VITALS August 2017

BAYSHORE MEDICAL CENTER AND EAST HOUSTON REGIONAL MEDICAL CENTER • A BI-MONTHLY NEWSLETTER FOR PHYSICIANS • AUGUST 2017

Bayshore Medical Center and East Houston Regional Medical Center

VITALS

Standard of the Month Bayshore Medical Center and East
Houston Regional Medical Center
INTEGRITY
INTEGRITY: I am committed to Names New
the power of my integrity. Chief Medical Officer Dr. John Tynes
- I will act with honesty in all I say
and do. Please join us in welcoming Dr. John Tynes to John Tynes, MD, MBA,
- I will be dependable and worthy of Bayshore Medical Center and East Houston Regional FACOG
trust. Medical Center. Dr. Tynes will be starting on Sept. 15
-I will choose to do the right thing as our new Chief Medical Officer (CMO) for both Chief Medical Officer
even when difficult or when no one campuses. Dr. Tynes comes from St. Anthony North
is looking. Health Campus and Longmont United Hospital in
Westminister/Longmont, Colorado as a dual-facility
We are a healtcare team Chief Medical Officer. These Level 3 trauma facilities
committed to excellence by included oversight for 4 neighborhood health centers,
always providing high quality, a freestanding emergency department, and included a
patient and family centered Family Medicine resident program with 30 residents
care to our community, one each year. He is not new to Texas though as he
completed his Medical Degree at UT Southwestern in
patient at a time. Dallas, Texas and completed residency in OB/GYN at
Baylor University Medical Center in Dallas, Texas.
EDITOR/LAYOUT Dr. Tynes also holds an MBA from Regis University in
Anum Arif Denver, Colorado.

Director of Marketing/PR In his previous role in Colorado as the dual-campus CMO, he served as a liason for
(713) 359-5571 over 700 physicians and providers. Notably he led the hospital to an improvement in
preventable harms including reduced CLABSI's, CAUTI's, SSI's and also led an
[email protected] improvement in hand hygiene. Prior his appointment as CMO at St. Anthony/
Longmont, he was Medical Director of Speciality Care including Orthopedics,
Basyhoremedical.com Neurosurgery, Neurology, Otolaryngology, and Psychiatry in addition to Women's
Easthoustonrmc.com Health roles in Englewood, Colorado and Crescent City, California.

Dr. Tynes and his wife have three grown children.

CEO Update JEANNA BAMBURG
Chief Executive Officer
Bayshore and East Houston Medical Staff:
ERIC EVANS
We are pleased to announce HCA Healthcare Gulf Coast Division’s acquisition of three Chief Executive Officer
acute-care hospitals and one acute care hospital in the greater Houston area.

• Houston Northwest Medical Center;
• Cypress Fairbanks Medical Center Hospital;
• Park Plaza Hospital; and
• Plaza Specialty Hospital, long-term acute care hospital

In addition to the recent purchase of Tomball Medical Center, these hospitals join our
growing list of outstanding community healthcare facilities in the greater Houston area. The
Gulf Coast Division is already a significant presence in the region, as it also includes hospitals
in Corpus Christi and South Texas.

These acquisitions represent a very purposeful commitment to filling what we see as a gap in
community healthcare excellence in Houston and throughout our region. Our growth
strategy focuses on:

• Improving medical services in terms of people, infrastructure, technology and equipment to
deliver and continuously improve healthcare in the communities we serve;
• Providing resources that attract and keep the best physicians and healthcare staff in
neighborhoods so they are readily accessible to those in need; and
• Continuing to be a responsible pillar in our communities and ensuring a continuum of care
for families through a wide array of services — from prevention to diagnostic to treatment.

We are driven by our own belief that quality healthcare should be available in everyone’s
backyard. In order to fulfill that vision, we will continue to improve our delivery of care
through the recruitment of top talent, as well as through acquisitions, joint ventures and
affiliations in order to fill existing gaps in health care delivery.

Sincerely, Sincerely,

Jeanna Bamburg Eric Evans
Chief Executive Officer Chief Executive Officer
Bayshore Medical Center East Houston Regional Medical Center

A BI-MONTHLY PUBLICATION FOR PHYSICIANS • OCTOBER 2016

CEO Update

Please help us welcome our new physicians at Bayshore Medical Center and East Houston Regional Medical Center:

Agnes Hernandez-Grande MD Bayshore Campus Pediatrics
Aisha Amin MD East Campus Internal Medicine
Ali Moussaoui MD Dual Neurology
Amanda Bruggman MD East Campus Emergency Medicine
Anitha Abraham MD Dual Neurology
Bernard Ezigbo MD Bayshore Campus Critical Care
Beverley Collins NP Dual Nurse Practitioner
Christie Tung MD Dual Neurology
Christine Parisien MD Bayshore Campus Diagnostic Radiology
Dharmpal Vansadia DO
Dual Orthopaedic Surgery
Dhuha Alkhaiat MD East Campus Internal Medicine
Esli Gollapalli DO East Campus Emergency Medicine
Folashade Bernard MD Dual Internal Medicine
Gregory Ferenz DO Bayshore Campus Neurology
Herbert Watkins MD East Campus Urology
Hitomi Saso PA East Campus Physician Assistant
Imtiaz Ahmed MD Bayshore Campus Critical Care
Jacklyn Pancrudo DO Bayshore Campus Internal Medicine
Jawdat Hafez DPM Bayshore Campus Podiatry
Jay Bernstein MD Bayshore Campus Emergency Medicine
Jaya Sariga NNP Dual Nurse Practitioner
Jeffrey Chambers MD East Campus Emergency Medicine
Johanna Morton MD Dual Neurology
Jose Gutierrez Contreras MD Dual Neurology
Joseph Krainin MD Dual Neurology
Leslie Neipert PhD Bayshore Campus Clinical Psychologist
Mary Maxian MD Dual Anesthesiology
Meer Ahmed MD No Value Specified Family Medicine
NamrataGoel MD Bayshore Campus Nephrology
Naveed Mughal MD Bayshore Campus Emergency Medicine
Nesha Prasla DPM Bayshore Campus Podiatric Surgery
Nicolas Spampinato MD East Campus Emergency Medicine
Nidhi Aggarwal MD Dual Nephrology
Paul Chukelu MD Bayshore Campus Emergency Medicine
Precious Pogoson ANP Bayshore Campus Nurse Practitioner
Richard Logue MD Dual Emergency Medicine
Robert Martinez MD Dual Emergency Medicine
Ronny Tschokonte MD Bayshore Campus Critical Care
Rupal Patel MD Bayshore Campus Nephrology
Salman Waheed MD Bayshore Campus Critical Care
Sarita Dillard DPM Bayshore Campus Podiatry
Scott Blumenthal DO Dual Neurology
SuchmorThomas MD Bayshore Campus Emergency Medicine
TheodoreLawler MD No Value Specified Family Medicine
Thomas Valdez MD Bayshore Campus Emergency Medicine
Vladimir Karpitskiy MD Dual Neurology
Wayne Gordon MD East Campus Neurology
William Goldsmith DO Bayshore Campus Critical Care
Xinlei Deng NP Bayshore Campus Nurse Practitioner

CEO Update

Bayshore Medical Center received 3 Five Star Excellence Awards from the Professional Research Consultants
(PRC) for Scoring at the top 10% nationally for Electronic Medical Record System, Physician Engagement and
Administration.
Each year Professional Research Consultants (PRC) recognizes those healthcare organizations that have excelled in
creating excellent experiences for patients, as well as making their organizations a better place to work and practice
medicine. The five star award designation is given annually to healthcare facilites, providers, outpatient service lines,
and inpatient units that score in the top ten percent (i.e., at or above the 90th percentile). These awards are based
on the percentage of patients who rate the facility, healthcare provider, outpatient service line, or inpatient unit
"Excellent" for the Overall Quality of Care question (Overall Quality of Doctor Care question for Healthcare
Provider-Level Awards.

Congratulations to Jeanna Barnard and Wesley Bamburg who were married over
Memorial Day weekend in Puerto Vallarta, Mexico! Jeanna's last name has been
changed to Jeanna Bamburg. Jeanna's email has changed to
• [email protected].
•
•
•

New Leadership

at Bayshore Medical Center and East Houston Regional Medical Center

Quinnetta Claytor, MHA, has joined Bayshore Medical Center and East Houston Regional Medical QUINNETTA CLAYTOR
Center as the Associate Chief Operating Officer. Quinnetta's responsibilities will include oversight of Associate Chief Operating Officer
Plant Operations, Security, and the Dietary Department.

Quinnetta comes to Bayshore Medical Center and East Houston Regional Medical Quinnetta Claytor
Center from Washington, D.C. where she was a part of the HCA Performance Associate Chief
Operating Officer Improvement Corporate SWAT Team as a Manager and Director. Quinetta was
accepted into the HCA Executive Development Program for the Class of 2018. She received her
Bachelor of Science in Psychology from the University of Iowa and received her Master of Health
Administration at Virginia Commonwealth University.

Quinnetta loves shopping, cooking, traveling, working out and mentoring the youth. As she gets
acclimate to BMC and EHRMC, she may be assuming additional responsibilities. Please join us in
welcoming Quinetta to Bayshore Medical Center and East Houston Regional Medical Center.

Shannon Forrest, ACNO has joined the East Houston team as the new clinical leader. She will
be working closely with Eric Evans, CEO to ensure every patient has a world class patient
experience and excellent clinical outcomes. One of the tactics currently underway is hourly
rounding with a purpose. With this initiative, patients will be rounded on every hour and
assessed for pain, comfort, safety and the need for assistance to the bathroom. We have
completed training and Nursing Directors are in the validation process. Please let us know if
you have any questions, suggestions or ideas.

SHANNON FORREST John Mier BSN, MBA, will be the ACNO at Bayshore Medical Center. John’s ACNO
Assistant Chief Nursing Officer responsibilities will include oversight of IMCU, PSU, 3S-OBS, Med-O, ICU, MTU and Behavioral
Health Nursing Units. As he gets acclimated to Bayshore Medical Center, he may be assuming
JOHN MIER additional responsibilities.
Assistant Chief Nursing Officer John comes to Bayshore after being at Conroe Medical Center for 6 years where he was the
Director of Med/Surg and Telemetry. John worked at several other hospitals, including
Houston Northwest Medical Center. He received his BSN from Lamar University, his MBA
from University of Phoenix. John and his wife stay active with their 2 children and he loves
spending time outdoors.
John’s ACNO responsibilities will include oversight of IMCU, PSU, 3S-OBS, Med-O, ICU, MTU
and Behavioral Health Nursing Units. As he gets acclimated to BMC, he may be assuming
additional responsibilities. Please join me in welcoming John to Bayshore.

Imaging News

Bayshore Medical Center and East Houston Regional Medical Center

Low Dose Lung CT (LDCT)
Bayshore Medical Center and East Houston Regional Medical Center now offering low dose lung CT
scans for lung cancer screening in individuals who are at high risk for developing lung cancer.

Eligibility factors:
• Age between 55-77
• Current or previous smoker within the last 15 years
• 30 pack year smoking history (example: 1 pack/day 30 years)
• No lung symptoms (no symptoms of fever, cough, coughing up blood, chest pain, new

shortness of breath, unexplained weight loss)

For more information or to schedule a patient, please contact our Lung Cancer Navigator:
Lisa Doherty RN – 713-359-1409.

New Radiation Oncology Treatment Machine
VitalBeam is a sophisticated radiotherapy system that enables advanced treatment for
cancer. It quickly delivers powerful cancer treatments with pinpoint accuracy and
precision. A VitalBeam system enables clinicians to deliver advanced forms of
treatment for a broad range of cancers in a setting close to home.

VitalBeam expands options for patients who may have had limited choices
before, including challenging cancers such as head/neck, pancreas, paraspinal,
lung, liver, breast and prostate.
VitalBeam delivers many forms of advanced treatment techniques, including image-guided radiotherapy (IGRT) and
intensity-modulated radiotherapy (IMRT). The integration of MV, kV, and optical imaging modalities enables VitalBeam
to support a wide variety of imaging and treatment delivery techniques.

VitalBeam imaging technology can produce the three-dimensional images used to fine-tune tumor targeting with
speed and precision, using cone-beam CT scans to deliver 25% less X-ray dose than previous image-guidance
technologies. VitalBeam is automated, which helps to increase accuracy, decrease the patient’s time in treatment, and
in turn, improve patient comfort.

Breast Cancer Navigator

Our Breast Cancer Navigator is available to guide your patient
through the initial mammo to biopsy to surgery to radiation
therapy if needed. The Navigator will keep you updated and in
control through the entire process.

To contact our Breast Cancer Navigator at Bayshore Medical
Center call: Karen Wilson, RN at 713-359-3304.

To contact our Breast Cancer Navigator at East Houston Regional
Medical Center call: Christina Garcia, BSN 713-393-2757.

KAREN WILSON , BMC CHRISTINA GARCIA,
EHRMC

BAYSHORE MEDICAL CENTER HOSTS
FREE COMMUNITY BABY FAIR

Bayshore Medical Center hosted its 1st Free Community Baby Fair on June 24th to showcase the long-term health benefits of
breastfeeding, provide ongoing support and promote community resources for new moms. Over 200 expecting, new and
experienced families attended the event.
The day's festivities began with tours of the newly renovated Labor and Delivery Department at 10:30 am. Followed along with
a Zika Viruspresentation by Dr. Bassem Tawadrous, a Breastfeeding presentation by Diana Forrester, Bayshore Medical
Center's Lactation Consultant, and a Nutrition in Pregnancy presentation by Jana Cryan, Certified Nurse Midwife at the
Women's Care Center.
During the day, there were ongoing information sessions including: Bayshore Medical Center's Labor and Delivery; Neonatal
Services; and the Women's Care Center. Bayshore Medical Center teamed with families and vendors, including Dr. Nguyen
and her pharmacy team, Altus Dental, Children's Enchanted Learning Center, Eclipse Massage & Spa, Essential Oils, Legacy
Community Health, Mary Kay, Rodeo Dental, Serenity Spa & Wellness Center, Summit Dental, Texas Children's
Hospital Injury Prevention, Vecino Health Clinic, Walgreens,WIC, and Women's Care Center. Over 130 prizes were given
away including a Graco Car Seat!

CNO Update

Bayshore Medical Center and East Houston Regional Medical Center

CARRIE CAPPS Carrie Capps, CNO Bayshore Medical Center and East Houston Regional
Chief Nursing Officer Medical Center

New Leader
Rachel Rivera, MBA is the new Administrator at Fairmont 24 hour Emergency
Center. She comes to Bayshore with previous experience in several different
healthcare venues, including another freestanding emergency center. Rachel has
been serving in the interim Administrator role at the Fairmont facility since
January.

SERVICE EXCELLENCE

At Bayshore Medical Center and East Houston Regional Medical Center our focus is to consistently meet and manage
patient expectations. Clinical excellence is a priority for us. Below is data for Bayshore Medical Center's Inpatient Overall
Rating of Care (HCAHPS), Nurse Leader Rounding Percentage and Nursing Communication Overall (HCAHPS)

Bayshore Medical Center

CNO Update

Bayshore Medical Center and East Houston Regional Medical Center

At Bayshore Medical Center and East Houston Regional Medical Center our focus is to consistently meet and manage
patient expectations. Clinical excellence is a priority for us. Below is data for Bayshore Medical Center's ED Overall
Rating of Care and Patient Call Manager.

Bayshore Medical Center

CNO Update

Bayshore Medical Center and East Houston Regional Medical Center

At Bayshore Medical Center and East Houston Regional Medical Center our focus is to consistently meet and manage
patient expectations. Clinical excellence is a priority for us. Below is data for East Houston Regional Medical Center's
Inpatient Overall Rating of Care (HCAHPS), Nurse Leader Rounding Percentage and Nursing Communication Overall
(HCAHPS)

East Houston Regional Medical Center

CNO Update

Bayshore Medical Center and East Houston Regional Medical Center

At Bayshore Medical Center and East Houston Regional Medical Center our focus is to consistently meet and manage
patient expectations. Clinical excellence is a priority for us. Below is data for East Houston Regional Medical Center's
ED Overall Rating of Care and Patient Call Manager.

East Houston Regional Medical Center

CNO Update

Bayshore Medical Center and East Houston Regional Medical Center

At Bayshore Medical Center and East Houston Regional Medical Center our focus is to consistently meet and manage
patient expectations. Clinical excellence is a priority for us. Below is data for both Bayshore Medical Center and East
Houston Regional Medical Center Inpatient HCAHPS Percentile Ranking,Tests and Treaments and Ambulatory
Surgery and Fairmont 24 HR Free Standing ER Overall Rating Percentile Ranking.

CNO Update

Bayshore Medical Center and East Houston Regional Medical Center

DAISY Award Recipients

The following nurses have received the DAISY award representing Nursing Excellence. These nurses were nominated by patients/
families and co-workers to receive this prestigious honor.

Noelle Hackfeld, RN ICU Maria Martinez, RN IMCU Ashe Thomas, RN 2North

Private Rooms at East Houston Regional Medical Center
We have also completed our transition to providing more private rooms for our patients in order to help improve both the
patient’s experience and to their expedite healing. 2S (Medical Unit) has transitioned from 13 semi private rooms to 7 semi
private rooms which allows a gain of 6 additional private rooms for a total of 11 private rooms. 2S will have 25 beds total. 2N
(Surgical/Orthopedic) has transitioned from 9 semi private rooms to 1 semi private room which allows a gain of 8 additional private
rooms for a total of 23. 2S will have 25 beds total.

In an effort to improve our patient throughput, we opened the Clinical Decision Unit (the observation area) in Mid-May to create a
staging area for our ED admissions and direct admits. In this area, patients will have their admission assessment and home
medication list completed. All new order will be initiated. Once the work is complete, the patient will be “transitioned” to a room
on one of the units. This will allow for correct patient placement upon admission so the patient can receive their care from the
appropriately trained nursing staff.

IMCU Private Rooms at Bayshore Medical Center
We are dedicating 12 rooms on IMCU for our cardiac and neuro patients that are either elective cases or have high acuity
nursing needs. In this way we can use these rooms for quick turn-around cath lab patients so patient flow can be better
established. We can also group our high acuity patients together for better consistency of care.

CNO Update

Bayshore Medical Center and East Houston Regional Medical Center

Shared Governance:

Bayshore and East Houston Nursing has developed a Shared Governance structure that is made up of staff nursing from across the
organizations. These councils review metrics, develop plans for education and improvement, help raise awareness, set goals for
nurse development and create a better environment for nursing practice. Below is a diagram of this structure and descriptions of
each council.

Nursing Leadership
The Nursing Leadership Council provides leadership, coordination and planning for nursing services within Bayshore Medical
Center and East Houston Regional Medical Center. This Council also provides a forum for Nursing Leaders in all departments to
communicate about common issues related to nursing practice, workflow, and the nursing professional practice environment.
Professional Growth and Development
The Professional Growth & Development Council provides a forum to address issues, explore strategies that promote a practice
environment which supports and enhances professional achievement and role development, recognize contributions to the
Bayshore mission, and foster the recruitment and retention of talented Clinical staff. This council also supports professional
advancement such as nursing certification, advancing education, and unit recognition.
Professional Practice and Quality
The purpose of the Practice and Quality Council is to oversee the development, implementation and evaluation of practice
standards and guidelines in accordance with regulatory requirements, evidence-based literature and practice, and professional
organizations. This council will also improve patient care through the utilization of nurse sensitive quality indicators. The council
will review quarterly data and determine opportunities for improvement. The council collaborates with other councils and quality
committees sanctioned by the hospital to effect change and improvement in nurse sensitive indicator results.
Communication and Recognition
This council will focus on hospital wide communication with the intent of keeping nurses informed of changes in practice, individual
and unit accomplishments, and general nursing department information. This council will also focus on recognition of nurses such
as the DAISY Program, Professional recognition days, and unit/individual accomplishments.
Education Council
This council will focus on educational needs of nursing, both house wide and unit specific. They will also work in conjunction with
the other councils to roll out initiatives brought forth by these councils.
Coordinating Council
This council provides a forum for the coordination and consolidation of information, invention and improvements of other councils
as well as serving as a liaison to other hospital interdisciplinary and multidisciplinary committees and serves as the “filter” for
hospital-wide projects

CNO Update

Bayshore Medical Center and East Houston Regional Medical Center

Right Line, Right Time
During the 3rd quarter of 2016, we noted that at least 20-25% of patients who were transferred from ICU to IMCU still had
central line access. Reasons included poor venous access, multiple blood transfusions, multiple antibiotics, IV fluids and the need
for multiple blood draws. We began looking at devices for alternative venous access. Bard’s Powerglide was reviewed including
ease of use, indications for use, and number of days for utilization. IMCU was chosen as the trial unit in Quarter 4 of 2016.
Bard provided all training including indications for use, insertion, maintenance and use of ultrasound for placement. Nurses
were deemed competent after 10 successful insertions. The need for central lines were reviewed daily by the Assistant Nurse
Managers on the IMCU unit, patients were assessed for potential Powerglide insertion; once patient was determined to meet
criteria, the Powerglide was inserted and order for central line discontinuation was obtained and line discontinued.
The device utilization percentage and SUR improved quarter over quarter. The DU% remains lower than 3rd quarter results of
19.48% and the SUR continues to be lower than 3rd quarter results of 1.166.
The impact on the clinical outcomes for patients in our IMCU unit includes the reduction of the potential for the development
of complications including Central Line Associated Blood Stream Infections and catheter associated Venous Thromboembolism
(VTE) often leading to an extended length of stay or even death.

CNO Update

Bayshore Medical Center and East Houston Regional Medical Center

ROLLING 12-MONTH RN TURNOVER

RN Turnover Reduction
In October 2016 we began to explore the reasons behind our 27.5% RN Turnover rate. With the help of the Corporate HR team,
Hospital HR team, and Division HR team, Unit Directors drilled down to identify main causes for turnover. After these causes of
turnover were determined, each director wrote a corresponding action plan to reduce turnover. Senior leadership also developed
action to increase visibility, especially with off shifts and new hires.
Through Monthly Meeting Models, we ensured that the Directors were keeping their action plans alive. We also held a check-in
meeting in January 2017 to share ideas and success stories. Each month we shared our turnover statistics at management, physicians,
and staff meetings. As we began to see turnover decline, our nursing leadership teams became believers and it further propelled our
action plans.
At this same time, we welcomed StaRN participants and our nurses saw that these nurse were well prepared and a great solution to
our staffing shortages. These new StaRNs helped to halt some resignations as our RN staff saw the culture changing. As of June 2017
our RN Turnover rate has decreased to 20.9%. Throughout this journey, we became better leaders, saw the organization grow more
committed to care, and leaders felt a sense of accomplishment. We have incorporated 112 StaRN’s into our hospitals and have seen
great results with this program both in quality of these new RN’s and adding value to our Nursing culture.

Trauma Survey Date-September 10-11, 2017

SEPSIS Complete & Accurate Documentation

at Bayshore Medical Center and East Houston Regional Medical Center

By Dr. Carl Vartian, HCA Gulf Coast Division Chief Medical Informatics Officer

There continues to be confusion around the diagnosis of sepsis, severe sepsis and septic shock. The distinctions are
very important, as expected outcomes (mortality rates, length of stay [LOS], cost of care, etc.) are generally least for
sepsis and highest for septic shock. If these specific terms are not properly documented, the data we collect and report
to external entities, e.g. payers (including CMS) and quality organizations will be flawed and may not accurately reflect
physician and hospital quality of care.

Fortunately, the definitions are straightforward:

1. SIRS (Systemic Inflammatory Response Syndrome) represents the body’s response to an insult. SIRS may or may not
be due to an infection but, when it is, we call that sepsis. SIRS is defined as any two or more of:

a. Tachycardia (HR>90/min)
b. Tachypnea (RR>20/min)
c. Temperature >38.30 C. (1010 F.) OR <360 C. (96.80 F.)
d. WBC >12.000/mm3 OR <4000/mm3 OR >10% immature neutrophils
2. Sepsis is simply SIRS plus a suspected or documented infection; [does not need a + culture]
3. Severe sepsis is Sepsis plus evidence of one or more organ dysfunctions, e.g. elevated creatinine, lactate level > 2,
CNS changes (confusion, obtundation, etc.), LFTs, etc.
4. Septic shock is severe sepsis plus refractory hypotension or lactate level ≥ 4, regardless of blood pressure. Note that
a lactate level ≥ 4 represents tissue hypoperfusion, and therefore shock, even if the blood pressure is not critically low.
Note that no stage of sepsis requires a + blood (or any other) + culture.

What about the “New” definitions for sepsis? JAMA published the Third International Consensus Definitions for Sepsis
and Septic Shock (Sepsis-3) in February 2016. Briefly, there was is a proposal to move away from SIRS and use a
different set of clinical criteria. In August, CMS released a response stating that the agency does not intend to adopt the
new definitions. It is unclear when (or if) these new definitions will be adopted. For now, the ICD-10 terms and the
SEP-1 CMS sepsis core measure all use the traditional SIRS-based definitions discussed in detail above and clinicians
should not change their practice, but continue to utilize the above definitions.

Documentation Tips

Document Sepsis as soon as it is suspected. If your H&P discusses pneumonia and later in course (or in D/C summary)
the word “sepsis” is used, the sepsis may be coded as hospital-acquired. Neither our doctors nor the hospital should
be blamed for something that was POA (Present on Admission).
Document phase of Sepsis:

– Sepsis = SIRS + Suspected/Proven Infection (name it)
– Severe Sepsis = Sepsis + Organ Dysfunction (name organ)
– Septic Shock = Sepsis + Refractory Hypotension or Lactic Acid ≥ 4

Urosepsis is NOT Sepsis. More appropriate to state “Patient has sepsis/severe sepsis/septic shock secondary to
pyelonephritis/urinary tract infection”. In fact, the term “urosepsis” is not even in the new ICD-10 list of diagnoses.
Also, if the organism is known, please state that specifically in your progress note, as some infections have different
ICD-10 codes depending on the causative organism. Coders are NOT allowed to abstract data from a laboratory
finding, e.g. a C&S, only from physician documentation. If it is not specifically stated, it cannot be coded.
Bacteremia (+ blood culture) and sepsis are NOT interchangeable terms. If you know the process/organism responsible
for the septic episode, please include that in your note e.g. “Sepsis due to MRSA soft tissue infection” OR “Septic shock
secondary to ischemic/perforated bowel”.
Document the most severe stage of sepsis that the patient manifested. This requires you to “know the big picture”. As
most of the sepsis we see in our hospitals is POA, the initial resuscitation is done in the ED. We have seen patients
present with septic shock but, as a result of the aggressive fluid/antibiotic resuscitation in the ED, improve so much that
the admitting physician sees (and documents on) a much improved patient. If septic shock was present in the ED, the
admitting diagnosis should reflect that, just as a STEMI should be called a STEMI, even if the ECG and enzymes have
reverted to normal, following a cath lab revascularization, by the time the hospitalist makes rounds.

Understand that simply stating “Rule/out sepsis” can result in that diagnosis being coded. We have seen patients dying
from advanced cardiovascular disease and obvious cardiogenic shock end up included in our sepsis mortality figures. All
it takes is a clinician, likely without understanding the implications, to document cardiogenic shock, r/o septic shock
somewhere in the record. Although there are different types of shock, e.g. septic, hemorrhagic, anaphylactic, etc., it
would be unusual to have two of these at the same time.

SEPSIS Complete & Accurate Documentation

at Bayshore Medical Center and East Houston Regional Medical Center

Documentation
is KEY!

BAYSHORE MEDICAL CENTER RECEIVES THE AMERICAN HEART
ASSOCIATION’S MISSION: LIFELINE® GOLD PLUS STEMI AWARD

AND BRONZE NSTEMI AWARD.

Bayshore Medical Center has received the Mission: Lifeline® Gold Receiving Quality Achievement Award and the Mission:
Lifeline® NSTEMI Bronze Quality Achievement Award for implementing specific quality improvement measures outlined by the
American Heart Association for the treatment of patients who suffer severe heart attacks.
Every year, more than 250,000 people experience an ST elevation myocardial infarction (STEMI) the deadliest type of heart
attack caused by a blockage of blood flow to the heart that requires timely treatment. To prevent death, it’s critical to restore
blood flow as quickly as possible, either by mechanically opening the blocked vessel or by providing clot-busting medication.
The American Heart Association’s Mission: Lifeline program’s goal is to reduce system barriers to prompt treatment for heart
attacks, beginning with the 9-1-1 call and continuing through hospital treatment. Bayshore Medical Center is recognized for
having a 85% composite adherence and at least 24 consecutive months of 75% or higher compliance on all Mission: Lifeline
STEMI Receiving Center quality measures to improve the quality of care for STEMI patients.
“Bayshore Medical Center is dedicated to improving the quality of care for our patients who suffer a heart attack, and the
American Heart Association’s Mission: Lifeline program is helping us accomplish that goal through nationally respected clinical
guidelines,” said Jeanna Barnard, CEO. “We are pleased to be recognized for our dedication and achievements in cardiac care,
and I am very proud of our team.”
In addition to receiving the Mission: Lifeline Gold Receiving award, Bayshore Medical Center has also been recognized as a
recipient of Mission: Lifeline’s Gold-Plus award, which recognizes the hospital has not only reached an achievement score of 75
percent or greater on all Mission: Lifeline Receiving Center Quality Measures, but also for achieving at least a 75 percent
achievement on First Door to Device time under 120 minutes for STEMI transfer patients from other facilities.
“We commend Bayshore Medical Center for this achievement award, which reflects a significant institutional commitment to the
highest quality of care for their heart attack patients,” said James G. Jollis, MD, Chair of the Mission: Lifeline Advisory Working
Group. “Achieving this award means the hospital has met specific reporting and achievement measures for the treatment of their
patients who suffer heart attacks and we applaud them for their commitment to quality and timely care.”
Bayshore Medical Center earned the award by meeting specific criteria and standards of performance for the quick and
appropriate treatment of STEMI patients by providing emergency procedures to re-establish blood flow to blocked arteries when
needed. Eligible hospitals must adhere to these measures at a set level for a designated period to receive the awards.

Electrophysiology Lab

at Bayshore Medical Center

Procedures at Bayshore Medical Center are performed in a state-of-the-art Electrophysiology Lab (EP Lab).
The electrophysiology physicians are supported by a dedicated team of nurses, technologists and tertiary
staff. These cardiac professionals combine extensive knowledge of electrophysiology procedures with years
of experience in the field.

During a procedure, these personnel work hand-in hand at the table side with the physician while focusing
on the safety and comfort of the patient. Each staff member is able to decipher the complex pattern of
electrical impulses inside the heart -- expertise that allows the physician to focus on curing the patient.

With the vast array of advanced systems involved in electrophysiology, a lab can quickly fall behind the curve.
The technology in the EP Labs at Bayshore Medical Center represents the most advanced in the South East
Houston County area. Since the renovation of the EP Lab in March 2017, there have been 8 PVI for AFIB
cases performed at Bayshore Medical Center for the A-FIB Program using the Biosense Carto 3 machine
with the Uniview technology; which allows for less radiation during cases. The nurses and technologists of
Bayshore Medical Center are trained in using these advanced mapping and imaging systems. This enables
Bayshore Medical Center to remain on the leading edge in the race to improve every facet of technology
involved in electrophysiology.

Bayshore Medical Center will also start a WATCHMAN Left Atrial Appendage Closure (LAAC) Procedure
Program in August 2017.

Palliative Care

at Bayshore Medical Center

We are excited to announce in collaboration with Seasons Palliative
Bayshore will be implementing a Palliative program. The palliative program
will be utilized as a consult. There will be a nurse practitioner and social
worker assessing the palliative consults for end stage disease management,
end of life discussions, transition to palliative /hospice at alternate level of
care post discharge . The program will be rolled out in the ICU first them
additional units will be added over the next 6-12 mos. Physician and
employee education TBA .

Palliative Care Services
- Supportive & Medical care that is aimed at relieving the full spectrum of suffering/total pain (Physical,
Spiritual, Emotional, Psycho-social) that is caused by a life-limiting disease process
Should be implemented at early, moderate, or late stages of such illnesses
- The care team consists of physicians, advanced practice nurses and social workers
- Palliative care does NOT require that patients give up curative or disease controlling treatment
methodologies

Clinical Goals of Palliative Care
- Sustain/increase quality of life level through end of life care
- Alleviate or reduce symptoms such as pain, dyspnea, nausea/vomiting, anxiety, among others
- Educate patient/family on disease progression in advanced illnesses
- Facilitate transition through the continuum of care with a focus on quality of life
- Coordinate the plan of care with the attending physician, healthcare team, and patient/family
- Palliative care aims to facilitate the best treatment for the patient in concert with his/her wishes

Our Patients
- Advanced life-limiting illness? (You wouldn’t be surprised if the patient died in the next 12 months)
- Any End-stage Chronic Disease (Excluding Renal)
- Consideration of ventilator withdrawal with expected death/
- Prolonged or failed attempt to wean from ventilator
- Multi-organ failure
- Stage IV Metastatic Disease
- Family distress impairing surrogate decision making
- Severe CNS disease such as massive stroke, severe encephalopathy with multiple co-morbid conditions,
or severe dementia. Exclude trauma

Our Team 
- Physicians/Advance Practice Nurses/Social Workers & Chaplains

Who can provide a referral or request involvement of the palliative team?
- CRM, SW, RN, and all disciplines working with the patient

Obstetrix Medical Group OB/GYN Hospitalist
Program Now Available at

Bayshore Medical Center and East Houston
Regional Medical Center

Obstetrix Medical Group, a MEDNAX affiliate, is pleased to offer its OB/GYN hospitalist services to three HCA Gulf
Coast Division hospitals, including The Woman’s Hospital of Texas, Bayshore Medical Center and East Houston Regional
Medical Center effective September 1st. With local, regional and national support, Obstetrix is uniquely positioned to
develop and operate successful OB/GYN hospitalist programs in collaboration with hospitals and obstetrician groups.
The dedicated OB/GYB hospitalist program offerings include on-site 24-hour coverage with experienced, board-certified
OB/GYNs; management of OB/GYN emergency department (ED) patients; evidence-based, standardized care; successful
integration with the MFM/perinatal services, neonatal services, ED and ICU clinical teams; extender services to support
pprriavcattiece physicians in the community; educational support for physician trainees and training compliance; and services
with incentives to maximize productivity and reduce costs.

“Acting as in-house physician extenders, we are readily available to help alleviate your busy schedules,” said Dr. C.
Penick, who serves as the MEDNAX OB Hospitalist Medical Director. “You can take comfort in knowing that we are
here 24 hours a day, seven days a week to help you respond to emergencies, assist on C-sections and other surgeries
and even completely oversee care on any given occasion at your request, to create a more manageable life for you and
guarantee improved patient safety and outcomes.”

Dr. Angela Houghton Dr. Cimberly Penick

Key program elements include:

Establishment of OB Emergency Departments
Pregnant patients who arrive in the Emergency Department with labor-related issues or other medical problems benefit
from the evaluation of an OB hospitalist. As one of the first practices to establish an OB Emergency Department,
Obstetrix offers unmatched expertise with several different types of OB ED programs. Highlights include protocol driven
evaluations (e.g. preterm labor), trauma evaluation of pregnant patients, coordination of obstetrical care and follow up
and checks and balances to ensure appropriate billing codes.

Obstetrix Medical Group OB/GYN Hospitalist
Program Now Available at

Bayshore Medical Center and East Houston
Regional Medical Center

Establishment of OB Critical Care Teams
Rapid responses to Labor and Delivery emergencies, such as emergency C-sections, shoulder dystocia, postpartum
hemorrhage and code blue, is critical to optimize outcomes. Led by an OB hospitalist, Obstetrix establishes multi-
disciplinary OB Critical Care teams, including anesthesia, nursing and other rapid response personnel, to ensure we can
respond to urgent patient care needs.

Flexible Models
Obstetrix recognizes that each community is unique both in its needs and the challenges it faces. We don’t subscribe to
a one-size-fits-all approach and offer a variety of staffing models, including a hybrid of community-based and hospitalist-
based programs.

Integration with Maternal-Fetal Medicine and Neonatology Providers
Through partnerships with MFM and neonatology specialists, Obstetrix coordinates care of the most difficult patients
and scenarios. For close to a decade, we have cultivated these relationships through collaboration with our practices.
This collaboration and team approach to patient care has been instrumental in creating a safe environment for both
OB/GYN patients and staff, and has helped establish our organization as a leader in OB/GYN hospitalist medicine.

Performance Metrics
Providers are constantly challenged with the complicated task of improving quality while reducing costs. Obstetrix’s
clinical and business infrastructure helps maximize operational efficiencies and reduce costs, while supporting a high
quality, patient-centered approach to care. We have established medical specialty standards for our group, collect
related data and report our results. We have demonstrated improvement in areas critical to an OB hospitalist
program’s success, including reduced C-section rates, increased rate of vaginal birth after C-section and reduced
induction rates.

Physician Leadership Engagement
We have dedicated physician leadership to work directly with practices in the community on process improvements,
safety initiatives and other patient care issues. We also have advanced continuing education and simulation training
dedicated to keeping our physicians abreast of the constantly evolving clinical and business challenges related to health
care deliveries.

Diabetes is the Leading Cause of Lower
Limb Amputations

By: Dr. Abdul Moosa

The Centers for Disease Control and Prevention (CDC) estimates that
29.1 million people, or 9.3 percent of the population, have diabetes. Of
that 29.1 million, nearly 28 percent are undiagnosed. Risk factors for
diabetes includes heredity, age, diet, activity level and obesity.

People diagnosed with diabetes can also experience co-existing conditions Dr. Abdul Moosa
such as heart disease, stroke, blindness, kidney failure and lower-limb Bayshore Advanced Wound
amputation. In 2010, about 73,000 non-traumatic lower-limb amputations
were performed in adults aged 20 years or older with diagnosed diabetes. Care Medical Director
This accounts for 60 percent of non-traumatic lower-limb amputations.
Diabetes related amputations are related to chronic wounds caused by
diabetes, especially diabetic foot ulcers. People with an amputation have a
50 percent mortality rate within five years.

It is estimated that diabetes costs $245 billion in the United States directly and indirectly. This includes
medical costs, disability, work loss and premature death. The average medical cost for people diagnosed
with diabetes is 2.3 times higher than people without diabetes. Diabetes-related amputations are also costly
for the healthcare system. Diabetes-related amputations cost approximately $38,077 per amputation.
The good news is that lower-limb amputations seem to be declining. The CDC reported in 2012 that the
rate of lower-limb amputations related to diabetes declined by 65 percent between 1996 and 2008.
Although the frequency of diabetes-related lower-limb amputations is going down, there is still much that
can be done to help diabetes patients avoid amputations.

People with diabetes should pay special attention to their feet due to nerve damage and sensory loss. It is
also important for them to wear proper footwear, inspect their feet daily and take extra care when
trimming nails and treating cuts, scrapes and blisters. If a wound does not heal or shows sign of infection,
consider a referral to the Advanced Wound Center. These precautions can help prevent diabetes-related
amputations even more in the future.

If you have a patient with a diabetic foot ulcer that is not healing, contact the Advanced Wound Center at
3801 Vista Rd. Suite 180, Pasadena, TX 77504 or by calling 713-359-2273.

Scott Lacey Named Director of
Physician and Provider Relations

We are proud to announce the addition of Scott Lacey to Bayshore and East Houston SCOTT LACEY
Regional’s leadership team as Director of Physician and Provider Relations effective May 8,
2017. In his new role, Scott will be responsible for supporting the growth and
development of our Primary Care, Internal Medicine, and Women’s & Children’s service
lines.

Scott moved to Houston from Baltimore last year with over 20 years of combined
healthcare, leadership and business development experience. He studied Biology,
Emergency Health Services, and Management at the University of Maryland, Baltimore
County while working and volunteering as an Emergency Medical Technician and
Firefighter. With a passion for business development early in his career, Scott acquired
American National Finance Corp., an underperforming business and transformed it into a
well-respected Mortgage Lender in the state of Maryland. Scott was drawn to healthcare
by his desire to serve others and care for his community.

Scott will be visiting with many of you over the weeks to come to learn about your practice. We would greatly
appreciate your collaboration and support so he can integrate quickly.
Thank you for all you do for our hospital, patients and the community we serve.

Cerified Hand Therapist at
BMC & EHRMC

Bayshore Medical Center and East Houston Regional Medical Center announce the addition of a Certified Hand
Therapist to our staff!

Please welcome Jennifer Ogilbee to our clinics. Jennifer Ogilbee, OTR/L, CHT is an Occupational Therapist and
Certified Hand Therapist. She has thirty years of experience working with patients who have upper extremity diagnoses
including flexor and extensor tendon lacerations, joint injuries, fractures, wounds, arthritis, tendonitis, RSD/CRPS. She is
skilled in custom fabrication of static, static-progressive, and dynamic splints for thumbs, fingers, wrists, and elbows.

If you would like to refer patients for an evaluation/therapy, please call 713-359-5490.

Bayshore Welcomes New Clinical
Neuropsychologist

Leslie Neipert, Ph.D. Leslie Neipert, Ph.D. is a Clinical Neuropsychologist who provides assessment of cognitive
Clinical Neuropsychologist function, academic achievement, personality, and mood, as well as psychotherapeutic
interventions. Her training background and clinical interests include working with adult/
geriatric patients who have acquired brain injury (e.g., stroke, TBI, anoxia, etc.),
neurodegenerative illnesses (e.g., dementia, Parkinson’s Disease), and ADHD. She also
provides individual psychotherapy based on empirically-supported treatments, including
Cognitive-Behavioral Therapy (CBT) or Cognitive Processing Therapy (CPT), to facilitate
coping and adjustment to health-related problems, and to treat depression and anxiety
disorders. Research interests have focused on identifying predictive patterns of performance
in neuropsychological assessment, relationships between concussion and PTSD in veterans
with exposure to blast injury, and predictors of recovery from acquired brain injury.

Dr. Neipert obtained her Ph.D. from the University of Houston clinical psychology-
neuropsychology track program. She completed her internship at the University of Alabama
Psychology Training Consortium with a focus in rehabilitation/neuropsychology, and a 2-year
neuropsychology postdoctoral fellowship at Mentis Neuro Rehabilitation. From there, she
became a partner at Medical Psychology Associates, PC, and currently consults at various
facilities in the Southeast Houston area.

Bayshore Medical Center Welcomes First Class
of Lincoln Memorial University Medical
Students for Clinical Rotations

Bayshore Medical Center welcomes it’s first class of eighteen medical students from Lincoln Memorial University-DeBusk
College of Osteopathic Medicine (LMU-DCOM) in Harrogate, Tennessee. Physicians and staff are looking forward to
working with them and being a part of their medical school education.
Third and fourth year medical school students began rotations at Bayshore Medical Center on July 24th. Clinical rotations
allow them to progress out of the classroom and lab into clinical scenarios for the many service lines we offer at the
hospital. Under the direct supervision of physicians, the medical students interview and examine patients, review clinical
information, make hospital rounds, participate in interdisciplinary team meetings, practice appropriate documentation and
perform procedures.
The Lincoln Memorial University-DeBusk College of Osteopathic Medicine students are very enthusiastic to make a
difference and bring new energy to the hospital. Their medical training consists of four years of graduate school, which
includes second years focused on classroom and lab studies at first. The final two years are their actual hands on training,
which is what they hope to experience here at Bayshore Medical Center and gain exposure to the many different service
lines we offer such as Behavioral Health, Obstetrics/Gynecology, General Surgery, and Cardiology.
"Bayshore Medical Center is committed to providing opportunities for the medical students to learn and contribute to
caring for our patients." said Jeanna Bamburg, Chief Executive Officer.
“We believe that hospitals that teach tend to be better,” said Bamburg. “This is a journey of education for these young
people that are devoting their lives to the care of others. Exposing these students to the quality of life here in the
Pasadena community, it is our hope that many of our graduates will remain local, providing compassionate, patient-
centered care for the underserved in our communities.”
The students from LMU-DCOM can add to the culture here at Bayshore Medical Center with their enthusiasm, vitality,
and build diverse interests at our facility. The Pasadena area would also see a positive impact as they support the local
economy living and dining in the area.

LMU-DCOM medical student Uchenne Mbaraonye went on to speak about the Pasadena community, “The community
has been supportive and welcoming, which has made the transition easier. In my current rotation in Geriatric
Psychology, I have learned that the physician-patient relationship is the key to treatment.”

“Taking the time to slow down and engage with psych patients is important. It has opened my eyes to realize that they
were living a normal life and are now in a vulnerable stage. It is up to us as medical providers to help them get back to
being a healthier and mentally stable person. It reminds me of the quotes from Abraham Varghese ‘I think we learn from
medicine everywhere that it is, at its heart, a human endeavor, requiring good science but also a limitless curiosity and
interest in your fellow human being, and that the physician-patient relationship is key; all else follows from it.’ This
program is teaching us to be competent and compassionate caregivers," said Mbaraonye.

LMU-DCOM Chief Medical Student Kelsi Curnow discussed her pediatric rotation with Dr. Ashu Syal as being
“Challenging and rewarding at the same time. Dr. Syal has really taken me under her wing to learn more about Pediatrics.
She has changed the way of how I thought a standard medical diagnosis and treatment might work for every patient to
now thinking differently about each individual patient’s needs and care.”

Curnow went to add that “I am really glad I chose Bayshore Medical Center in Pasadena, Texas as the site for clinical
rotations. It is the third largest site out of the twenty-four our school allows us to choose from. I am looking forward
learning at Bayshore Medical Center,” said Curnow.

Another student from LMU-DCOM James Hubley who grew up in Madisonville, Texas discussed more about the
opportunity mentioning, "This is the opportunity that we have been fortunate to have as students as we learn more about
clinical medicine. Many of us have grown up in communities similar to Pasadena and it is an honor to have a hand in
serving this community."

To learn more about the LMU-DCOM program, contact Sarah DeSantiago, Bayshore Medical Center medical student
coordinator, at 713-359-1010.

Lincoln Memorial University Medical
Students at

Bayshore Medical Center

Beginning Monday, July 24, 2017, Lincoln Memorial University's 3rd and 4th year Medical students will
start their rotations at Bayshore Medical Center. There will be a total of 18 students.

Required Rotations and Selective/Elective Rotations
Internal Medicine 8 weeks
Medical Selective 4 weeks
General Surgery 4 weeks
Surgical Selective 4 weeks
Obstetrics/Gynecology 4 weeks
Primary Care Selective 4 weeks
Pediatrics 4 weeks
Elective 4 weeks
Family Medicine 4 weeks
Winter Break 4 weeks
Behavioral Health 4 weeks
Special Thanks to our Preceptors
Sathish Cayenne, MD Cardiology
Rajan Parikh, MD Emergency Medicine
John Kirkwood, DO Family Medicine
Toby Kirkwood, DO Family Medicine
Milton Kirkwood, DO Family Medicine
Ronald Kirkwood, DO Family Medicine
Daniel Darmadi, MD Gastro
Harry Ojeas, MD Gastro
Ronald Sanchez-Silva, Hospitalist
Cindy Trinh, MD ICCIntensivist
Bassem Tawadrous, MD OB/GYN
Fernando Ocon, MD OB/GYN
Ashu Syal, MD Pediatrics
Adran Trabulsi, MD Pediatrics
Salah Qureshi, MD Psychiatry
David Lam, MD Surgery
David Gelber, MD Surgery



Schedulilng ExpressSM

Bayshore Medical Center and East Houston Regional Medical Center

FAQs for Surgeon offices on Scheduling
ExpressSM

These are broken into two sections, the first section is for the Calendar View-Only release, and the second is
for the use of the eBooking requests, which are anticipated to be available the first quarter of 2017.

Section One: Calendar View-Only

• How long does it take to log in?
o Not long at all, typically 3-5 seconds (username and password required)
o Surgeons and their staff can use their “preferred” email address as their username, which is
included as part of the eSAF process.

• Does it matter what version of windows people have? What operating system or web
browsers?

o Scheduling ExpressSM can be accessed using Apple or PC desktops/laptops. The only thing
that really matters is browsers:

- Internet Explorer 11 and above
- Safari
- Chrome
- Firefox
o Scheduling Express was not designed for a mobile browser on the iPad or iPhone, but appears

to be able to be viewed. Screen size is a factor and is not recommended for iPhone
smartphone use, as it is difficult to view properly.

• How often is Scheduling ExpressSM updated?
o Scheduling ExpressSM automatically receives the live schedule from Meditech approximately
every 5 minutes, so that the schedule and block information will be very closely in sync with
what is in Meditech.

• How can people tell which rooms are which?
o Scheduling ExpressSM displays the room’s name that exists in Meditech, and the facility OR
analyst can update Meditech to display pertinent information in the room description, like if it
is a robotic room, has special equipment, etc.
o Additionally, the Hospital Scheduler can limit which rooms a surgeon and their staff can view,
so that they have access to the rooms that are pertinent to their specialty (e.g. Ortho
surgeons can see the Ortho rooms)

• Will other surgeon offices be able to see other surgeon’s case volume and/or book into their
block time on this tool?

o No, time that is related to another surgeon, either as a case or block, will be displayed in
Scheduling ExpressSM as ‘Confidential’ to other surgeons. Privacy of cases, patient
information, and blocks are important to surgeons, and Scheduling ExpressSM is designed to
respect that privacy.

FAQs for Surgeon offices on Scheduling
ExpressSM

• Who do surgeons and their staff call for problems with Scheduling ExpressSM?
o Questions about the schedule (missing cases/blocks, etc.): Contact the Hospital Scheduler
o Can login but don’t have any hospitals to choose from: call the Physician Support Coordinator
o Have never logged in: request access from the Physician Support Coordinator
o Have been able to login before, but can’t login anymore, or receive an error: call the same support
number they use for the other HCA systems, which is typically the technical support number for the
hospital’s Meditech support line.

• How do surgeons get new staff registered to be able to use Scheduling ExpressSM if there is
turnover?
o The local Physician Support Coordinator for the hospital will be responsible for getting new staff
registered into Scheduling ExpressSM, as well as deactivating access for those that have left

• Can it be used for multiple HCA hospitals?
o Yes, as long as they have permissions in Meditech for associated HCA hospitals

• Can they set the default hospital to their preferred hospital if they have privileges to multiple
HCA hospitals?
o Not yet, and this has been noted to be included in a future release.

Section Two: eBooking Requests (availability anticipated Q1 of 2017)

• Will the surgeon or their staff be able to book via ipad or iphone?
o Mobile Browsers on iPads/iPhones are not supported at this time. The ability to view the schedule
appears to work well using Chrome on an iPad, but filling out the electronic form does not appear
to work and is not advised.

• Is Scheduling ExpressSM going to replace the in-house OR schedulers?
o No, this will simply be another (easier and more accurate) way for them to receive the booking
requests.
o Furthermore, due to the complex nature of case scheduling, the items/equipment/staff/instruments
that need to be available for a case to be scheduled, we need our schedulers to continue to check
that we have everything needed so that the case CAN be scheduled, and then to actually schedule
it in Meditech. Scheduling ExpressSM will not do this for them.
o Also, the schedulers will still need to be available for our surgeons and office staff to call them for
add-ons, as well as the cases that are needed within 24-48 hours of the day of surgery. Scheduling
ExpressSM will not allow electronic requests for cases to be submitted this close to the day of
surgery.
o Studies have also shown that when an electronic form is used, there is a positive impact to patient
care due to less interpretation of spelling, handwriting, etc.

• Is Scheduling ExpressSM interfaced directly into Meditech, or does the Hospital Scheduler still
need to schedule the case?
o The scheduler will still need to review the electronic request and use it to manually schedule the
patient in Meditech (there is no interface back into Meditech). Once they are done scheduling it in
Meditech, the case information will automatically flow from Meditech over to Scheduling ExpressSM
and match up with the electronic request.

FAQs for Surgeon offices on Scheduling
ExpressSM

• How do they know their case has been approved and booked in Meditech? Will they receive
notification?
o Once scheduled, the request will disappear from the calendar view and be replaced by the actual
case, with a visual indicator that the case was scheduled as the result of the request.
o Also, the office staff will have a worklist view where they will be able to see a request change status
to “Completed”
o Also, the office staff can decide to turn on various email notifications using their user settings in
Scheduling ExpressSM

• When a case gets “moved” in Scheduling ExpressSM, does it automatically get moved in
Meditech?
o No, this is treated as a “reschedule” request, which shows up in the Hospital Scheduler’s worklist to
be processed. Once the Hospital Scheduler reschedules it in Meditech, the case will automatically
update in Scheduling ExpressSM with the new date/time/room, etc.

• Will surgeons be able to book in cysto and endo rooms as well or just ORs?
o Yes, as long as the room is assigned to a room type (General, Open Heart, Cysto, Endo) for the
Surgical Services Dashboard, the room will be available in Scheduling ExpressSM. This strategy also
allows for rooms to be separated into facilities/locations that share a Meditech database, which is
managed in the Surgical Services Dashboard.
o People have asked if Cath Lab cases can be scheduled through Scheduling ExpressSM. Not at this
time and there are no plans in the near future to do so. Only rooms that are part of the Surgical
Services Metrics Dashboard are available in Scheduling ExpressSM.

• Can all of a surgeon’s schedulers see all of their surgeon’s cases in Scheduling ExpressSM, or
can each scheduler only see the cases they themselves have booked?

o They can view all of their surgeon’s cases and requests
• If someone is a scheduler for multiple surgeons, or if a set of office schedulers is responsible for

a group of surgeons, can they book in all of their surgeons’ blocks, and yet be able to
differentiate when trying to book a case as to which doctor is doing the case?

o Yes, they will be able to see blocks and cases for all the surgeons in their practice. When they fill out
the electronic request, they will select which specific surgeon is doing each procedure for the case.

• If there are comments/changes, will the trail of comments be visible to both OR and office
schedulers?

o Yes, Scheduling ExpressSM will keep track of all the comments (and when they were made) and be
available to everyone that has access to that case/request.

• Can Scheduling ExpressSM be used to request a case during a surgeon’s block?
o Yes, the office will still have to fill out the electronic request so the scheduler can actually schedule
the patient in Meditech, and the case will then automatically flow back into the tool and show as
scheduled in that Surgeon’s block.

FAQs for Surgeon offices on Scheduling
ExpressSM

• What happens if a surgeon or their staff submits a case online and someone else calls in for a
case request at the exact same time? Who gets priority?
o The Hospital Scheduler is still expected to follow their facility’s policy for order of priority, and to
treat a Scheduling ExpressSM electronic request the same as a faxed request (which also has a
timestamp of when it was faxed). Furthermore, the Hospital Scheduler will be able to review
Scheduling ExpressSM while they are on the phone or looking at a fax request, in order to know if
there has been a request for the same time. Scheduled cases, blocks, and submitted requests will all
be displayed together on Scheduling Express’SM calendar view, in order to provide a quick and easy
way to view any scheduled and requested activity for the room and day.

• If their procedure requires special equipment, personnel, or other such special requests, how
can they request those and be assured that they are factored in when the case is approved (i.e.
robot, microscope, laser, Interventional radiologist, etc)?
o There is a place in the request to note any special needs like this. The hospital scheduler will review
the notes and confirm they are available in order to schedule the case.

• Can the Surgeons and Clinic staff attach documents, and send over surgery orders this way?
Or do they still have to fax in orders?

o Each facility determines what types of attachments they can accommodate in Scheduling ExpressSM.
If the facility has added “orders’ as an available file type, the users can attach orders for the patient,
as well as several types of documents, like the patient’s info from your own EMR. They are still able
to fax in orders and/or other documents if desired

•How does the preop testing scheduling happen and how do patients get notified of their preop
testing appointment?

o The PAT requested date and time gets processed following the current process at each facility. For
example, if the Hospital scheduler also schedules PAT and then notifies the surgeon’s staff, then they
will continue to follow that process.

• How do the hospital schedulers calculate turn-around time between cases and or surgery
lengths to ensure that offices aren’t cramming cases into a timeslot knowing that they will push
later cases back?

o Prior to actually scheduling the case, the Hospital Schedulers will continue to use their knowledge
and/or the Meditech screen that calculates the average duration for the surgeon for the procedure
requested. The offices may request durations that aren’t actually possible to accommodate, and the
hospital scheduler can either return the request or call the office to work out an alternative time
prior to completing the request.

• What is the average time to book a case using Scheduling ExpressSM vs calling in?
o At a minimum, each request should be processed the same day it is submitted.
o Also, the submitted requests display on the schedule and the system does not allow others to submit
a request while the request for a room/date/time is waiting to be processed.
o Furthermore, each facility will set expectations for their schedulers to process these requests. Each
user can also use various email alerts to inform them of aging requests.

BAYSHORE & EAST HOUSTON REGIONAL MEDICAL CENTER PRESENT

2017 EMS Symposium

THURSDAY, SEPTEMBER 14, 2017 7:30 AM TO 4:30 PM COST: Free, includes CEs and Meals

FEATURED SPEAKER BOB PAGE, M.Ed., NRP, CCP, NCEE

Bob Page is an internationally known speaker, instructor, author and
paramedic. He has presented seminars across the United States, Canada,
Mexico Europe, the Middle East and Japan. He is recognized for his
energetic, humorous and motivational style. Bob takes ordinarily dry and
hard to teach topics and transforms them into a fun, learning experience.

Please join us in touring the AMBUS and to view the resources our
region has in the event of mass casualty incident or natural disaster.
EMTF-6 will set up the AMBUS, Decon and Communications
trailer and various supplies to demostrate what is available in
the event they are called out for additional assistance.

HANDS ON HEART DISSECTION WITH ABBOTT
VENDOR BOOTHS

BREAKFAST, LUNCH AND SNACKS WILL BE PROVIDED

CE PARTNER WITH SETRAC

RSVP Space is limited - Register today!
TODAY! Leslie Ferrell, HCA Director
of EMS & Outreach
BS-920-0785
Text or call (281) 795-9299

Email: [email protected]

New Leadership

at Bayshore Medical Center and East Houston Regional Medical Center

Mark Kelton Jenny Smith
Trauma Manager, EHRMC Director ER, EHRMC

What is ePrescribe

at Bayshore Medical Center and East Houston Regional Medical Center

ePrescribe will allow the provider to send electronic prescriptions, both controlled and non controlled
substances, to participating pharmacies

Real time insurance eligibility

Formulary checking is performed within Meditech

Are you Ready to ePrescribe?

Do you discharge patients electronically via Meditech with prescriptions?

If you are interested in ELECTRONICALLY SUBMITTING your prescriptions to your patients pharmacy of
choice – please call 713-359-2763 (CPOE) and let us know you would like to be set up.

A BI-MONTHLY PUBLICATION FOR PHYSICIANS 4

Set up is easy, free for providers who meet requirements (400$ annual fee is waived) and the only
requirement is to utilize ePrescribe on Discharged Inpatients.

Social Media

We live in the age of social media, Post, Blog, Link, Chat, Share, Follow, Friend and Comment.

We want everyone to know where, what, when, and how we are doing. And the fastest way to get that information
out?

On the internet; however, being in the Healthcare business we have to ensure that our Patients Privacy is protected.
What can be posted on social media? Below is a link to the HCA policies and guidelines that outline what your
responsibilities are when on social media networks.Any questions please contact Melissa Monmouth, Facility Privacy
Official at 713-359-1089 or 713-393-2161.

https://pf.idf.medcity.net/idp/SSO.saml2
EC.026
HCA Social Media Guidelines

Patients’ Right to Request Privacy Restrictions

Medical privacy is vitally important. Maintaining the privacy of medical information literally saves lives because, without
the assurance of privacy, people may avoid life-enhancing and life-saving treatments. In the case of health care, though,
privacy is very much a means to improving medical outcomes. People who know they can trust the health care system
are more likely to seek full treatment. In this way, privacy has concrete benefits for each individual, and for society as a
whole. A quick reminder/update on the correct steps to take when a Patient requests a Privacy Restriction.
Below are the highlights of what is required when the Patient requests a Privacy Restriction:
1. The facility must permit a patient to request restriction on the use of PHI.
2. Request for restriction must be present in writing.
3. The written request must be routed to the FPO; the FPO and designee are the only individuals who may

agree to any restrictions.
4. This right to request and the process are also located in the NOPP (Notice of Privacy
Practices).

What is
MyHealthOne?

A secure, online environment Today we have many consumer & patient portals. MyHealthOne will allow these
that connects patients and features and functions to reside together in one place.
caregivers to personal health
records and tools through REGS PATIENT
local facility Websites. PORTAL
MEDITECH
Represents a significant
transformation of our existing Meets Meaningful Use requirements
MEDITECH Patient Portal, creating (MU2)
an industry-leading digital
experience for patients DATA Hospital
Integrates with HUT: SOURCE
Healthcare Unified Physician
Technology, the HCA BASIC practice*
strategic web solution FEATURES
Will allow HCA to quickly and View, download & transmit clinical
consis-tently launch new features info
and func-tions to local facilities Schedule an appointment
online
Combines HCA brand
standards with local facility Bill
branding. pay

Prominently features local Find a
branding and is accessible from physician
local market facility websites
Creates a consistent Sign up for classes and
user experience across events
all HCA facilities
New design, easier navigation Pre-register for
and user profiles create a procedures
personalized, user-friendly
experience Send messages to care
team*
CLINICAL
INFORMATION Request
refills*
Transition of care;
summary of care *Indicates Future Release

AVAILABLE IN
MYHEALTHONE
Immediately. Content in the transition of care/summary of care is visible to patients
once the data has been delivered from MEDITECH, which may be immediately after
finalization in MEDITECH or upon discharge

Discharge instructions One hour after discharge
Lab results Lab results (including microbiology, sensitive labs, and abnormal results; only
excluding pathology and blood bank) display to patients immediately after test is
verified and resulted by lab

Imaging reports 96 hours after final signature
Procedure list Approximately 3-4 days post discharge, once health information management coding is
complete

Medical Staff Calendar

2017 BAYSHORE/EAST HOUSTON MEDICAL STAFF LEADERSHIP MEETING CALENDAR

August 17th Bayshore Department of Pediatrics @12:30
August 21st Bayshore Medical Center Campus Executive Committee @ 6 pm C 1 & 2
August 22nd East Houston Campus Executive Commitee @ 12:30 pm LCR
August 22nd Peer Review - East Houston @ 7:00 am HR/2
August 23rd Dual Campus Medical Executive Committee @ 7 am
August 23rd Board of Trustees Conference Call at 12 pm
August 24th East Houston Department of OB/GYN and Pediatrics @ 12:30 BMC
BMC DDR/EH LCR