Winthrop 2012 annual report designed by Curran & Connors

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Information about Winthrop 2012 annual report designed by Curran & Connors
Health & Medicine

Published on February 4, 2014

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Winthrop-University Hospital :: 2012 Annual Report Education / Healthcare / Research Winthrop-University Hospital  2012 Annual Report 259 First Street Mineola NY 11501 516-663-0333 defining healthcare and much more

Defining Healthcare and Much More quality care quality care Winthrop-University Hospital :: 2012 Annual Report teaching teaching research research Insets: Students in the Simulation Center Eitan Akirav, PhD, Research Scientist Winthrop is about Annual Report Design: Curran & Connors, Inc. / patient safety On the cover: TAVR Team left to right: Kevin P. Marzo, MD, Chief, Division of Cardiology Scott Schubach, MD, Chairman of TCV Surgery John A. Goncalves, MD, Chief, Division of Cardiothoracic Surgery Richard Schwartz, DO, Director of Cardiovascular Outreach patient safety Winthrop is about

Defining Healthcare and Much More Winthrop-University Hospital’s mission is to provide high quality, safe, culturally competent, and comprehensive healthcare services in a teaching and research environment which improve the health and well-being of the residents of Nassau County and contiguous county areas…based on a profound commitment to an enduring guiding principle, “Your Health Means Everything.” 2012 defining healthcare and much more Page 1

Winthrop-University Hospital :: 2012 Annual Report “Winthrop has harnessed the power of its management, medical and academic acumen to grow and thrive in a responsible manner that will ensure we continue to meet the needs of our patients now and in the future.” Page 2 Charles M. Strain, Chairman of the Board John F. Collins, President & Chief Executive Officer

Defining Healthcare and Much More to our friends: A Message from the President & CEO and Chairman of the Board It is with great pleasure that we report on Winthrop-University Hospital’s accomplishments for 2012, one of the most impressive years in our history in terms of programmatic expansion. At a time in which healthcare institutions are challenged by economic and national health policy realities, Winthrop has harnessed the power of its management, medical and academic acumen to grow and thrive in a responsible manner that will ensure we continue to meet the needs of our patients now and in the future. We have experienced expansion of both our facilities and the treatment options we offer patients. We’ve grown our physician network, continued to lead our region in the use of information technology and set in motion a number of plans that will bring the highest level of care to Long Island and beyond. Building for the future One of the most visible manifestations of our progress is the active construction site along Mineola Boulevard where we broke ground in 2012 for our Research and Academic Center. The Center last year was awarded a grant of $1,000,000 from the Regional Economic Development Council that will be used to help defray the cost of construction. Forty-five permanent new jobs are expected to be created by the Center, as well as countless construction jobs during the course of completion. The 95,000-square-foot, five-story building will consolidate our research programs into one location, will offer our faculty, medical students and residents greater access to research, and will allow us to perform more bench-tobedside research. This ability to combine basic science, clinical application and medical education is invaluable. Combined with a full-featured simulation lab, the education and training opportunities offered by the Center will transform medical education in our region. As a result of our successful redesign of patient care toward more outpatient services, we doubled the size of our Ambulatory Surgery Center to accommodate the increasing number of patients and procedures performed on an ambulatory basis. Preliminary planning began last year to add a new tower to expand bed capacity, as well as expand our highly successful CyberKnife radiosurgery program into Manhattan. Financial strength Our accomplishments are possible, in part, because our financial position remains strong. In 2012, total operating revenues reached $1 billion and our market share remained steady at 16%. The financial community recognized our financial health with the successful sale in October 2012 of $130,180,000 in revenue bonds through the Nassau County Local Economic Assistance Corporation. The issue was awarded investment-grade ratings of Baa1 and BBB+ by Moody’s Investor Service and Fitch Ratings, respectively. A portion of the proceeds were used to refinance outstanding debt, yielding $19 million in net present value debt service savings, with the remainder of the proceeds being allocated for the Research and Academic Center. In a further demonstration that our sterling reputation for effective management and exceptional responsiveness to community needs is recognized, a $25 million capital campaign for the Center already has achieved 60 percent of its target. Page 3

Winthrop-University Hospital :: 2012 Annual Report Innovation in clinical care Our most important job is bringing to the community the most up-to-date, effective healthcare, and our 2012 accomplishments in this area are significant. Patients in need of heart valve replacement whose frail condition makes them ineligible for open heart surgery have new hope. Last year, Winthrop was selected as one of only about 70 hospitals and medical centers in the United States to offer Transcatheter Aortic Valve Replacement (TAVR) and currently performs the most TAVR procedures in the region. In fact, during 2012, Winthrop performed 64 TAVR procedures. (As of this printing, Winthrop has performed over 100, making it perhaps the busiest center in the U.S.). The procedure involves cardiologists and cardiothoracic surgeons working as a team to insert the new valve through an artery in the groin and then guide it into place, eliminating the need for invasive surgery. Winthrop currently is participating in a clinical trial to use the technique for intermediate-risk valve replacement. The hospital’s first computer-assisted total knee replacement was performed last year. The procedure utilizes an advanced cutting guide that greatly enhances the accuracy of the replacement knee’s fit. In response to the community need for dental care and as part of our academic mission to train healthcare providers of the future, we completed planning of our Center for Family Dental Medicine which opened in early 2013. Expanding successful programs Our pioneering fetal surgery program continued to grow last year as more Page 4 physicians and neighboring hospitals referred expectant parents. Using minimally invasive techniques, surgery can be performed in utero to treat such conditions as fetal anemia, twin-to-twin transfusion syndrome and fetal/placental tumors, with much lower risk than traditional surgery. Winthrop pioneered a novel treatment for a swallowing disorder called achalasia that allows definitive surgical incision of the sphincter muscle without the invasiveness of laparoscopic surgery. Since 2009, Winthrop—the first center in the United States to perform this advanced technique known as peroral (through the mouth) endoscopic myotomy (POEM)— has treated more than 85 patients. Physicians from around the world look to us for training in advanced techniques such as POEM. With the goal of exposing participants to novel technologies and techniques that may shape the future of endoscopy, Stavros Stavropoulos, MD, Director of Gastrointestinal Endoscopy and Director of the Program in Advanced Gastrointestinal Endoscopy (PAGE) at Winthrop, conceptualized the Long Island Live Endoscopy Course. This annual course—which has doubled in attendance since its inception in 2009— brings together health professionals to experience live, challenging endoscopy cases performed in Winthrop’s endoscopy unit and broadcast in real time through a live webcast. In the area of cancer care, Winthrop has established itself as a world leader in use of CyberKnife radiosurgery, particularly for treating prostate cancer. This technology utilizes highly targeted radiation beams rather than actual surgery to treat both benign and malignant tumors. Our radiation oncology team also applies its experience with this technique to treat patients with other cancers, such as brain and lung tumors, and also is involved in a promising clinical trial utilizing CyberKnife treatment for breast cancer patients undergoing lumpectomy. New frontiers of science Our expanding research program continues to emphasize investigation of chronic illnesses affecting our local community, including diabetes, obesity and neurodegenerative diseases, such as amyotrophic lateral sclerosis (ALS). Of particular importance, last year marked the commencement of par­ ticipation in a National Institutes of Health-funded study to determine if methotrexate, an anti-inflammatory drug, can reduce the risk of heart attack and stroke in patients with diabetes. Winthrop will be collaborating with Paul Ridker, MD, MPH, the Eugene Braunwald Professor of Medicine at the Harvard Medical School, for the multi-year study, and our researchers will both monitor enrolled patients and perform additional research. In other diabetes-related research, Winthrop scientists, collaborating with colleagues from other institutions, are unlocking the mysteries of beta cells. These cells are responsible for creating and releasing insulin.

Defining Healthcare and Much More defining clinical leadership Department Chairs: Top row, left to right: Scott Schubach, MD, Chairman of TCV Surgery; Aaron Katz, MD, Chairman of Urology; Michael Niederman, MD, Chairman of Medicine; Anthony Vintzileos, MD, Chairman of OB/GYN; Mark Stecker, MD, Chairman of Neurosciences; James Capozzi, MD, Chairman of Orthopaedic Surgery; Collin Brathwaite, MD, Chairman of Surgery; and Warren Rosenfeld, MD, Chairman of Pediatrics. Bottom row, left to right: Virginia Donovan, MD, Chairman of Pathology; Barry Rosenthal, MD, Chairman of Emergency Medicine; Orlando Ortiz, MD, Chairman of Radiology; Joseph Greco, MD, Chairman of Anesthesiology; Francis Faustino, MD, Chairman of Family Medicine; Michael Ammazzalorso, MD, Chief Medical Officer. Page 5

Winthrop-University Hospital :: 2012 Annual Report  Academic Leadership: Left to right: Steven P. Shelov, MD, MS, Associate Dean, Undergraduate Medical Education, Winthrop Clinical Campus, Stony Brook University School of Medicine; Susan Guralnick, MD, Designated Institutional Official, Associate Dean, Graduate Medical Education and Student Affairs, Winthrop Clinical Campus, Stony Brook University School of Medicine; Jack R. Scott, EdD, MPH, Assistant Dean, Faculty Development & Curriculum, Winthrop Clinical Campus, Stony Brook University School of Medicine.  Physician Hospital Organization (PHO) Committee: Left to right: Robert Bartolomeo, MD, FACP, FACG, Chairman of Winthrop PHO, Inc.; Palmira M. Cataliotti, CPA, FHFMA, Senior Vice President and Chief Financial Officer, Treasurer of Winthrop PHO, Inc.; Armando D’Arduini, MD, Additional Director of Winthrop PHO, Inc.; Barbara Kohart Kleine, Senior Vice President, Administration, Presi­ dent and Chief Financial Officer, Secretary of Winthrop PHO, Inc.; Michael Ammazzalorso, MD, Chief Medical Officer, Additional Director of Winthrop PHO, Inc. Paul Harnick, MD, Vice Chair of Winthrop PHO, Inc., is missing from the photo.  Nursing Leadership: Front row, left to right: Elaine Rowinski, RN, MPS, CEN, CCRN, Director of Nursing, Division of Cardiology; Valerie T. Terzano, MSN, RN, NEA-BC, Senior Vice President, Chief Nursing Officer; Diane Bendelier, RN, CPAN, Director of Perioperative Services; Christine Marsiello, MSN, RN-BC, CCRN, Director of Professional Nursing Practice and Education; Maura Corvino, RN, MSOL, CEN, Director of Nursing Emergency Department; Janet Shehata, MSN, RN, OCN, Director of Nursing Oncology Services; Eileen Magri, MSN, RN, NE-BC, Director of Nursing Maternal Child Health. Back row, left to right: Rita Roberts, RN, CNOR, Assistant Vice President, Perioperative Services; Lee Moldowsky, MSN, RN, BC, Nursing Quality Improvement Coordinator; Joan Marchiselli, MS, RN, NE-BC, Administrator, Continuous Compliance; Theresa Criscitelli, EdD(c), RN, CNOR, Assistant Director of Professional Nursing Practice and Education; Donna Caccavale, RN, BSN, MBA—Director of Nursing Critical Care. Page 6

Defining Healthcare and Much More Academic excellence The pioneer class of Stony Brook Univer­ sity School of Medicine students who selected Winthrop to complete the final two years of their full-time medical education on our clinical campus entered their fourth and final year in 2012 and will graduate in 2013. It is a moment of great pride to watch these young physicians move on to continue their educational journey. Assuming full responsibility for medical student training has added depth and breadth to our patient care, and we are pleased that applications to study on our campus continue to increase and to exceed our capacity. Education at every level—novice through experienced physician—and in varied disciplines ranging from nursing to pharmacy, is pivotal to our objective to become one of the premier academic medical centers in the United States. Effective management Effective management rests on capable, dedicated leadership and a focus on continuous improvement. The longevity of our top leadership team, as well as the cohesiveness of our board of directors, is a major factor in our success. We are pleased to report that last year we met our objective of a full complement of department chairs, adding leaders in neuroscience, urology and podiatry. These talented professionals will not only manage their respective departments, but also will have academic responsibilities for teaching and research. Of particular note is the Surgery Depart­ ment which, under the leadership of its newly appointed chair, Collin Brathwaite, MD, has expanded its surgical oncology program and is offering new modalities for pancreatic cancer treatment. In 2012, the Department successfully recruited John Allendorf, MD, FACS, a renowned pancreatic cancer surgical expert, formerly at Columbia Presbyterian Hospital, to head this new effort. He also will serve as department Vice Chairman. In the area of continuous improvement, we reorganized our quality and patient safety activities to better reflect our renewed commitment in this area. Last year, we appointed a Chief Quality Officer and a Patient Safety Officer, both reporting directly to the president. The emphasis on quality and patient safety is visible throughout the hospital, with everyone from medical students and staff to nurses and physicians participating in education and process improvement projects all focused on ensuring that Winthrop remains a highreliability institution. Our early adoption of, and significant investment in, healthcare information technology is greatly advancing our quality and patient safety efforts. As a matter of fact, Winthrop was named by Hospitals & Health Networks magazine as one of the nation’s “Most Wired” hospitals in 2012. Cognizant of the need to nurture new ways to improve care, Winthrop is participating in the New York State Digital Health Accelerator Program, an initiative to help early- and growthstage companies bring cutting-edge technology to the healthcare community. We are piloting a telephonic patient communication system that will facilitate follow-up after discharge. As one of the first hospitals in the nation to attest to Phase 1 Meaningful Use of Healthcare IT, we last year embarked on Phase 2. Attesting to meaningful use is the first stage of a long-range program to create a nationwide IT infrastructure that will connect providers and patients through compatible, standardized electronic health records systems. Building on success We have endeavored here to provide just a taste of the many accomplishments of the men and women who every day give their best to our patients, and we invite you to read on. Our board members, volunteers, administrators, physicians, nurses, other health professionals, and staff strive every day to make each patient’s experience a positive one. While they harness the benefits of technology, they never forget that the human touch is, perhaps, the most effective medicine. They never forget our solemn commitment to you—“Your Health Means Everything.” Sincerely, Among our recent accomplishments is equipping the entire hospital with wireless cardiac telemetry capability, allowing patients with pre-existing cardiac issues to be monitored within any unit of the hospital, rather than having to be moved to a cardiac unit. Charles M. Strain, John F. Collins, Chairman of the Board President & CEO Page 7

Winthrop-University Hospital :: 2012 Annual Report defining advances in medicine our most important job is bringing to the community the most up-to-date, effective healthcare, and our 2012 accomplishments in this area are significant. Page 8

Defining Healthcare and Much More Winthrop-University Hospital is the first and leading center in the U.S. to perform the Peroral Endoscopic Myotomy (POEM) procedure. Stavros N. Stavropoulos, MD, Chief of Endoscopy, Director, Program in Advanced GI Endoscopy (PAGE), with Pegeen Roberto, RN simulating an endoscopic procedure. Page 9

Winthrop-University Hospital :: 2012 Annual Report our commitment to patients: The Most Advanced Care Available New Hope for High-Risk Cardiac Patients  In 2012, Winthrop-University Hospital became one of approximately 70 hospitals and medical centers in the United States to offer the Edwards SAPIEN Transcatheter Heart Valve (TAVR) for patients who are not candidates for open-heart surgery and were previously considered untreatable. This procedure, which was in clinical trials of select patients by inserting the which irregular heartbeats in the upper for five years before being approved by replacement through a groin artery heart chambers start and stop suddenly the U.S. Food and Drug Administration and advancing it into the heart using a on their own, usually for minutes or even in November 2011, treats severe symp- catheter. The replacement valve then is days at a time. tomatic native aortic valve stenosis, a deployed with a balloon and immedi- condition in which the aortic valve is ately functions in place of the patient’s With the Arctic Front® Cardiac CryoAblation narrowed and does not open properly, defective valve. Catheter system, the first and only cryoballoon in the United States indicated to hindering the flow of blood from the heart to the rest of the body. The stress Winthrop’s success in offering previously treat certain PAF cases, physicians can use placed on the heart because it must work untreatable patients the TAVR procedure freezing to scar or kill the tissue causing harder weakens the heart and can cause rests on the exceptional teamwork of the erratic electrical signals that prompt chest pain, palpitations, fatigue, dizzi- Heart and Vascular Institute’s cardiology irregular heartbeats. The minimally inva- ness, loss of consciousness, and heart and cardiovascular surgery specialties. sive procedure involves inserting the murmur and may lead to heart failure. The presence of such a collaboration of catheter through a vein in the groin, experts is a primary reason Winthrop advancing it to reach the heart. The most widely used treatment for was selected as one of the first sites for aortic stenosis has been and continues this advanced procedure. Traditional ablation treatments sometimes require multiple applications to be valve replacement via open-heart surgery. But this is not suitable for some, Winthrop debuts heart rhythm of radiofrequency, or heat, to destroy leaving such patients with few or no disorder treatment faulty electric circuits in the heart, while options, until now. Winthrop physicians last year were the the Arctic Front dissolves cardiac tissue first on Long Island to offer a new ther- through one application of a coolant, The new Edwards SAPIEN valve enables apy for patients with paroxysmal atrial which is delivered through a catheter. physicians to replace the aortic valve fibrillation (PAF), a serious disorder in This new procedure offers our physicians Page 10

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Defining Healthcare and Much More one more tool to help cure more PAF Radiosurgery pushes cancer technology that enables physicians to patients. treatment boundaries perform surgeries with less scarring and Winthrop was the first health center in quicker recovery for patients when com- Compassionate, advanced the New York metro area to incorporate pared to other surgical techniques. cancer care the CyberKnife stereotactic radiosurgery Cancer patients last year were welcomed system into routine cancer care. Despite The technology also is being used into the Institute for Cancer Care’s new its name, CyberKnife is not surgery. successfully at Winthrop for bariatric Infusion Center that doubles the facility’s Rather, it is a mechanism for delivering weight loss surgery, as well as colorectal capacity and allows more patients to precisely targeted radiation to tumors, and thoracic surgeries, providing area be treated. Designed for the maximum minimizing damage to healthy tissue patients with greater options for more comfort of patients, amenities include and allowing access to malignancies comfortable surgeries and faster recovery. wireless Internet access, personal tele­ previously thought to be unreachable visions and seating areas for family and untreatable. members and companions. Single Incision Laparoscopic Surgery (SILS™), the latest innovation in lap­ We have had significant success treating aroscopic surgery, is now available to In its continuing efforts to ease the bur- prostate cancer patients with CyberKnife, Winthrop patients. Through a small inci- den of cancer patients and their families, and the technology is now also being sion in the patient’s navel, the surgeon the Institute last year expanded its staff used to treat gynecological and neuro- inserts a soft, flexible SILS port through of social workers, nurse administrators logical cancers. which specialized instruments can be and navigators, specially trained nurses inserted. Among the new procedure’s and physician assistants who help Of great interest is research initiated advantages over traditional laparoscopic patients with all aspects of their treat- here at Winthrop to study the value surgery is having only one access point ment, and also incorporated palliative of stereotactic radiosurgery in certain in the abdomen, which minimizes scar- care into the Cancer Center. breast cancer patients who have under- ring and the post-surgical pain often gone a lumpectomy. associated with additional sites of entry. the Institute inaugurated an oncology- More minimally invasive and The SILS procedure is available for hys- specific electronic medical record system robotic-assisted surgery options terectomy, removal of the gall bladder called ARIA that is fully compatible with The Institute for Cancer Care is well and sleeve gastrectomy for weight loss. the hospital-wide electronic records sys- known for its use of the daVinci Si-HD tem. These specialized records permit an Surgical System robots for the treatment Looking toward continued innovation, accurate flow of information so that the of cancers of the cervix, ovaries, uterus, groundwork was laid in 2012 for surgical chemotherapy team and pharmacy have kidney, prostate and bowel. The daVinci programs to treat hernias, adhesion all the information necessary to custom- system features magnified 3-D high diseases and foregut diseases. When ize treatment drugs for the patient. definition visualization and robotic these programs are fully operational in With patient safety improvement in mind, ® Upper right: Eva Chalas, MD, Chief, Division of Gynecologic Oncology, Director, Clinical Cancer Services. Bottom: Jonathan A. Haas, MD, Chief of Radiation Oncology with Matthew Witten, PhD, DABR, Director of Cyberknife Radiosurgery and Chief Physicist, Radiation Oncology. Page 13

Winthrop-University Hospital :: 2012 Annual Report the near future, patients will have greater early in gestation. If left untreated, the standpoint of patient safety and improv- choice of treatment. abnormality will cause progressive and ing the long-term health of mothers irreversible fetal damage as pregnancy and babies. Winthrop is one of the first A focus on women’s and progresses. Among the conditions in the region to adopt a policy prevent- children’s health treated through fetal surgery are fetal ing elective deliveries prior to 39 weeks At Winthrop, women will find complete anemia, twin-twin transfusion syndrome of pregnancy. life-cycle care. From our Women’s and lower urinary tract obstruction. Resource Center, which connects female A growing body of scientific evidence patients with physicians, support groups, Caring for high risk newborns shows that babies need 39 weeks to educational materials or other health- The Neonatal Intensive Care Unit (NICU) develop properly, and mothers do bet- related resources, to the Department is a New York State Department of ter when delivering at full term. As a of Obstetrics and Gynecology, area Health designated Regional Perinatal result, at Winthrop, early birth for non- women have access to quality care that Center (RCP), meaning that it provides medical reasons is not permitted. specifically meets their needs. the highest level of perinatal care provided by hospitals in the region. It con- Specialized care for children sistently delivers outstanding outcomes For children needing specialized services, nationally recognized Children’s Medical in both overall survival and survival with- our nationally ranked pediatric endocri- Center, a “hospital within a hospital,” out complications in extremely premature nology and pediatric urology programs offers all the services necessary to babies when compared to the Vermont offer the latest treatment options. The care for children from birth through Oxford Registry Network, one of the endocrinology program, in addition to adolescence. world’s largest databases and a highly having recognized expertise in growth respected authority on the measurement problems of children, also is a regional of care for high-risk infants. leader in the treatment of and research The same holds true for children. Our LONG ISLAND’S ONLY FETAL SURGERY PROGRAM on diabetes. Studies are currently under The health of babies prior to birth is a While we excel in caring for the most way to determine if there is a connection major thrust at Winthrop. In 2012, the fragile newborns, researchers here at between pre-teen obesity and diabetes. number of fetal surgeries increased as Winthrop are also investigating the referrals from area hospitals rose. Fetal causes of premature births. The work, surgical procedures are done in utero funded by grants from the March of through minimally invasive techniques Dimes and the National Institutes of with the help of direct visualization and Health (NIH), hopes to shed light on ultrasound guidance. how such births may be prevented. Such procedures are an option when Ensuring that pregnancies go to a full fetal abnormality is discovered very 39-week term is important from the Page 14

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Defining Healthcare and Much More Winthrop also is a regional leader in the nocturnal eating syndrome, nocturnal microelectrode recording (MER) to iden- development of protocols for treating seizure disorders and complex move- tify the areas in the brain that require pediatric sepsis infection, as our experts ment dis­ rders characterized by sleep o treatment. Once this first step is com- serve on the New York State Depart­ talking or walking with no recollection pleted, the DBS electrode is placed in ment of Health Severe Sepsis Advisory of this activity on wakening. a specific region to deliver electrical Committee and the Greater New York stimulation. Hospital Association Pediatric Severe Winthrop’s Sleep Center takes a holistic Sepsis Committee. approach to diagnosis and treatment. In addition to treating Parkinson’s dis- Multiple specialties, including psychia- ease, our Movement Disorders Program Improving both quality of care and trists, cardiologists and neurologists, also offers new options for those diag- access to it for underserved families in collaborate to ensure the best outcomes nosed with other conditions, including our community is a priority at Winthrop. possible. dystonias, Tourette’s syndrome and Under a $1.1 million grant from New essential tremor. York State and the Hospital Association New treatment for movement of New York State, Winthrop physicians disorders Advanced care for orthopAedic are piloting a medical home model of Patients with Parkinson’s disease and conditions care at a community clinic in Hempstead. other movement-related disorders are In 2012, orthopaedic surgeons performed The medical home model promotes a finding hope at Winthrop-University the hospital’s first computer-assisted team-based approach to care that is led Hospital through an advanced surgical total knee replacement utilizing an by a personal physician. procedure called Deep Brain Stimulation advanced robotic cutting guide. This (DBS). This innovative technique allows system works by accurately replicating Treating sleep disorders doctors to modulate the neurocircuitry a patient’s damaged knee joint, which We all appreciate the value of a good of the brain and achieve results with helps the surgeon identify the proper night’s sleep, but many people find this low risk. size, position, alignment and orientation unattainable. Our Sleep Disorders Center, of the implant before bone cuts are made. which opened in 1990, is Long Island’s DBS delivers electrical stimulation to As a result, the procedure is more pre- longest running accredited sleep center targeted regions deep within the brain cise and less invasive, which leads to and has helped thousands of patients that control movement-related commu- improved function of the joint and faster improve their health through better nications. Following treatment, many recovery times. quality sleep. With a pediatric sleep patients experience enhanced motor specialist on staff, even the youngest performance and quality of life and, in In its efforts to improve patient outcomes, patients find the help they need. some cases, reductions in medication. the Department of Orthopaedic Surgery Among the sleep disorders treated here There are two stages in DBS. The first Program for patients undergoing a joint are obstructive sleep apnea, insomnia, involves using imaging technology replacement. Winthrop offers a range of narcolepsy, restless legs syndrome, and an advanced technique called replacement surgeries, including total initiated the Comprehensive Total Joint Top left: Jan A. Koenig, MD, Chief of Joint Replacement Surgery and Director of Computer Assisted and Robotic Orthopaedic Surgery. Top right: Michael D. Weinstein, MD, FAASM, Director of the Winthrop Sleep Disorders Center. Bottom: Collin Brathwaite, MD, Chairman of Surgery, with a patient. Page 17

Winthrop-University Hospital :: 2012 Annual Report replacement of the hip, knee and ankle, Protecting children from bone In addition, sports trainers affiliated with as well as joint replacement revision. and joint injuries Winthrop have been meeting with local The Orthopaedic Surgery Department high school personnel to discuss injury The goal of the Comprehensive Total has implemented several initiatives prevention and treatment, and an ortho­ Joint Program is to educate patients aimed at preventing injuries among chil- paedic surgeon is now assigned to the and their families, because an educated dren. Area school nurses and volunteer Emergency Department’s Fast Track Unit patient is a more successful one. At spe- sports coaches were invited to attend on Saturdays during football season, the cial sessions, orthopaedic nurses explain special programs focused on treatment day on which many school and amateur all aspects of surgery, pre- and post- of common orthopaedic injuries. Public athletes sustain injuries. operative, as well as a range of topics programs also were sponsored to edu- that include infection control, pain cate parents and the community at large management and rehabilitation. about pediatric concussion issues. Page 18

Virginia Peragallo-Dittko, RN, BC-ADM, CDE, FAADE: Executive Director of Winthrop’s Diabetes and Obesity Institute Patient-centered diabetes care Diabetes is a 24/7 condition. People who live suc­ cessfully with diabetes do so through sophisticated self-management, but too often their expertise goes unrecognized during a hospital stay. “Why should self-managing diabetes patients give up their autonomy while in the hospital? After all, they are the experts about their day-to-day condition,” says Virginia Peragallo-Dittko, RN, BC-ADM, CDE, FAADE, Executive Director of Winthrop’s Diabetes and Obesity Institute. “If patients are well enough to self-manage, we need to collaborate with them, and if they aren’t well enough, they need to trust that hospital staff knows what to do,” she adds. To create this partnership between staff and inpatients with diabetes, the Institute has spearheaded over the past few years a hospital-wide education program to teach all patient-care staff—from physicians and nurses to pharmacists and social workers—how to treat the special needs of patients with diabetes. The result is that Winthrop became the first major teaching hospital in New York State to earn The Joint Commission’s Gold Seal of Approval for Advanced Inpatient Diabetes Care. Winthrop historically has been a leader in diabetes care. Our Diabetes Education Center, the first diabetes education program in New York State to be accredited by the American Diabetes Association, has been serving as a resource for members of the community since 1979. And, research into the causes and treatment of diabetes has been ongoing and will continue to be a focus in the Research and Academic Center under construction. “The new building represents Winthrop’s academic commitment to treating the healthcare needs of our community in which so many people have diabetes,” Peragallo-Dittko explains. “By having clinicians and scientists working together in the same place, the synergy of skills and talents will lead to innovative study design and changes in clinical practice.”

Winthrop-University Hospital :: 2012 Annual Report Giving mothers and babies a healthy start Having completed the necessary preparations, in 2012 Winthrop-University Hospital applied to become Long Island’s first Baby-Friendly Hospital. The Baby-Friendly Hospital Initiative (BFHI) is a global program launched by the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) that recognizes hospitals that offer an optimal level of care, assistance and support for mothers to initiate and continue breastfeeding their newborns. Currently, there are some 100 BFHI- Page 20 designated hospitals in the United States, four of them in New York State and none on Long Island. milk from donor mothers. Winthrop is the only hospital on Long Island to include milk donors. In collaboration with the New York State Department of Health, Winthrop completely revised its nursery procedures to permit mothers to remain with their babies and to remove any barriers to breastfeeding and skin-to-skin contact. Additionally, all maternal and infant care nurses, as well as pediatricians and attending physicians, have received training to support breastfeeding. Breastfeeding provides both mothers and babies with a healthy start. Accord­ ing to the U.S. Department of Health and Human Services Office of Women’s Health, breast milk can help protect a baby from ear infections, childhood obesity and other conditions, and mothers who breastfeed lower their risk of developing breast and ovarian cancers and diabetes. Infants in the hospital’s Neonatal Inten­ sive Care Unit have been included in the initiative. Eighty percent of NICU babies are fed breast milk, including At Winthrop, we want every baby and mother to be as healthy as possible, and we are willing to make every effort necessary to ensure that happens.

Amy Mascia: “Every nurse from shift to shift knew what was going on, and that was so comforting. I don’t think my experience would have been the same elsewhere.” For people with diabetes, insulin pumps are a lifeline, which is why Amy Mascia was thrilled to learn that Winthrop’s Obstetrics Department would allow her to use her pump during labor. Insulin pumps are medical devices that deliver insulin continuously throughout the day and eliminate the need for insulin injections. “Many hospitals have patients discontinue pump use during labor because blood sugar levels fluctuate rapidly,” explains Virginia PeragalloDittko, RN, BC-ADM, CDE, FAADE, Executive Director, Diabetes and Obesity Institute. “Here at Winthrop, we try to accommodate pump use to the extent possible within safety guidelines. We educate all our departments in the collaborative management of blood glucose using an insulin pump.” Seven weeks before delivery, Ms. Mascia, who has Type 1 diabetes, met with one of Winthrop’s diabetes nurse clinicians who outlined insulin pump-specific expectations during labor and delivery. The combined expertise of the obstetrical team in blood glucose management using an insulin pump and in obstetrical care during labor and delivery was evident when baby girl Laila was born. Following the birth of her daughter, Ms. Mascia met with Winthrop’s endocrinologists to determine what insulin pump adjustments were necessary both immediately post-partum and after discharge from the hospital. “It’s obvious that Winthrop is expert in treating diabetes and meeting the needs of people with diabetes,” the Glendale resident says. A long-time leader in treating diabetes, Winthrop has sought to prepare staff hospital-wide for meeting the needs of patients with diabetes. Its efforts were recently recognized when Winthrop became the first major teaching hospital in New York State to earn The Joint Commission’s Gold Seal of Approval for Advanced Inpatient Diabetes Care. The benefit to patients of this multidisciplinary, con­ centrated approach is clear. “It was impressive how continuous and expert the care was,” Ms. Mascia explains. “Every nurse from shift to shift knew what was going on, and that was so comforting. I don’t think my experience would have been the same elsewhere.” Profile: Tommy Scudero

Winthrop-University Hospital :: 2012 Annual Report defining nursing care from inpatients to neighbors, Winthrop’s nurses strive every day to bring the best and safest care possible because they know that healing is best when human interaction is present. Page 22

Defining Healthcare and Much More Hands-on, personal care provided by our nurses remains paramount. Page 23

Winthrop-University Hospital :: 2012 Annual Report the power of healing: Our Nurses Technology is essential to delivering high-quality healthcare, but the importance of the hands-on, personal care provided by nurses remains paramount. Continually seeking ways to improve patient care and safety, Winthrop’s Nursing Department last year began the complex application process for The American Nurses Credentialing Center (ANCC) Magnet Recognition Program®, the most prestigious distinction a healthcare organization can receive for nursing excellence and quality patient outcomes. At present, only 395 institutions, including four outside the U.S., hold the designation. We anticipate completing our Journey to Magnet Excellence in early 2014. Magnet recognition offers consumers an objective way to measure quality of care. U.S. News & World Report includes it when assessing nearly 5,000 hospitals for its rankings list, and so does the Leapfrog Hospital Survey, the nation’s oldest survey comparing hospital performance in safety, quality and efficiency. Magnet recognition improves patient outcomes More important, research shows that Magnet-designation hospitals have better outcomes. In 2012, ANCC, a subsidiary of the American Nursing Association, reported new research findings that surgical patients had lower mortality rates in Magnet hospitals than in those without the designation. Researchers based their findings on data from 564 hospitals Page 24 in four states; 56 of those institutions received Magnet recognition. Another study reported that very-lowbirth-weight babies born in Magnetrecognized hospitals have better outcomes than those born in nonMagnet facilities. The research team studied more than 72,000 high-risk, preterm infants born in 558 hospitals. Empowerment is key The best care is delivered when all involved in patient care participate in designing and implementing effective systems. To foster such a participative culture of innovation, our nurses are fully engaged in the shared governance proc­ ess, which is demonstrated by nurses’ participation on unit/department-based councils throughout the organization. These forums empower nurses to make decisions regarding their practice and work environment that lead to better bedside nursing. Broader hospital-wide councils address organization-wide issues that impact nursing practice, ensuring standardization and best practice. These councils include: Operations, Education/Professional Development, Clinical Practice, Quality and Safety, and Nursing Research and Evidence-Based Practice. Lifelong learning ensures quality care From student to experienced nurse, the need for continual learning is essential to providing the highest quality care.

(Left to right) Maura Corvino, RN, MSOL, CEN, Director of Nursing for the Emergency Department; Barry Rosenthal, MD, Chair of Emergency Medicine; and Valerie Terzano, MSN, RN, NEA-BC, Senior Vice President, Chief Nursing Officer and Emergency Department Administrator. Meeting regional emergency medicine needs As a New York State-designated Regional Trauma Center, Winthrop-University Hospital is well equipped to treat the most serious injuries, including mass casualties, and our Emergency Department is the nexus for delivering this highest level of care around the clock. The Department includes a nine-bed Fast Track Unit, a comprehensive 15-bed Chest Pain Rule-Out Unit, a separate 4,500-square-foot, 10-bed Pediatric Emergency Unit and an emergency diagnostic imaging center that includes a dedicated CT scanner and additional X-ray and digital imaging technology for fast and accurate diagnoses of emergency room patients. The communities we serve rely on our Emergency Department. In 2012, the department handled approx­ imately 70,500 visits, a substantial increase from the 49,050 reported in 2003, and we continually seek ways to improve patient safety and quality of care. With the appointment of Valerie Terzano, MSN, RN, NEA-BC, Senior Vice President, Chief Nursing Officer, who assumed administrative operations responsibility of the Emergency Department, and the full cooperation of Barry Rosenthal, MD, Chairman of the Department of Emergency Medicine, Maura Corvino, MSOL, RN, CEN, Director of Nursing for the Emergency Depart­ ment, and several members of Nursing Administration, a renewed focus has been placed on the Department and its growing needs. To that end, Winthrop expanded the Depart­ ent staff in 2012 to ensure that patients m were well served. “It may be a time of contraction at other area hospitals, but at Winthrop we are thoroughly evaluating the needs of both our patients and staff and providing the necessary resources to deliver the highest level of safe, quality patient care and customer satisfaction,” said CEO John Collins. In addition to providing the resources to obtain additional nursing staff, Winthrop has renewed its commitment to improving processes and maintaining consistency for all standards of care and practice, all of which influence core measure requirements set forth by The Centers for Medicaid & Medicare Services. “It is my hope that all of these initiatives will go a long way toward enhancing the already world-class care that is delivered each day in Winthrop’s ED,” said Mr. Collins.

Winthrop-University Hospital :: 2012 Annual Report At the undergraduate level, in 2012 Winthrop’s Nursing Department col­ laborated with Adelphi University on a curriculum that will bring eight thirdyear students to the hospital for three semesters. Known as a Dedicated Education Unit (DEU), students work alongside a nurse mentor on full shifts for entire semesters in order to engage in experiential learning. Winthrop-University Hospital is an approved provider of continuing nursing education by the New Jersey State Nurses Association (NJSNA), which is accredited as an approver of continuing nursing education for nurses by the ANCC Commission on Accreditation. Our Nursing accredited programs were offered beyond our staff and were well attended. Our paid nursing internship program last summer hosted 15 students entering their final year of training. For eight weeks, these students worked under the supervision of a preceptor. Research initiatives Continuous improvement requires continuous research. The Nursing Depart­ ment regularly hosts Research Boot Camps, lecture series that cover important topics and assist bedside nurses in their research and evidence-based practices endeavors. The opening of a grant-funded, state-ofthe-art simulation laboratory at Winthrop will expand ongoing training for our nurses. Nearly 900 nurses will be involved in simulated scenarios, which will allow them to remain current on the latest procedures and best practices. Page 26 Reaching patients where they live Community involvement is a critical component of the Nursing Department’s mission. Last year, Winthrop nurses offered blood pressure and cancer screenings, educational presentations, informational material and a host of other patient education activities at local health fairs and community events. From inpatients to neighbors, Winthrop’s nurses strive every day to bring them the best and safest care possible because they know that healing is best when human interaction is present. It is through our staff’s clinical expertise and team approach to patient care that Winthrop’s Home Health Agency consistently provides a nationally rec­ ognized level of excellence. Winthrop’s award-winning certified home healthcare agency offers nursing, as well as physical, speech and occupational therapies in conjunction with medical social work and home health aide services. This program was recently expanded beyond Nassau to include coverage in Queens and Suffolk counties.

Angela Santopadre: “The palpitations and the shortness of breath stopped. I’m so relieved not to have this problem anymore. Thanks to Dr. Parekh I feel safe.” When Angela Santopadre was admitted to Winthrop’s Emergency Department suffering from pneumonia, little did she know that the mystery of her life-long sporadic fainting spells would soon be solved. Over the years, this East Williston resident and grandmother of four had many scary moments, blacking out suddenly in Penn Station, the New York City subway and even in her backyard one Thanksgiving morning. Fortunately for her, when pneumonia brought her into our Emergency Room, she fainted while a nurse was at her bedside. Winthrop physicians suspected Ms. Santopadre may have been experiencing a disruption in her heart’s electric system, which controls the rate and rhythm of heartbeats. When heart rates speed up, blood pressure drops and you are likely to faint. “The doctors found that during the course of one month, I had experienced these episodes five times,” Ms. Santopadre explains. Cardiac electrophysiologist Sameer Parekh, MD, performed a catheter ablation to destroy the small areas of heart tissue where an arrhythmia starts. “The palpitations and the shortness of breath stopped,” she says, adding, “I’m so relieved not to have this problem anymore. Thanks to Dr. Parekh I feel safe.” Finding help at Winthrop has been a family affair for Ms. Santopadre. Quick response by our stroke team prevented her father from suffering permanent damage so that he could continue working as an artist after his stroke, and our pediatric urologists repaired lifethreatening kidney damage of one of her granddaughters. “I guess you could say I kind of love Winthrop,” Ms. Santopadre says. At her follow-up visit, it was suggested that she have an implantable loop recorder inserted under the skin of her chest that would continuously monitor her heart for up to three years and record any episodes of arrhythmia, as the condition of irregular heart rate or beats is called. Profile: Tommy Scudero

Winthrop-University Hospital :: 2012 Annual Report defining quality and patient care the Department of Patient Safety, Quality and ­Innovation works with the hospital’s clinical and administrative leadership, as well as front-line staff, to facilitate ongoing evaluation of performance in all quality domains, and the development of strategies and solutions to support continuous improvement. Page 28

Defining Healthcare and Much More Weekly leadership “huddles” take place with front-line staff to discuss safety and quality initiatives. Page 29

Winthrop-University Hospital :: 2012 Annual Report a high-reliability organization: Quality Care and Patient Safety For more than a century, Winthrop-University Hospital has dedicated itself to offering patients the best and safest care possible by embracing technology, research, standardized implementation of evidence-based best practices and medical innovation, while promoting a culture of safety and continuous improvement, all of these being the foundation of a high-reliability organization. The key to embedding safety in daily Quality and patient safety command patient’s condition using SBAR (Situation, operations is raising awareness and such importance at Winthrop that the Background, Assessment and Recom­ promoting mindfulness throughout the Chief Quality Officer and the Patient mendation), training in TeamSTEPPS® organization. To this end, hospital exec- Safety Officer report directly to our CEO. (Team Strategies and Tools to Enhance Performance and Patient Safety) and utives meet each week with front-line multidisciplinary rounds. staff of a different department for an A culture of safety and open discussion of safety and quality continuous improvement issues affecting that particular unit in Fostering an organizational culture in We also continued the roll out of our order to share best practices and solve which all parties are attuned to quality “Just Culture” program, which is designed problems. and safety is the cornerstone of long- to encourage open discussion of errors term success and positive patient and near misses in order to learn and outcomes. improve. In a just culture, everyone rec- Additionally, hospital-wide initiatives ognizes that systems impact performance have been implemented to assist staff at all levels and in all disciplines, including In the past year, we have instituted sev- and the focus is on correcting the fac- medical students, residents and fellows, eral programs that address improving tors that contributed to the error and to understand quality and safety princi- team communication to avoid misunder- designing safe systems, while holding ples and how to incorporate evidence- standings and errors. These programs staff responsible for carrying out proce- based improvement strategies into daily include implementation of a structured dures correctly. practice. approach to communicating changes in a Page 30

Defining Healthcare and Much More An ounce of prevention is, indeed, worth a range of issues that affect the comfort prevent hospital-acquired conditions and a pound of cure. At the suggestion of a and safety of patients and propose potentially preventable readmissions. unit nursing council, Winthrop instituted improvements. We are participating in 11 out of the 11 the Good Catch Program, which rewards initiatives and, as of the first calendar staff for observing a potential problem Patient safety focus quarter of 2013, are performing better and suggesting ways to guard against Regarding patient safety, which centers than the NYSPFP average in eight, better accidents. Unit nursing councils are an on keeping patients free from harm than the goal in five, and at or above the important component of the Nursing resulting from care, our fall prevention, 90th percentile in two. Our scores have Department’s quality initiative and pro- pressure ulcer and hospital-acquired placed us in the “exemplary” category. vide staff with a forum for discussing infection prevention programs continued performance improvement. to deliver excellent results. Additionally, we introduced a triplecheck, enhanced patient verification In 2012, we laid the foundation for a Winthrop is an active participant in the procedure to ensure correct identifica- patient experience program in which New York state Partnership for Patients tion of patients and match to the service department-level work groups will study (NYSPFP), part of a national program to or treatment to be provided. Page 31

Winthrop-University Hospital :: 2012 Annual Report The Pharmacy Department continues Several of our disease-specific quality stroke care is based on the most current to process more than 2,500 medication programs earned national recognition in scientific guidelines and recommendations. orders and dispense several thousand 2012. Winthrop became the first major doses of medications per day. The Medi­ teaching hospital in New York State to The role of technology cation Safety Team meets every two earn The Joint Commission’s Gold Seal Winthrop is a pioneer in the use of tech- weeks to review and analyze reported of Approval for Advanced Inpatient nology and data collection to improve medication variances. Trends are care- Diabetes Care. This designation indicates patient care and safety. We are a leader fully monitored to identify opportunities that our services address the critical fac- in the development and implementation to improve the system and educate staff tors influencing long-term improved out­ of electronic medical records and cur- about potential problems. This process comes for diabetic inpatients throughout rently chair the e-Health Network of of constant monitoring keeps the threat our hospital. Long Island. Our Primary Stroke Center received a Last year, the Network became the first Furthermore, enhancements to Winthrop’s Gold Level quality achievement award Regional Health Information Organiza­ computerized provider order entry (CPOE) from the American Heart Association/ tion (RHIO) to sign an agreement with and the Pharmacy Department’s clinical American Stroke Association’s Get With the New York e-Health Collaborative, computer system continue to build in the Guidelines (GWTG) Program. GWTG the first step to connecting RHIOs so extensive medication management tools is a quality improvement initiative that that providers may view health informa- to ensure patient safety. helps hospitals ensure that cardiac and tion of consented patients statewide. of variances to a very low degree. ® WUH vs NYS 2012 Risk Adjusted Mortality WUH vs NYS 2011 Risk Adjusted Mortality (9 months) 5.54 0.61 3.01 3.43 5.52 11.39 4.67 0.61 0.65 3.09 3.60 12.24 9.38 0.44 3.96 2.10 2.97 7.75 1.98 2.00 % % % % % % % % % % % % % % % % % % % % NYS WUH NYS WUH NYS WUH NYS WUH NYS WUH NYS WUH NYS WUH NYS WUH NYS WUH NYS WUH AMI Source: 2012 SPARCS data Page 32 CABG CHF PNEUMONIA STROKE AMI Source: 2011 SPARCS data CABG CHF PNEUMONIA STROKE

Aaron Katz, MD: Chairman of Winthrop’s Department of Urology Setting the standard in urological care Aaron Katz, MD, is determined that adult and pediatric patients with urological conditions or urology-related cancers find the most advanced treatments and surgeries here at Winthrop-University Hospital. Since being named Chairman of Winthrop’s Department of Urology in 2012, Dr. Katz and his staff have set a course to expand the robotic surgery program for treatment of prostate, bladder and kidney cancers, as well as the use of cryotherapy for prostate and percutaneous renal ablation. Renal ablation, which involves inserting a probe into a tumor and “freezing” it with liquid nitrogen, is performed in partnership with the Department of Radiology and is one of the newest procedures available anywhere. “Here at Winthrop, you can have your kidney tumor ablated on an outpatient basis, without invasive surgery,” Dr. Katz explains. “It’s all done under CT scan guidance. There is no general anesthesia, no large incision. Healing is faster as a result.” Also on his radar are expanding treatment options for female urological conditions, in particular the use of robotic surgery to treat urinary incontinence, as well as establishing an integrated men’s health center, the first on Long Island. “There is a need for one place where men can come to get help with diet, cancer screenings, heart health and other matters,” says Dr. Katz, who most recently was Vice Chairman of Urology at Columbia University Medical Center. Research is also a focus. The Department is participating in a clinical trial of high-intensity focused ultrasound (hiFU) treatment for the recurrence of prostate cancer in men previously treated via radiation. “When this becomes approved for use, the Winthrop team will have gained a tremendous amount of knowledge and experience with these procedures, an advantage for patients who will be seeking this treatment,“ he says.

Winthrop-University Hospital :: 2012 Annual Report We lead on the national level as well. applications to allow patients to access Technology is an essential tool, but it is As one of the first hospitals in the nation their medical records. Informed patients the everyday actions of the outstanding to attest to Phase 1 Meaningful Use of can be significant contributors to quality men and women who work here collab- healthcare IT, we embarked on Phase 2. and safety. oratively that make a difference. That Attesting to meaningful use is the first is why many of our quality and patient stage of a long-range program to create Among our recent accomplishments in safety initiatives revolve around work a nationwide IT infrastructure that will terms of in-house technology is equip- groups that include stakeholders connect providers and patients through ping the entire hospital with wireless throughout the organization. When compatible, standardized electronic cardiac telemetry capability, allowing ideas and information are shared freely, health records systems, a move that will patients with pre-existing cardiac issues the best innovations come forth. And, improve patient safety and outcomes. to be monitored within any unit of the when it comes to quality and safety, our hospital, rather than having to be moved patients deserve nothing less than our Patient and family engagement is a to a cardiac unit. In time-sensitive situa- best efforts. major component of Phase 2, and our IT tions, this capability greatly improves professionals are designing web-based the effectiveness of care. Partnerships Winthrop is… a par tner in the Winthrop South Nassau University Health System a member of the New York-Presby terian Healthcare System a member of the Nassau-Suffolk Hospital Council a member of the Long Island Health Network a founding member of the e-Health Network of Long Island Page 34 Winthrop is… a par tner in the Winthrop South Nassau University Health System

Phyllis-Ann O’Connell: “I was very unhappy for about 10 years, not being able to get around and do the things I wanted to. I’m much happier now. I have my life back!” While shopping for clothes may be a chore for many, for Phyllis-Ann O’Connell it’s a wonderful experience. A life-long veteran of the “Weight Wars,” Ms. O’Connell underwent a laparoscopic sleeve gastrectomy at Winthrop Hospital and weighs 150 lbs. less than she did two years ago. “I am better at age 61 than I was at 50,” the Franklin Square retired teacher says. Exposure to mold in the workplace brought on severe asthma and she was treated with steroid medications, which include weight gain among possible side effects. Ms. O’Connell ballooned up over 300 lbs., eventually resorting to use of a motorized scooter to alleviate knee discomfort. Seeking to improve her mobility, Ms. O’Connell discussed knee replacement surgery with a specialist who ruled out surgery until she lost weight. “This was my ‘light bulb’ moment,” she explains, adding, “My brother had gastric bypass, but I was afraid. But, I then realized that I had to do something and decided to attend a Winthrop gastric bypass information session.” After consulting with bariatric surgeon Alexander Barkan, MD, he recommended the sleeve procedure, which is less invasive than a gastric bypass and can better accommodate the use of steroids, if Ms. O’Connell needed to continue their use. This procedure involves a nickel-size incision in the abdomen through which the surgeon reduces the size of the stomach. Winthrop was one of the first hospitals on Long Island to perform the sleeve procedure, which now has been approved by Medicaid and Medicare. Ms. O’Connell credits Winthrop’s bariatric surgery weight loss support groups with helping her maintain her weight loss and improve her health. The entire process has been life changing for her. “I was very unhappy for about 10 years, not being able to get around and do the things I wanted to,” she says. “I’m much happier now. I have my life back!”

Winthrop-University Hospital :: 2012 Annual Report defining medical education we continue to develop our role as a vital academic medical center on Long Island that serves not only students and new physicians, but also the larger community of physicians, nurses, pharmacists and other healthcare professionals. Page 36

Defining Healthcare and Much More Winthrop-University Hospital has more than 240 medical residents in specialty training. Page 37

Winthrop-University Hospital :: 2012 Annual Report ensuring the future of healthcare: Medical Education For nearly half a century, Winthrop-University Hospital has played a significant role in the medical education of physicians on Long Island and throughout the region. In 2012, Winthrop’s academic focus continued to expand with new educational programs and a greater concentration of resources across the continuum of undergraduate, graduate and continuing medical education. In late 2011, Winthrop-University Hospital University, New York University and Promoting research and was designated as a Clinical Campus Tulane University. Stony Brook University scholarship of the Stony Brook University School of School of Medicine graduates accounted Our robust educational environment for Medicine. Each academic year, 80 Stony for 23 percent the 2012 entering resi- medical students, residents and fellows Brook medical students select our dency class. includes research and other forms of Clinical Campus as the site for their clinical rotations. academic scholarship. Winthrop’s Fifth In 2012, the Accreditation Council for Annual House Staff and Medical Student Graduate Medical Education announced Research Day took place in April 2012 Third-year medical students complete the Next Accreditation System, an with more than 100 medical research required specialty clerkship rotations, outcomes-based evaluation system posters presented. This event highlights while fourth-year students select from that will ensure the competency of the breadth and depth of Winthrop’s nearly 60 subspecialty

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