • Must have been diagnosed with biomarker low-risk, node-positive breast cancer and no evidence of metastases
  • Must already have been treated with BCS or mastectomy and will receive endocrine therapy for five years
  • Must be willing to undergo the treatment protocol as specified for the study arm into which the patient has been randomized

The Main Line Health principal investigators for the Tailor RT study are Albert DeNittis, MD, and Paul Gilman, MD. For more, email cancertrials@mlhs.org or visit www.mainlinehealth.org/research/clinical-trials/tailor-rt

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LIMR Seminar About Brugada Syndrome and Treatment

Jose Di Diego, MD, research associate professor at the Lankenau Institute for Medical Research, will give the one-hour seminar “A whole-heart model of Brugada syndrome strongly favors repolarization hypothesis, readily predicts successful treatment with blockers of transient outward current.”

Brugada syndrome is an inherited disease that affects the heart’s electrical activity, often with little or no warning, and can take the lives of infants, children and young adults. Dr. Di Diego will discuss a treatment option.

The seminar will be held on Thursday, January 9th from 2 – 3 pm in Lankenau’s McLean Conference Room. All clinicians and researchers are welcome to attend.

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RFID Go-Live for Main Line Health Begins January 13, 2020

After many months of planning Main Line Heath will begin using Stryker Surgi-Count Radio Frequency Identification (RFID) in the Operating Rooms, Labor and Delivery, and C-Section Rooms commencing January 13, 2020. This technology will take our sponge tracking process to a higher level of safety as all sponges used during a case must be scanned in and out to ensure no sponge is left behind.

The timeline and staff education are outlined in the table below.

Bryn Mawr Go-Live: Jan 13th Lankenau Go-Live: January 15th
Morning In-Service:   December 17th Morning In-Service:   December 6th
Hands-on training: January 3, 6, 8, 9 Hands-on training: January 6, 8, 9, 14
Paoli Go-Live: Jan 20th Riddle Go-Live: January 22nd
Morning In-Service:   January 8th Morning In-Service:   December 11th
Hands-on training: January 9, 14, 15, 17 Hands-on training: January 16, 17, 20, 21

Staff education via in servicing has begun and hands on training will begin January 3rd as outlined above. In addition, clinical resources from Stryker will be on site in all areas impacted throughout go-live and for follow-up support post go-live.

One key workflow change is that all sponges need to be removed from the surgical field and counted into SurgiCount prior to patients leaving the room. This means all sponges must come off of the field versus being thrown away in drapes that may occur in some instances at this time.

We ask your support and patience and we transition to this new technology to improve patient safety.

Patrick Ross, Jr., MD PhD – Chair, Department of Surgery
Joseph M. Gobern, MD, MBA, FACOG – Chair, Department of Obstetrics & Gynecology
Sean M. Rowland, CRNA, MS, MBA – Surgical Services Director, Health System

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Remote Access Multi-Factor Authentication Upgrade

Main Line Health Information Services will be upgrading our Multi-Factor Authentication process that is used to verify users who are attempting to remotely access our systems. Multi-factor authentication sends a random 6-digit code to your registered mobile device when you remotely access MLH systems. The upgrade provides MLH with enhanced security features that support the protection of sensitive MLH data such as clinical, financial, personal and other business information.

The Multi-Factor Authentication upgrade will occur on Saturday, January 18th between 2:00 AM and 6:00 AM.  Remote access will not be available during this time.

After the upgrade, ALL users will be required to re-register their mobile phone number BEFORE their next attempt at getting remote access.  This will impact ALL remote users including employees, physicians, 3rd parties with access including non-MLHC physician practices, and vendors.

Please remember, Mobile phones are the only option supported for communication with multi-factor authentication.

More information, including instructions on how to re-register your phone number will be shared closer to the upgrade date.

Thank you for your attention as we work to keep our network secure.

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