Group Title: DoHM newsletter
Title: DoHM newsletter. October 2008.
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 Material Information
Title: DoHM newsletter. October 2008.
Series Title: DoHM newsletter
Physical Description: Serial
Creator: Division of Hospital Medicine, College of Medicine, University of Florida
Publisher: Division of Hospital Medicine, College of Medicine, University of Florida
Publication Date: October 2008
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Bibliographic ID: UF00088874
Volume ID: VID00006
Source Institution: University of Florida
Rights Management: All rights reserved by the source institution and holding location.


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Present on Admission (POA)-New CMS update

Special points o1

* Present on Adm
sion (POA)

* Admission and
charge Notificat

* October Babies

* Hospitalist Hum

Inside this issue:

Opioid dependence

Hurricane Season

This Month's events

Personal Message
from Dr House

Under Construction

Getting to know you





The Centers for Medicare and Medicaid Services
(CMS) has recently updated their Hospital Acquired
Conditions and Present on Admission indicators.
Effective October 1, 2008, if there is no documenta-
tion indicating the condition was present on arrival,
CMS will not pay for the treatment costs. A list of
these conditions is listed below:

* Stage III and IV pressure ulcers

* Fall or Trauma

* Vascular catheter-associated infection

* Foreign object retained after surgery

* Certain surgical site infections

* Air embolism

* Blood incompatibility

* Certain manifestations of poor control of blood

* Deep-vein thrombosis and pulmonary embo-
lism after total knee or hip replacement.

These changes are occurring in effort for CMS to
not pay for preventable inpatient complications
since in the fiscal year of 2007, Medicare assigned
more than $22 billion in higher DRG payments to
treat those events (Today's Hospitalist, September
2008). Per Dr. Draghut, Physician Advisor for
Shands Health Information Management Departe-
ment, the Division of Hospital Medicine needs to
indicate in their history and physical, if a patient
has any of those conditions upon arrival. Dr.
Draghut will be in attendance for the division meet-
ing in October to further clarify these new require-


Today's Hospitalist Magazine. September 2008

Admission and Discharge Faxes

2 Dr. House and Felixia Colon met with Bill Hastede and Ron Timonere on Sept. 30, 2008 to discuss the newly
implemented, automated admission and discharge fax capability. Janet Gordon, Clinical Application Manager in
2 IT has confirmed that when patients "indicate that they want their Primary Care Physician notified of their ad-
mission, a notice will automatically be faxed with the admitting diagnosis. Upon discharge, a summary notice is
3 faxed and it will include the discharge status of the patient, i.e. home health, d/c home or d/c to nursing home".
In lieu of this new service, the Division of Hospital Medicine needs to indicate if the patient has a PCP and note
3 the PCP name, if applicable, in the patient's history and physical. Also, Shands Health Information Management
3 Department (HIM) has confirmed that they are mailing out discharge summaries to "outside MDs, nursing
homes, clinics, etc". Currently, no discharge summaries are being mailed to UF physicians since they should
access the summary through Portal. Annette Wrabel, Director of HIM, has verified that discharge summaries are
being mailed on a daily basis. Physicians need to also remember when completing dictations, please include the
PCP name in the cc:d section. More information will be forthcoming as these processes develop.

Is M N st

Opioid Dependence

October birthdays:

October 4

Dr. Sanchez

October 13

Wendy (C i,,,,, ,, i,

The pain can be as simple as a back ache, a patient gets a prescription for Hydrocodone. Then after a
while, a person's dependence on that opioid prescription may become progressively worse. Accord-
ing to, opioid dependence is one of the fastest
growing "addictions" and is one of the highest untreated conditions as
well. Currently, there are 1847 treatment programs found in the United
States, with Florida having 68 programs(www.
',.'...i,.c is a buprenorphine HCl/naxlone HC1 dihydrate Clll sublin-
gual tablet that is indicated for the treatment of opioid dependence
( Due to recent change in legislation, a physician can
now treat up to 100 opioid dependent patients. Per iii,.- .. .i inc website, there are currently four (4)
UF physicians that can treat opioid dependence; Drs. Sternberg, Reisfield, Wilson, Michel and
Kancha. If you would like to find out more information, please visit

Hurricane Season-Its still not over!!

For those of us that
live on the eastern
seaboard, hurricane
season runs from
June 1st until No-
vember 30th. Last
year, tropical
storms such as
Melissa, Fifteen
and Olga occurred
late in the season. As well as Hurricane Noel
that passed over areas of the Caribbean late
October 2007 ( The Division
of General Internal Medicine and Hospital
Medicine have a hurricane preparedness plan
that is to be implemented in the event of a hur-
ricane warning/hurricane. Based upon the divi-
sions' hurricane plan, an alpha and an omega

This Month's Events

team will rotate every 48 hours. A copy of this
policy is saved on the divisions' common shared
folder and in the 4th floor office. The team assign-
ments for the Hospital Medicine Division:

Alpha Team
Team Leader: Dr. Po
Drs. Garg, Cottey, Aung, Gupta, Chisholm, Asis-
tores, and Sanchez
Non-Physician Provider: Elaine Borne

Omega Team
Team Leader: Dr. Konda
Drs. Kancha, Ayvazyan, Maalouf, Kharrazi, Htoo,
Hernandez, Kodali, Mughal
Non-Physician Provider: Wendy Chambers

Every Wednesday

12:00pm/LRC Audito-

Grand Rounds

Itinerary of topics and
events will be posted in our
office. Friendly reminder
page will be sent to the
physicians on site on Wed.

October 7,2008

Tower II, 10th floor

Mandatory Provider Edu-
cation Training Session

This is a mandatory meet-
ing that all providers must
attend each year. Those
scheduled for October's

Dr. Maalouf

October 21, 2008

October 29, 2008

12:30/7th fl Conference 1:30/Morgan Conference
Rm. Rm

Journal Club

Presenter for the month of
September is Dr..
Friendly reminder page
will be sent to the physi-
cians on site that day.

Division Meeting

Open Forum discussion of
issues that impact your
work at UF & Shands is
also included on the

SPage 2

Ask Dr. House-Personal Message

A Personal Message from Dr.

It is with a heavy heart I announce
that October will be Elaine Borne's
last month with the division of hos-
pital medicine. She will be leaving
to concentrate on raising her son,
Christian. Elaine has been with this
program for several years and her
contributions are large part of this

divisions success. She has been a
diligent clinician and has always
taken excellent car of her patients. I
thoroughly have enjoyed the 8 years
together, both here and our previous
hospital medicine program. Good
luck Elaine. You will be greatly

Under Construction

Recently, the chairman of the
College of Medicine, Dr. Arshag
Mooradian, completed a town-
hall meeting with the Division of
Hospital Medicine. In that meet-
ing suggestions, complaints and
issues were brought up. Consid-
ering that the Hospital Medicine
Division now has the man power
to staff the floors, ER and Pavil-
ion appropriately, its time to
move onto the next stage. The
Division will be undergoing "new
construction ", meaning a process
and protocols can now be estab-
lished. Dr. House has sent out

several emails in regards to be-
havioral norms, standards and
expectations of his staff. A mis-
sion and vision statement are cur-
rently being formed to provide
staff of the division's purpose
and goals. The division will be
working closer with Case Man-
agement to develop specific dis-
charge protocols and more thor-
ough follow up care for patients
who are underserved in the com-
munity and those that have insur-
ance. Dr. House and Felixia Colon
will be meeting with UF satellite
clinics to open up communication

channels. They will also be marketing
to community physicians to explain
the services the Division of Hospital
Medicine provides. Please look for-
ward for more information from Dr.
House in regards to physician cham-
pions for various committees and
tasks. Please be mindful of the "dust"
while the division is under construc-

Getting to know you...Nonette

Full Name: Nonette Asistores

Place of Birth: Cavite, Philippines

Favorite Color: Red

Favorite Food: Fried Ice Cream, Sweet Banana Fritters with Jackfruit

Something Unique about you: Multiple awards for BEST ACTRESS, BEST DIRECTOR, and BEST DANCE
CHOREOGRAPHER in intercollegiate competitions

Place you would like to visit: Prague, Czech Republic and Beijing, China
SPage 3

Dr. Jeff House, Division
Chief Hospital Medicine

Nonette Asistores, MD

M ison o Hopita Medcin

Division of Hospital Medicine The Division of Hospital Medicine has an established team of highly
655 West 8th Street qualified, specially trained, experienced providers. Our team works in
Jacksonville FL 32209 partnership with various entities within the hospital including special-
Phone 904-244-7024 ists and case management.
Fax 904-244-4799
E-mail hospital medicine@jax ufl edu

"Hospital Medicine is a service that allows the physicians
to optimize and provide seamless patient coverage"
-Dr. House, Division Chief Hospital Medicine

SWe're on the web! ]

Hospitalist Humor

It was on a short-cut through the hospital kitchens that Albcrt
was first approached by a member of the Antibiotic Resistance.

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