As many of you may recall, we

used a program called the Health-

Stream Learning Center (HLC) to

assign and track Care Connect

training. We will continue to use

this program to assign and track a

variety of education for all RGHS

staff.

Team Members will use Self Serve

to connect to the HLC to view and

complete assigned learning.

A 10-minute course called “About

the HealthStream Learning Center

(HLC)” has been assigned to all

staff and provides instruction

about navigating the HLC pro-

gram. If you have not completed

this yet, please begin with this one.

If you have completed it and

would like to review it again, the

course will be found under “My

Transcript”. This is where your

completed learning is stored for

you and your manager to review.

RGHS mandatory courses will be

assigned using this program.

Please note, any course shown in

your “My Learning” has been

assigned to you and you are re-

quired to complete it. As the year

progresses, other education will be

assigned to team members so

check the HLC frequently (at least

monthly). If you have any question

regarding an assignment, please

contact your leader.

Should there be any questions

regarding access to the HLC,

please contact the Help Desk at

922-4357.

All RGHS Team Members

Bryan’s Notes Dr Bryan Gargano

Capnography coming to the bed-side by RT 5/16 – be ready! Know your waveforms!

Etomidate – RGH is almost out of Etomidate. Strong is out.

Interpreters – use the phone, call interpretation services, be mindful of the staff.

Strokes - go to CT BEFORE labs - Call the Stroke Neurologist 911 BEFORE - the CT

Rape Kits—can only be done within 96 hours of the assault

Call in Notes– Read notes from PCP’s for expected patients.

Holding Orders – you will be called by the floors if you forget to write Holding Orders.

Clinical Impression – Need to put one in the charts.

CIU patients– Order daily meds if patient will be in ED overnight.

Charts Completion – goal is within 7 days for billing.

Recent Award Winners “Congratulate Our Team”

Leadership Excellence Shari McDonald

Support Staff Excellence Julie Knapp

Best Preceptor Melissa Shannon

Best Mentor Jeff Bouvy and Amber McGrath

Best Team Player Laura Stahl

Best Patient Advocate

Ruth Kuhns and Ann Kelly

Best New Patient Advocate

Ann Kohagaten

Special points of interest:

Using the Health-Stream Learning Center (HLC) to assign and track Care Connect train-ing.

Occupational Expo-sure

Press Ganey Scores

Overflow Area

Updates and Tips

Volume 1, Issue 1

Information Services & Technology: Clinical

Education Organizational Development

Your Regular Source of ED News And InformationYour Regular Source of ED News And InformationYour Regular Source of ED News And Information

Volum

RRREACHINGEACHINGEACHING GGGREATREATREAT HHHEIGHTSEIGHTSEIGHTS EEEVERYVERYVERY DDDAYAYAY

Health Stream learn-ing Center Brian’s Notes Clinical Alert Quality and Safety Service Peer Interview Team Nurses Week Karen’s Korner ED Summer Party MOU/CDU/PEDS Patient Access Social Work Staff Birthdays

Inside this issue:

All Team members with an ex-

posure during off hours are to be

rapidly seen in the ED.

Use Care Connect ”ED Adult

Occupational Exposure” Order

Set to order all appropriate labs.

No paper lab requisition is need-

ed.

NYS Law allows HIV testing to

be completed with verbal con-

sent. The results are followed up

by Employee Health. The Lab no

longer assigns a confidential

tracking number.

The “source” consent form for

HIV testing no longer exists.

If the “source” is a patient on an

inpatient unit, it is the responsi-

bility of the unit’s nurse manager

or Off-Shift Director to facilitate

obtaining the labs samples. The

lab specimen does not need to be

emergently drawn since Employ-

ee Health will ensure the

labs are completed.

If the “source” is an active ED

patient, then the ED is responsi-

ble for obtaining consent. Again,

per NYS law, verbal consent for

HIV testing is allowable.

Use Care Connect “ED Adult

Occupational Exposure Treat-

ment” Order Set to order Post

Exposure Prophylaxis Medica-

tions (PEP) and prescriptions.

Consult the on-call Infectious

Disease (ID) person with any

questions regarding PEP indica-

tions

All Team Members are to be

referred to follow up with Em-

ployee Health the next business

day.

Down Time Procedures - order

the labs and medications as you

would for any other patient dur-

ing the down time period.

At point of discharge, PFS will

set the employees billing status

to employee health, so that they

do not receive a bill.

mation suggests the shortage will last at least into June if not long-er. We do have a supply of keta-mine and propofol as alterna-tives. Nalbuphine (Nubaine) injection is on national shortage. The duration may last into the summer

Press Ganey Scores are going

up to the 60%. Patients complain

about the hallway, and privacy,

wait times for provider and not

being informed of delays. so we

The Pharmacy recommends using the RX icon in Care Connect for communication regarding medications instead of calling. This works espe-cially well with ED boarder’s medications. Our supply of etomidate continues to dwindle during this shortage. RGH was receiving small shipments but none in several weeks. The sup-ply in RGH Pharmacy is less than 50 vials. The latest infor-

will be changing the assignment

sheets to better care for Over

Flow patients. Look for the hall

patients to be assigned to PCT’s

and to nurses as well. When

there is an OF nurse, they will

make every effort to line & lab

as well as assume the care with

assessments and medications.

Physical Therapy is only avail-able from 9-5:30pm, so make your referrals early! Mary Mahler, Interim Nurse Manager for 

Adult ED 

CLINICAL ALERT

Service

Quality and Safety For Your Information

Notification of Deaths

When a team member is reporting

any patient death to the operator,

they will be asked the name of the

family member that was notified

and the relation to the patient.

Confidentiality

Please be careful with medical

information in open areas.

Page 2

RGHED

Targeted Area for Improvement

(Over Flow )

RGHS ED Adult Occupational

Exposure Guidelines

All affiliates of RGHS are includ-

ed: NWCH, Hill Haven NH,

DeMay Living Center, Independent

Living for Seniors (ILS), Behavior-

al Health Network (BHN), Lat-

timore Surgical Center. Mary Mahler RN,  Interim Nurse Manager  for Adult  ED 

Bryan  Gargano, MD,  FACEP,  RGH  ED Medical  Director 

Dan DeMilio RPAC 

Patient Flow: It needs to be a team effort to facilitate getting admitted patients to their rooms quicker. When-ever you see 5 patients ready for transport, each PCT should take one up to improve patient flow.

BG’s on diabetics: Please-make sure you check BG’s on diabetic patients and ask Providers for orders.

Bar Code scanners: The new bar codes are to be scanned daily to ensure the Cerner Bridge functions properly.

Labs: Make sure there are proper labels on all labs. Do not send them with pa-tients. IV Pumps: Use guard rail

settings on IV pumps for medications. Quiet Patient Environ-ment: Be aware of noise and inappropriate conver-sations within ear shot. Patients can hear us very well.

Thanks for so many interviews

Amy Giampietro

Tamara Carlucci

Tammy Davis

Mary O’Grady

Rebecca Bourne

Vanessa Moore

Kari Burlee

Alan Crawford

Tasha Borys

Julie Knapp

Caleb Towner

Cara levy

Susan Everdyke

Caremen vega

Kathy Foote

Andre Williams

Kirstina Eder

Chrissy Anthopoulos

Elena Cedeno

Ruth Kuhns

Peer Interview Team, Please Thank Them for All They Do!

Page 3

Volume 1, Issue 1

CNAS Celebration:

Several ED nurses are ad-

vancing on the Clinical

Ladder.

Providing Excellence Every Day

Shining Stars 1st Quarter

2012

Nurses Week

May 6, 2012 ‐ May 13, 2012 was a week full of many exci ng events as we celebrated Nurses Week and Hospital Week!  

Thanks to everyone who shared there dishes as we celebrated Nurses Week in the ED. 

Thanks to Joelle and her team for

preparing breakfast, and the Night

shift for their donations for EMS

Week.

Rural/Metro Medical Services celebrated Emergency Medical Services (EMS)

Week May 20-26, 2012. which celebrated the dedication and compassion of the

nation’s 750,000 EMS providers, including more than 200 Paramedics and Emer-

gency Medical Technicians (EMTs) of Rural Metro Rochester, N.Y. division. On

Friday, May 25, Rural/Metro hosted an EMS Awards Ceremony honoring its very

own heroes, public safety partners, and area hospital emergency departments.

Among those honored were the employees of Rural/Metro, Rochester Police De-

partment, Rochester Fire Department, Emergency Communications Department,

Rochester General Hospital, Newark- Wayne Community Hospital, Strong Me-

morial Hospital, Unity Health System, and Highland Hospital.

EMS Week

Hand-painted mural hanging in Main Lobby of Rural/Metro Medical Services Rochester

Thanks to Dr Santiago for partici-pating in the Region’s Celebration of EMS Week. Dr Santiago provid-ed educational offerings to EMS providers attending the first annual EMS Week celebration at the Mon-roe County Public Training Center. Plans are already underway to make the regional celebration of EMS Week Bigger and Better!

Getting information to all ED staff is some-

times difficult, especially since we are all so

busy. This “korner” will be dedicated to

providing monthly tips and updates which

may be new and informative for some, or just

a reminder for others. If you have any issues

or tips you would like me to add in this corner,

please let me know and we’ll review it to

publish next month. I’d love to get some feed-

back if you find this information helpful.

I find that good communication and working

together is the best way to get issues resolved.

As always, please feel free to contact me if

needed. I’ve seen this department improve and

expand dramatically in the past ten years. We

have a great Management team and team

members which makes RGH ED the best!

MONTHLY UPDATES AND TIPS

MONTHLY TIPS/REMINDERS 1. Check underneath stretchers for oxygen

tanks not in use - especially in EMS hallway. These tanks need to be taken and stored in the Med Gas Room. Also, No tank should ever be left unsecured.

2. Reminder to lock all Room Supply carts and Specialty carts after use! We need to always stay in the habit when we leave a room of securing supplies.

3. Instruments taped with yellow belong to ED. These instruments are NOT DIS-POSABLE and need to go to SPC for re-sterilization.

4. Difficult Airway cart must be restocked and maintained after EACH USE! Blades must go to SPC to be cleaned.

5. Make sure that all defibrillators are plugged in and charging after transport and use.

UPDATES: 1. Rapid Rhino - Product #552 - 5.5 Bilateral -

No Airways have been discontinued. We will continue to use up our current stock. Manufacturer recommends using the Rapid Rhino #550 - 5.5 Anterior - No Airway in its replacement.

2. Environmental Services has been doing a weekly terminal cleaning on all of the ED stretchers. They have been taking one or two at a time on Monday mornings to clean and as we have requested, and began maintaining a log as they are completed. We do have a supply of additional mattresses for ED and PEDS ED stretchers only. If you do come across an ED stretcher that needs a new mattress, please contact me and I’ll arrange to have it changed out.

Candice Gantt: has accepted the position of Lead Secretary in the Adult Emergency Department effec-tive June 1, 2012. We are very excited to have her as a leader who will be supporting one of our most important and valued em-ployees, the secretaries. Candice has been employed by Roch-ester General Health System for four years. Candice has her Associate’s degree in Medical Assistant and has a certification in medical office. We look forward to more great things from Candice as she takes on this important new role in our system. Please congratulate Candice on her new position.

Andre Williams: will be assisting George Glessner with IT and Commu-nication Services in the ED, PEDS, MOU, CDU, & CIU. Please direct any technical issues to either of the two. Secretaries: no longer have to make admission phone calls to Twig and OPD or keep a paper log of the calls. Phones: you must log on, communi-cation is expected , use the communi-cator if you’re leaving the desk.

Rounding: is expected by all secre-taries at the greeters desk and in the department. If you need classes for comfort, we will set that up

EKG’s: Continue to page PCTs as needed for EKG’s.

Translating: If asked to translate, please refer to the interpreter and the translator phones. Bryan and Shari both support this and will disseminate to the physicians and nurses that the translators need to be used. You can be used if it’s an emergency, and please let us know if staff are still call-ing on you.

Privacy at the greeter desk: SS#, asking for IDs- Every patient should be asked for either a social security card and/or driver’s license. If the patient is uncomfortable you can give them a piece of paper and pen and ask them to write it down. Remember to discard it in a shredder or offer it back to the patient. 2 privacy barriers are on order for the greeter desk. They will be installed soon.

Phone transfer process: Identify yourself, do not coldly transfer a call back. Let the provider know who is on hold or on the receiving end and then connect the call. This is the expecta-tion at all times. For pharmacy calls print the chart, take down the phar-macy’s phone number, who you spoke with and then present it to the provid-er.

Scanning: make sure any paperwork received with our about a patient is scanned immediately.

Patient family members: If calling the emergency department for pa-tients, transfer to them to a patient room or nurse, never to a provider’s phone.

KAREN’S KORNER

ED SECRETARIES

ED PAINTBALL PICTURESED PAINTBALL PICTURES

MOU/CDU

Clare Pullano: has accepted the Nurse Manager position for the MOU/CDU.

“I am very excited to be in my new role! It has been an enormous change, but I have had such incredible support from the MOU/CDU team, Adult/Peds ED, Shari McDonald, and all of the ED leadership. I’m very proud to say that I am a part of the RGH Emergency Department team. I’m really enjoying the collabo-ration that is occurring between each area in the department and look forward to us all getting to know one another a little better and truly working together as one ED team!!!”

Clare M. Pullano, MS, BSN, CCC/SLP, RN Nurse Manager

P

Imelda & Clare’s Corner

MOU treated 546 patients in the month of May! The average length of stay was 18.41 hrs. Observation Service increased to 26 beds (22 in MOU, 4 in CDU) as of June 11, 2012.

Obs Unit accepts rate controlled A-Fib patients.

Cardioversion for Obs patients occur right in the MOU now! The Cath lab team will come to the bedside to cardiovert the patient, recover the patient, and then hand care over to the MOU nurse.

CDU is an 11 bed short stay unit (with 5 hallway surge beds) within the Emergency Department that takes admitted patients from the ED to facilitate flow and decrease overcrowding during times of high volume/surge. Patients typically stay between 24-48 hours, however the priority is to move them upstairs to appropriate in-patient beds as they become available.

There is not specific CDU provider coverage, nor do we have central monitoring; therefore for the safety of the patients, specific exclusion criteria exists. If a patient meets any of the following, he/she is NOT appropriate for the CDU: - Hemodynamically unstable - Not yet cleared by PAO as indicated - Requiring ICU level of care - Requiring oxygen therapy via high flow system (i.e. non-rebreather) - Requiring a Cardiac drip - Trach dependent - Septic

Weddings: Andreanna Iannettone 8/17/12 Gianni Bermudez 7/7/12

Welcome to the MOU!!! Stacey Incardone, NP Vijay Aluri, MD Sandra Eckhart, MD

Goodbye and Good luck!!! Tiffany Lowey, PA Neha Bedheka, MD Jennifer Zarpentine, RN

Graduations: Allie Smith (PCT), Bache-lor of Science from RIT

Medical Observation Unit/Clinical Decision Unit

Britaine Little (RN), Savannah Hawkins (RN) were nominated through patient discharge call back and staff compliments. They were both nominated during nurses week for best mentor and team player by their peers also. They received lotto and meal tickets, and tokens of appreciation for all their hard work and pos-itive attitude they bring to the department.

Press Ganey: May 84% Volume: 2,780 in May Hand Hygiene: April 53% Pain Documentation: Initial assessment: 64%, Follow-up after medication: 50% Falls: 0 Quantros Referrals for May: 3

Sarah Brooks (RN), has obtained her Clin III status and jacket this year.

Sarah has worked in the Peds ED for almost 2 years, and serves as our

Unit Council chair, POCT super user, and organizer of our annual Pediat-

ric Child Health and Safety Fair.

pions have been asked to begin modeling the

positive behaviors of patient safety. They will

receive additional educational sessions and

materials throughout the next year and be-

yond. Thanks to both of them for the commit-

ment to our patients and the PEDS ED.

Welcome our new staff:

Elizabeth Kaspar, RN from 7800 (finished orientation 5/30)

Victoria Spence, RN from Highland Hospi-tal (started 5/14 abd will finish 7/14)

Christina Cramer-Mills, RN from school system ( starts 6/18 abd will finish 8/20)

Tabitha Milevich, RN from Strong Hospital

Nurses Week winners:

Best Team Player: Tiffany Maynard

Best Preceptor: April Schoenberger

Best Mentor: Sarah Brooks

Best Patient Advocate: Rosemary Magill

April Schoenberger, RN and Meghan

Aldrich, PNP has been selected as the Pa-

tient Safety Champions for Peds ED. They

will be collaborating with each other and the

team on our unit project: Hand Hygiene.

They will be attending the Leadership De-

velopment Institute on 6/21 where the topic

is: Patient Safety Summit. The Safety Cham-

(starts perdiem 7/9)

Daisy Matos, US from Strong Hospital ( started perdiem 6/4)

Giana Nitti, PCT from 2800 (starts perdiem 7/1)

Tabitha Preston, RN Nurse Manager

Pediatric Emergency Department 922-5371 (office) 729-9249 (cell)

Staff Updates

Employees of The Month

Quality

PEDS ED

Our Access Associates in the Emergency Room have been a part of the team efforts

to help keep up with daily volume increases. The job they complete on a daily basis

is crucial to Patient Safety (proper identification), follow up care (Correct phone

number/addresses for safe transfers) as well as financial reimbursement for their

care. To complete an accurate registration, team members collect the following in-

formation: Correct Spelling of name and date of Birth, Demographics, Primary con-

tact, Primary care physician, Insurance verification, and Collection of co-pays.

To make sure we are reaching our Goals we have been approved for 3 Full time Ac-

cess Associates. We will be adding one position to each shift mainly to accommodate

the increased Patient Volumes in Pediatrics.

Please extend a warm welcome to:

Lina Cammarata

Kariann Schoenheit

Susan Evans

Wendy Raley

Try to prioritize and alert the Triage nurse and

EKG tech if you have a patient in line that

may have any of the following complaints:

Chest pain

Shortness of breath

Syncopal episode

Dizziness

Weakness

Credit Card Machine:

We will be adding a Credit Card machine to

our Peds ED Pcc area and will need to have

one staff member stationed in this area at peak

times.

Co Pay Collections:

Kudos to all of our Access Associates who

have been working hard at our Co pay collec-

tions. In the Month of June we collected over

$14,000.

Staff:

Please remember to ask each and every pa-

tient for their co-pay. For every co pay not

collected we run the risk of only collecting 8

cents on every dollar!

Upcoming changes to look for:

While stationed at T2, please step up and put

the next patient in line into the Care Connect

system. It is vital that we have the patients

registered in Care Connect before an EKG is

taken.

Insurance Verification Training:

Holly and Tiffanie will be signing everyone

up to go through these classes.

Questions: Please if you have questions re-

garding insurance always ask. We need to get

it right the first time.

Thank you for being such an Awesome group

of individuals. Your hard work and dedication

What’s New with Patient Access

Patient Access

Jillian Hart

Jacob Burrows

Karin McCarns

Cheri Parnell

Starting in July

Christopher Affronti-

Maricela Marquez

AleydaMichel

P

PATIENT ACCESS

Holly Jarrell-Tiffanie Goins Supervisors, Patient Access

585-922-5171

Rochester General Hospital would like to give special thanks to ED Social Worker, Sharon Cerasoli, for her hard work and dedication to the department.

The House Of Mercy would like to thank Rochester General Hospital for the great care that we have given their patients.

Social work will begin collecting donations for flip flops, for patients in need.

Lately there have been several deaths of patients with no next of kin and homeless individuals. In these situations please notify Social Work or the Admitting Office. They can contact the County Of Monroe to get next-of-kin information and make burial arrangements.

Social Work

Upcoming Birthdays 2012

July/August

ED JULY

McGrath, Amber 7/4

Cooper, Charlene 7/5

Lee, William 7/6

Tefel, Wende 7/6

Rosenbloom, Dr 7/7

Z, Dr 7/7

Opoku, Afua 7/8

Scancarello, Tony 7/9

Kolhagen, Ann 7/18

Cutt, Midge 7/20

Kern, Elizabeth 7/20

Borys, Tasha 7/21

Patterson, E. Margaret 7/24

Taylor, Latwanda 7/24

Schoenheit, Kim 7/25

Heyward, Emery 7/27

Mincey, Linda 7/27

Griffin, Brittany 7/29

Johnson, Michelle 7/30

ED AUGUST Williams, Andre 8/3

Singley, Steve 8/3

Enright, Lynette 8/4

Marsden, Terry 8/6

Ragusa, Adam 8/7

Ross, Sarah 8/7

Purcell, Jennifer 8/8

Vorobeychik, Alina 8/9

Montgomery, Judy 8/10

O'Brien, Karrie 8/22

Jones, Tamara 8/25

Coughlin, Liza 8/29

Kuhns, Ruth 8/29

MOU JULY Patricia Sharp 7/15

Beth Wicks 7/18

AUGUST Patti Zimmer 8/3

Jackie Kreason 8/11

Alma Armand 8/14

Tiffany Taggart 8/21

Samantha Cyrana 8/24

Andre Williams

RGHED Newsletter Designer, and Editor

New Issue available

September 2012

HAPPY

BIRTHDAY EVERYONE

RGHED Softball TeamRGHED Softball Team Norton Village “Diamond 2” Thursday July 5, 2012 @6pm

Thursday July 12, 2012 @ 7:15pm Thursday July 19, 2012 @ 7:15pm

Complete Schedule is in the Bubble