ANESTHESIOLOGY NEWSLETTER

WEST VIRGINIA UNIVERSITY

June 21, 2004

Excellence through Teams of One

 

 

  1. Welcome Kelly Bible, our newest support staff. She will work in our HSC office suite.

Bible will help with our newsletters, so look for improvements because she has a bachelor’s degree in graphic communications technology from California University of Pennsylvania. Bible is relocating here from the Pittsburgh area. 

 

                                               

                                                       Kelly Bible

 

  1. Enter medical record numbers into CompuRecord very carefully.  CompuRecord

has an 8-digit field for the “Medical Record#” and a 12-digit field for the “Patient Account #”.  If the first 8 digits of these two numbers do not match, or if they do not match the 8 digit numbers in any pre-entered data, the anesthesia record will not print because of a CompuRecord protection against misidentification.  Unfortunately there is no screen warning that this is the problem when a record fails to print.

 

We seem to be making medical record number entry errors more frequently now due to two changes:

A.                 Medical record numbers have grown from six to seven non-zero

numbers.  Old numbers began 0089 from which we would delete the first zero to enter an eight-digit sequence beginning with a zero, e.g. “089….”  Now the numbers begin 0124. From this we delete the first zero to enter an eight-digit sequence beginning with a one.  Patients with both old and new numbers are entering the OR’s

B.                 The conversion to the HPF (Horizon Patient Folder) electronic

system means most patients are arriving with a bar-coded 13-digit medical record encounter number.  We must enter digits 2 through 9 into the “Medical Record #” field in CompuRecord.  To add to the confusion the red stamper card, which is being phased out, has 12 digits, missing the first zero.

 

After discussion with Health Information Management officials about the confusing way that medical record number information is presented to users, they agreed to split the patient identification numbers so that the needed numbers can be easily spotted.

 

  1. OR waste.  Due to privacy concerns we have a new gray waste bin in the

operating rooms for trash containing patient names.

 

The new paradigm for disposing of trash:

A.                 If it’s sharp ® red sharps collectors

B.                 If it’s biologically contaminated ® orange bags

C.                 If it has the name of a patient on it ® gray waste container with a locking top.

D.                 If it’s a washable fabric ® yellow laundry hamper

E.                  Everything else ® clear trash bag

 

  1. Grand Rounds – Wednesday 6:45AM, John Jones Auditorium.

 

This week.  Patients with neuromuscular disease.      John Finder, MD*

Next week.  Monitoring Intraoperative Coagulation  Brian Parker, MD

* Dr. John Finder is a faculty anesthesiologist at the University of Pittsburgh.

 

  1. Graduates.  Our senior residents and pain fellows are finishing their training, and moving to new life phases.  Dr.William Tippets will train in Washington, DC, and Dr. Mike Shackelford at the University of Cincinnati.  Drs. Rodney Dayo and Yeshvant Navalgund are starting up a pain management practice in Pittsburgh.  They will call it “DNA”, a good medical term, which in this case stands for Dayo Navalgund Associates.  Drs. Brian Grose and Shanis Padgett are joining the faculty at WVU.

 

            

Dr. William Tippets with family                       Dr. Shanis Padgett congratulated

by Dr. Johnstone.

        

Dr. Rodney Dayo with Pfizer award                Dr. Brian Grose with Chief Resident 

                                                                                      Certificate.

 

  1. The DNA logo that Drs. Rodney Dayo and Yeshvant Navalgund will use in their practice.

 

 

  1.  The department received two warnings recently for prohibited financial transactions.  Neither transaction shorted anyone of funds, but they illustrate the tight environment in which we’re currently working.  The transactions:

 

    1. Purchase of a gift certificate with the department credit card.  This

was the $100 gift certificate for the medical student who won the Eller Award as the outstanding anesthesiology rotator during the past year. Labeling the certificate as an award or paying for it with an invoice/check would have met the requirements.

           

    1. Including non-educational activities in an educational meeting payment. The clinician attending wrote a personal check to UHA, so that everything could be paid for at one time with one payment. UHA requires separate checks.

 

We must follow institutional rules.  They’re designed to comply with tax

regulations, meet accounting standards, and promote clarity.  Please help

the department meet them.

 

  1. Congratulations to Kelly Meyers CRNA. Last week she moved into a new house in Cheat Lake, the first house she has owned. She now lives in the same neighborhood as Kaye Swiger’s son Josh.  Kaye was her first visitor.

 

  1. Congratulations to the following WVU alumni and faculty. We spotted their names among the 640 anesthesiologists certified this spring by the American Board of Anesthesiology:

·        John Casto, MD – Lewisburg, WV

·        Ervin Czinege, MD – Morgantown, WV

·        Nick Cottrell, MD – Morgantown, WV

·        Charles Gairhan, MD – Germantown, TN

·        Chris Kwasny, MD – Morgantown, WV

 

10.  All faculty and resident anesthesiologist should be members of the American Society of   Anesthesiologists. These clinicians must complete and sign their applications, but the department pays the dues. Benefits for ASA members include receiving the journal Anesthesiology and the ASA Newsletter each month, as well as practice management materials, representation on federal legislative and regulatory issues, and complimentary registration for the ASA Annual Meeting. We also enroll all residents in the International Anesthesia Research Society and split the $75 annual fee between department and individual educational funds. This means all residents receive the journal Anesthesia and Analgesia, and are members of six subspecialty societies. IARS missions include teaching and education, which matches our residency goals.

 

11.  A case report in the June issue of the Journal of Electroconvulsive Therapy credits recent work from WVU for describing how to use remifentanil anesthesia to improve progressively shorter seizures. The article reports that the addition of remifentanil to the anesthetic regimen can reduce the dosage of methohexital by 30-40% while producing a 40% increase in the duration of ECT induced seizure activity. Remifentanil anesthesia also decreases the electrical requirement for induction of seizures compared with methohexital while providing an enhanced motor and EEG seizure in patients refractory to ECT induction using standard methohexital anesthesia.

 

See Dr. Pam Sullivan for more information.

 

  1. Dr. Johnstone serves on the ASA Quality Management and Department Administration   committee. It oversees the ASA Consultation Program that reviews and advises troubled departments requesting help. Johnstone thus must perform site visits from time-to-time, usually about once every other year. As part of this program he will visit a hospital next week that has had some recent anesthetic deaths, and be out two days. The next newsletter will be in two weeks on July 6.

 

  1. Mon General Hospital recently awarded a five-year anesthesia contract to Dr. Ken McNeil. This does not affect our provision of anesthesia for cardiac surgery at MGH. McNeil is a friend of WVU and will work closely with us. McNeil plans to live in Charleston, but work half-time at the MGH. WVU alumni, Drs. Roberto Valenzuela and Ervin Czinege will also work at the MGH.

 

  1. The Accu-Chek glucometer will read “error” or shut off if too much time elapses from the start to finish of a sample test. The Accu-Chek will shut down 3 to 5 minutes after being powered on.

 

  1. For the latest information about anesthesia billing see Linda Kelley or Barbara Bilotta. They attended the national Anesthesia Billing and Compliance Seminar in Philadelphia last week. Both report we’re doing things well, but picked up some new ideas and information, such as how to better code for intraop TEE’s. Bilotta used some spare time to visit the city. She reported, “It was also great to experience the sights and sounds of historical Philadelphia; from Independence Hall to the Liberty Bell. My husband and I attended the musical Hello Dolly along with an inspirational church service at St. Joseph’s Cathedral.”

 

  1. The hospital is studying computer information systems to replace IDX, CHIP, and other billing and scheduling systems. This week that four venders bidding on this major replacement will demonstrate their products in the Eye Center auditorium. The vendors are Center, IDX, Epic, and McKesson.

 

  1. STAR is the name of the customer service initiative that WVUH and UHA launched a year ago. STAR stands for Serving Together – Achieving Results. It is now achieving improvements in customer satisfaction ratings.

 

  1. Small World. A sales rep that calls on our department covers a territory that includes Cleveland. Last week she delivered a card from Dr. Fares Raslan, one of our alumni who is practicing at St. John West Shore Hospital in Westlake, Ohio, a suburb of Cleveland. Raslan sent his regards to everyone in the department.

 

  1. Congratulations to David Lorenze, son of Alice Lorenze, CRNA. David, a junior majoring in public and urban affairs at Virginia Tech, made the Dean’s List.

 

  1. Lately Dr. Johnstone has been getting ads for university degrees. These ads offer “Bachelors, Masters, MBA, and Doctorate (PHD) diplomas…there are no required texts, classes, books, or interviews.” They offer diplomas from “Harvard” and “law school” and add “confidentiality assured.” Someone is apparently buying these diplomas. In fact, one of our applicants this year listed a PhD degree on her c.u., but when we investigated, the university didn’t appear to exist. We dropped this person from consideration.

 

  1. By the end of summer 4 new physician faculty and one nurse anesthetist are scheduled to start. This will allow us to grant considerable summer vacation time. A week ago Dr. Johnstone spent a vacation week at his family house in Vermont. While there he and his youngest daughter, Stephanie, climbed to the summit of Jay Peak.

 

 

Stephanie and Bob Johnstone atop Jay Peak, June 8, 2004

 

 

The climbing was hard, but they were living a family motto, “sursum ad summum” or “rise to the highest.” They hope everyone has equally memorable vacations.

 

 

                                                                                                            Robert Johnstone