Category Archives: News

New Psychiatric Provider Answering Service

AlertMD On-Call number for Psychiatry: 815-206-3437

Effective Wednesday, September 13, 2017

Situation

There is no single point of access to contact the scheduled on-call Psychiatric Provider. At times, there is confusion around who is on-call for which service, which results in delayed responses.

Background

The Psychiatric Provider team manages multiple call lists for the ED, med floors, and inpatient behavioral health unit. Schedules are distributed across departments but become quickly outdated as schedules change.

Assessment

A single point of access is required to ensure a caller can access the correct Psychiatric

Provider within a timely fashion.

Recommendation

Utilize the Center and AlertMD to establish a single access point; populating the schedule behind the scenes to ensure each caller is accessing the most up to date on-call schedule and Provider resource.

Medical Providers, Nurses, and Care Coordinators serving patients on the Medical floors will be able to access the Psychiatric Provider by calling 815-206-3437.

After dialing this number, you will hear three options:

  1. If you are calling from the ER, please press 1
  2. If you are calling from a Medical Floor, please press 2
  3. If you are calling from the Inpatient Behavioral health floor, please press 3

Once you make your selection, you will be greeted by the operator. The operator will page the psychiatrist on call through Alert MD. The Psychiatrist has 15 minutes to respond. If they do not respond, the operator will page again.

Please contact Susan Yerkes with any issues. (815)334-5582 or Email: syerkes@centegra.com

     

CHM Receives Blue Distinction Award

From: Heidi Close, Director of Women’s Services Centegra Health System

Rachel Sebastian, President McHenry Hospital

Peggy Norton-Rosko, MSN, RN, NEA-C SVP & Chief Nursing Officer Centegra Health System __________________________________________________________________________________________

We are excited to announce that Blue Cross and Blue Shield of Illinois recently awarded Centegra McHenry Hospital the Blue Distinction® Center for Maternity Care designation (BDC). Blue Distinction® is a national designation program recognizing healthcare facilities that demonstrate expertise in delivering quality specialty care – safely, effectively, and cost efficiently.

Facilities are evaluated on quality metrics developed through a process that includes:

  • Input from the medical community and quality measurement experts.
  • Review of medical literature together with national quality and safety initiatives.
  • Thorough analysis of meaningful quality measures from objective, publicly available sources.

    In addition hospitals that receive the BDC Maternity Care designation must also attest to having certain structural components in place and commit to ongoing reporting and quality improvement obligations. The program also evaluates hospitals on overall patient satisfaction, including a willingness to recommend the hospital to others. Blue Distinction® Centers demonstrate better overall patient satisfaction and a lower percentage of early elective deliveries.

    Join us in congratulating our entire Women’s Health team as they continue to provide outstanding care to our community.

D5W / 0.45% NS Shortage 9.1.17

To:      Company-Wide

From: Dima Awad, PharmD, MS, System Director of Pharmacy Services

Date:  August 31, 2017

Re:      D5W/0.45% NS Shortage

SITUATION

We are experiencing a shortage in D5W/0.45% NS.

BACKGROUND

Medications including IV fluid shortages keep occurring at great frequency, this situation has been worsening over the past several years due to multiple factors such as fewer suppliers, inability to acquire active ingredients, issues with packaging and more.

ASSESSMENT

Currently, Pharmacy services has a 1 day supply of D5W/0.45% NS. When the current supply of D5W/0.45% NS becomes depleted, a plan for automatic substitution needs to be implemented. This is not a new workflow nor is it a change in practice in case of shortages.

RECOMMENDATION

When supply becomes depleted, Pharmacy services will initiate substitution with D5W/0.225% NS, to be administered at same infusion rate that was ordered. Pharmacy services will place “Substituted for D5W/0.45% NS” in the comment section of the Paragon order so that nursing is aware of the change. This substitution has been approved by The Pharmacy and Therapeutics Committee. Pharmacy will also maintain vigil on availability of D5W/0.225%, as we anticipate that increased use will decrease supply.

 

pembrolizumab (KEYTRUDA) in Patients with Multiple Myeloma: FDA Statement – Two Clinical Trials On Hold

Keytruda (pembrolizumab) in Patients with Multiple Myeloma: FDA Statement – Two Clinical Trials on Hold
AUDIENCE: Oncology
ISSUE: Based on data from two recently halted clinical trials, the U.S. Food and Drug Administration today is issuing this statement to inform the public, health care professionals, and oncology clinical investigators about the risks associated with the use of Keytruda (pembrolizumab) in combination with dexamethasone and an immunomodulatory agent (lenalidomide or pomalidomide) for the treatment of patients with multiple myeloma. Keytruda (pembrolizumab) is not approved for treatment of multiple myeloma.
The FDA statement is based on review of data from two clinical trials (KEYNOTE-183 and KEYNOTE-185) evaluating the use of Keytruda (pembrolizumab) combined with other treatments in patients with multiple myeloma. On July 3, 2017, the FDA required that all patients in these trials be discontinued from further investigation with this drug, because interim results from both trials demonstrated an increased risk of death for patients receiving Keytruda (pembrolizumab) when it was combined with an immunomodulatory agent as compared to the control group (see statistical analysis section below). Merck & Co., Inc. was made aware of the issue through an external data monitoring committee recommendation and suspended the trials to enrollment on June 12, 2017. Continue reading

Johns Hopkins ABX Guides

Pharmacy Services has subscribed to Johns Hopkins ABX Guide for use by all associates at Centegra Health System to support our multidisciplinary approach to the Antimicrobial Stewardship Program Clinical Decision Support Tools and Education

Johns Hopkins ABX Guide is a comprehensive web source that provides regularly updated, evidence-based decision resources regarding antibiotics, diagnosis, pathogens, management of infections and vaccines.

Prior to the Guide, CHS did not have a specific detailed resource for antibiotics clinical decision support.

Johns Hopkins ABX Guide may be accessed through Unbound Medicine’s uCentral as follows:

QUAD Strength Vasopressors

The following will no longer be available for use at CHS:

  • QUAD Strength NorEPINEPHrine
  • QUAD Strength Phenylephrine

Thank you,

Alan Mader, PharmD, BCPS, Pharmacy Clinical Coordinator  815-759-4407

FDA MedWatch – Canagliflozin (INVOKANA, INVOKAMET)

MedWatch – The FDA Safety Information and Adverse Event Reporting Program
Canagliflozin (Invokana, Invokamet): Drug Safety Communication – Increased Risk of Leg and Foot Amputations
AUDIENCE: Internal Medicine, Family Practice, Pharmacy, Patient
ISSUE: Based on new data from two large clinical trials, the FDA has concluded that the type 2 diabetes medicine canagliflozin (Invokana, Invokamet, Invokamet XR) causes an increased risk of leg and foot amputations. FDA is requiring new warnings, including the most prominent Boxed Warning, to be added to the canagliflozin drug labels to describe this risk.
Final results from two clinical trials – the CANVAS (Canagliflozin Cardiovascular Assessment Study) and CANVAS-R (A Study of the Effects of Canagliflozin on Renal Endpoints in Adult Participants With Type 2 Diabetes Mellitus) – showed that leg and foot amputations occurred about twice as often in patients treated with canagliflozin compared to patients treated with placebo, which is an inactive treatment. Amputations of the toe and middle of the foot were the most common; however, amputations involving the leg, below and above the knee, also occurred. Some patients had more than one amputation, some involving both limbs. See the FDA Drug Safety Communication for additional information, including a data summary.
BACKGROUND: This information is an update to the May 18, 2016 MedWatch safety alert. Canagliflozin is a prescription medicine used with diet and exercise to lower blood sugar in adults with type 2 diabetes. It belongs to a class of drugs called sodium-glucose cotransporter-2 (SGLT2) inhibitors. Canagliflozin lowers blood sugar by causing the kidneys to remove sugar from the body through the urine. It is available as a single-ingredient product under the brand name Invokana and also in combination with the diabetes medicine metformin under the brand name Invokamet.
RECOMMENDATION: Patients taking canagliflozin should notify your health care professionals right away if you develop new pain or tenderness, sores or ulcers, or infections in your legs or feet. Talk to your health care professional if you have questions or concerns. Do not stop taking your diabetes medicine without first talking to your health care professional.
Health care professionals should, before starting canagliflozin, consider factors that may predispose patients to the need for amputations. These factors include a history of prior amputation, peripheral vascular disease, neuropathy, and diabetic foot ulcers. Monitor patients receiving canagliflozin for the signs and symptoms described above and discontinue canagliflozin if these complications occur.
Healthcare professionals and patients are encouraged to report adverse events or side effects related to the use of these products to the FDA’s MedWatch Safety Information and Adverse Event Reporting Program:
• Complete and submit the report Online: www.fda.gov/MedWatch/report
• Download form or call 1-800-332-1088 to request a reporting form, then complete and return to the address on the pre-addressed form, or submit by fax to 1-800-FDA-0178
Read the MedWatch safety alert, including a link to the FDA Drug Safety Communication, at:
https://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm558605.htm
________________________________________
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Centegra Hospital Huntley Laboratory Passes Initial CAP Inspection

It is with great pleasure that we announce the successful completion of the Laboratory CAP (College of American Pathologist) inspection at Centegra Hospital Huntley.  We were surveyed Monday May 1, 2017 by 8 Inspectors from various hospitals in the Midwest as well as three College of American Pathologist inspectors.

Our Laboratory successfully met the Laboratory Accreditation Program standards in all areas.  Some corrections or additions of procedures and/or policies are required and will be fulfilled within the next 30 days.  This Accreditation also meets requirements for the Joint Commission and CMS.

The surveyors were very impressed with the quality of the laboratory and the helpfulness of the leaders and the staff.  Their comments were that the laboratory provided high quality care to our patients and was very well organized.  The inspectors stated that this was the best initial inspection they participated in.

The positive outcome of the survey is directly attributed to the daily dedication to quality demonstrated by the Associates of the laboratory.  The Laboratory Leadership and Associates are congratulated on this success!

  • Wendy Ward, MD Director of Pathology & Laboratory Medicine
  • Rebecca Rockwood, Administrative Director Laboratory Services, Respiratory, Sleep and Neurology

Physician’s Core Measures Pocket Guide

The Pocket Guide has been updated to include Sepsis.

Core Measure Physician Pocket Guide Medsource Version

CHW Ultrasound and Nuclear Medicine Change in Hours

Starting August 9th, the hours of operations for CHW Ultrasound will be as follows:

General Ultrasound

Monday-Friday 6:30 am to 7:30 pm

Saturday 7:00 am to 3:30 pm

Sunday call only

 

Monday-Friday on-call from 7:30 pm to 6:30 am

Saturday after 3:30pm to Monday morning on-call

 

 Echo Ultrasound

Monday-Friday 6:30 am to 3:00pm

Monday-Friday on-call from 3:00 pm to 6:30 am**

Saturday and Sunday on-call only**

***Cardiologist approval needed for STAT call-ins***

 

For CHW Nuclear Medicine:

Nuclear Medicine

Monday-Friday 7:00 am to 4:00 pm

 

Monday-Friday on-call from 4:00pm to 7:00 pm

Saturday and Sunday call only 7:00am to 7:00pm

 

Any emergent Nuclear Medicine after hour exams will need to be sent to CHH or CHM.