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Winthrop 2012 annual report designed by Curran & Connors

  1. 1. Winthrop-University Hospital :: 2012 Annual Report Education / Healthcare / Research Winthrop-University Hospital  2012 Annual Report 259 First Street Mineola NY 11501 516-663-0333 winthrop.org defining healthcare and much more
  2. 2. 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. / www.curran-connors.com 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
  3. 3. 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
  4. 4. 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
  5. 5. 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
  6. 6. 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.
  7. 7. 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
  8. 8. 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
  9. 9. 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
  10. 10. 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
  11. 11. 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
  12. 12. 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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  14. 14. Winthrop-University Hospital :: 2012 Annual Report Page 12
  15. 15. 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
  16. 16. 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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  18. 18. Winthrop-University Hospital :: 2012 Annual Report Page 16
  19. 19. 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
  20. 20. 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
  21. 21. 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.”
  22. 22. 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.
  23. 23. 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
  24. 24. 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
  25. 25. Defining Healthcare and Much More Hands-on, personal care provided by our nurses remains paramount. Page 23
  26. 26. 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.
  27. 27. (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.
  28. 28. 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.
  29. 29. 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
  30. 30. 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
  31. 31. Defining Healthcare and Much More Weekly leadership “huddles” take place with front-line staff to discuss safety and quality initiatives. Page 29
  32. 32. 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
  33. 33. 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
  34. 34. 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
  35. 35. 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.
  36. 36. 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
  37. 37. 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!”
  38. 38. 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
  39. 39. Defining Healthcare and Much More Winthrop-University Hospital has more than 240 medical residents in specialty training. Page 37
  40. 40. 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 clinical and program graduates to perform the research accomplishments. Many of research electives. In 2013, Winthrop will essential tasks for clinical practice in these research posters will be subse- graduate its first clinical campus class, the 21st century. quently displayed at national medical and we are certain each graduate will meetings. match into excellent residency programs In preparation for this new system, the in the specialty of choice. Office of Academic Affairs successfully The Office of Academic Affairs has taken completed a pilot project with Winthrop’s the lead in recognizing and advancing Residency programs remain pediatrics residency program regarding teaching excellence and educational vigorous the planned benchmarks for assessing scholarship at Winthrop, particularly in Each year Winthrop recruits many of the the preparedness of physicians in six the area of faculty development. brightest graduating medical students core competency domains. This cutting- and young physicians into our residency edge pilot and its outcomes will be pre- The Faculty Scholars Fellowship is a and fellowship programs. In 2012, enter- sented in 2013 at a national educational special initiative that enables clinician ing residents included graduates of conference so that other residency pro- educators to enhance their skills and prestigious institutions such as Harvard grams can learn from our experience. educational scholarship through inquiry- Page 38
  41. 41. John Aloia, MD: Chief Academic Officer Medical education for the 21st century Designation in 2011 as a Clinical Campus of Stony Brook University School of Medicine has transformed WinthropUniversity Hospital into a nationally recognized academic health center, to the benefit of patients, students and staff. Although Stony Brook medical students have completed clinical rotations at Winthrop for four decades, now that we are a clinical campus, 80 third- and fourth-year students live and learn here year round to complete the educational requirements for graduation from medical school. “Having students on campus full time has changed us for the better,” says John Aloia, MD, Chief Academic Officer and Dean of the Clinical Campus. “Teaching raises our intellectual level. Students ask us great questions. Ques­ tioning leads to discussion and then to learning by both students and faculty.” In committing to an expanded academic role, Winthrop has invested in the resources necessary to excel. A multifaceted faculty development program was launched last year to enhance and support the scholarly activities of the faculty. In addition, we broadened our training capabilities by opening a Simulation Center. Equipped with robotic mannequins and task trainers, the Center offers s ­ imulation-based skills training for students, residents, physicians, nurses and other health professionals. Our academic mission continues to encompass graduate medical education (GME) and continuing medical education (CME). Our residency and fellowship programs thrive and our GME program was distinguished for teaching excellence by being awarded a five-year institu­ tional accreditation period by the Accreditation Council for Graduate Medical Education in 2012. In addition, numerous innovations in medical education are being implemented and tested at Winthrop by our faculty. Similarly, The Accreditation Council for Continuing Medical Education awarded Winthrop’s extensive and diverse CME program Accreditation with Commendation. The Research and Academic Center now under construction will create greater opportunities for breakthrough ideas as clinicians and scientists work side by side. It is through such interdisciplinary activities that our faculty and students will redefine healthcare for the 21st century.
  42. 42. Winthrop-University Hospital :: 2012 Annual Report CME Participation Trends Hours of Instruction Physician Participants 2500 Non-Physician Participants Hours of Instruction 10,805 789 685 7,689 2000 789 hours 2012 8,085 1500 569 569 hours 2011 1000 4,529 3,680 2010 685 569 789 2010 2011 2012 0 2010 2011 2012 Continuing Medical Education Programs are increasing as the number of participants grows. Page 40 1,905 500 685 hours Continuing Medical Educatioon Programs are increasing as the number of participants grows. 2010 2011 2012
  43. 43. Defining Healthcare and Much More based, interactive class sessions. physician and nursing continuing educa- the CME curriculum, and an expansion Graduates of the annual Fellowship tion credits. Each year, Winthrop’s CME of live course offerings. The past year form a cadre of expert faculty who will programs attract more regional and has also seen a much greater emphasis help promote more effective instruction, national participants, attesting to the on designing curriculum appropriate for teaching, assessment and curriculum, as high quality of our presentations. the entire interprofessional team. Winthrop is a distinguished national Education as a bridge to quality provider of CME credit, receiving an As Winthrop enhances its quality The Fellowship is the capstone of a award of Accreditation with Commenda­ improvement and patient safety initia- comprehensive faculty development tion from the Accreditation Council for tives, continuing education for students, program that includes an annual series Continuing Medical Education (ACCME). faculty and practicing physicians becomes of campus-wide offerings designed to Our CME programs strive to support ever more essential. meet the needs of our diverse learners: physician educational needs for specialty clinical campus medical students, house board recertification under the new In 2012, Winthrop joined Aligning and staff, clinical faculty and those who teach American Board of Medical Specialty Educating for Quality, a continuing and assess learners. Maintenance of Certification program medical education and performance adopted by all recognized medical improvement initiative of the Associ­ specialties. ation of American Medical Colleges well as provide leadership, mentoring and educational research. A process of lifelong learning Our Office of Continuing Medical Edu­ (AAMC). We are one of more than 30 cation (CME) offers an array of annual Among several exciting initiatives major academic medical centers in the specialty courses, symposia and online launched in 2012 are our first accredited U.S. to be selected to participate based learning resources, accredited for both online learning module, a redesign of on our program’s level of capabilities. Upper right: G. Robert D’Antuono, MHA, Assistant Dean and Director of CME. Page 41
  44. 44. Winthrop-University Hospital :: 2012 Annual Report The AAMC initiative aims to help aca- patient safety and quality improvement Campaigns to improve team-based care demic medical centers integrate and program this year is the opening of a of patients with sepsis, trauma and other align existing quality improvement pri- state-of-the art interprofessional Simu­ medical emergencies will be part of a core orities and goals with continuing medical lation Center. Equipped with manne- curriculum to be offered by the Center. education curricula to improve clinical quins and task trainers, the Center will practice and patient care outcomes. offer simulation-based skills training for Continuing our academic students, residents, physicians, nurses mission and other health professionals. Continuing to expand our academic Another quality initiative was the establishment of the House Staff Quality role is vital to our mission of producing Council whose membership includes To assure its success, a cadre of 18 core an adequate, highly qualified physician medical students, residents and fellows. teaching faculty has been trained in the workforce for future generations. Our The Council’s function is two-fold: to principles and techniques of simulation- graduates will serve not only citizens of review and recommend quality initia- based medical education. Medical stu- Long Island, but also of the region and tives and to expose young physicians to dents will be tested in their patient beyond. At the same time, our faculty quality issues early in their careers. diagnostic and assessment skills using will continue their personal commitment standardized patients, while residents to life-long learning, assuring the deliv- Team-based medical education will perfect their technical procedural ery of effective, patient-centered care to One of the most exciting advancements skills using sophisticated virtual simula- all who seek it. These are the ongoing in our integrated medical education, tion machines. contributions of our dedication to education. Page 42
  45. 45. Jackson Israel: “The ICU team was there for all of us. Whenever we had questions or required a team meeting to get an overview, we were taken care of right away.” Preparation is the foundation of success, and in 16-yearold Jackson Israel’s case, it saved his life. When his parents realized that Jackson’s flu-like symptoms were serious, the Israel family came to the Winthrop Pediatric Emergency Department. Bacteria from an unrecognized bone infection had spread throughout Jackson’s body, and by the time he arrived Jackson had already developed severe sepsis, a life-threatening condition. Thanks to a quality initiative to improve severe sepsis care for pediatric patients begun in 2009 by the Children’s Medical Center at Winthrop, the Pediatric Emergency Department and Pediatric Critical Care team were ready. To address the threat to Jackson’s vital organs, the medical team implemented Early Goal Directed Therapy, an evidence-based process that involves rapid administration of fluids and medications to reverse shock and timely administration of antibiotics to combat the infection. Unfortunately, Jackson’s major organ systems had already sustained injury by the time treatment was initiated. During the next several weeks Jackson required invasive monitoring, support for his breathing, medications to maintain his blood pressure, and dialysis to support his kidneys. A blood clot spread the infection to his lungs, and he required surgery to control internal bleeding. During his three-month stay in Winthrop’s ICU, Jackson steadily regained his health. “The ICU team was there for all of us,” says Raquel Israel, Jackson’s mother. “Whenever we had questions or required a team meeting to get an overview, we were taken care of right away. They always kept us informed and explained things to Jackson. I never saw him frightened.” Jackson benefitted from the pediatric department’s team approach to treatment. Consultation with various subspecialties was coordinated to assure the best treatment “This was reassuring for us,” says Mrs. Israel. “We knew every option was being explored.” As Jackson prepares to rejoin his classmates, both his family and his Winthrop medical team are grateful. “That he survived severe sepsis without any disabilities and that his cognitive function is intact are remarkable,” says Maria Lyn Quintos-Alagheband, MD, Associate Director of Pediatric Critical Care, Chair of the Pediatric Surviving Sepsis Campaign at Winthrop, and advisory taskforce member of the Greater New York Hospital Association and statewide sepsis campaign. Profile: Tommy Scudero
  46. 46. Winthrop-University Hospital :: 2012 Annual Report defining research as part of our overall focus on quality, more than 100 patient-centered research projects are under way that seek to determine the effectiveness of treatments. Page 44
  47. 47. Defining Healthcare and Much More Winthrop-University Hospital research focuses on major national health priorities. Page 45
  48. 48. Winthrop-University Hospital :: 2012 Annual Report fulfilling the promise of health science: Research The highest quality of care is found in settings that nurture education and research because such institutions value inquisitive minds striving for knowledge that improves patient outcomes. Our commitment to research has always been strong, but it crystallized in 2012 with the groundbreaking for the Research and Academic Center, which will become the home of our research programs and the intersection of our science and academic missions. Fellows, residents and medical students will have the opportunity to learn from leading researchers how to collect data and apply it to providing better care, and scientists and clinicians will share their expertise to improve treatment options for patients. The 95,000-square-foot, five-story facil- to understand the role of beta cells, Applying our knowledge ity will house laboratories, academic which create and release insulin. One of our newest initiatives, a Molecular lecture halls and clinics, which will facili- Pathology Laboratory, got under way tate bench-to-bedside research, cross- Another collaboration is studying whether in 2012 and is now operational. The lab fertilization of ideas and access to the methotrexate, an anti-inflammatory studies molecular markers, or genetic most current information available. drug, can reduce the risk of heart attack markers, which are a particular DNA and stroke in patients with diabetes. sequence identifiable within the context Addressing our community’s At Winthrop, researchers will monitor of the entire genome. health issues enrolled patients and contribute addi- Winthrop has chosen to focus many of tional research. This study is funded by Molecular markers can assist in the its research programs on health issues the National Institutes of Health and is diagnosis and treatment decisions for a directly affecting the communities we being led by a Harvard Medical School variety of conditions. For cancer patients, serve. Diabetes, therefore, is a primary faculty member. for example, markers can indicate if focus, both in the adult and pediatric population. patients will respond well to a particular Other research topics include avoidance type of chemotherapy. By collaborating of premature births, effectiveness of with clinical oncologists, the new lab Among the various diabetes-related high-intensity frequency ultrasound to applies basic science research to finding studies is a collaboration with several treat recurring prostate cancer, a vac- the best and safest treatment options institutions, including the University of cine to protect against recurrence of for patients. Massachusetts, the University of Toronto gynecological cancers, and molecular- and the Medical College of Wisconsin, level study of Amyotrophic Lateral Sclerosis (ALS). Page 46
  49. 49. Allison Reiss, MD: Head of Winthrop’s Inflammation Section unlocking the mysteries of cardiac disease risk Researchers often do not necessarily know where their work will lead. For Allison Reiss, MD, head of Winthrop’s Inflammation Section, it has led her and her team to participation in a Harvard Medical School-led national study that may help reduce cardiac disease risk among diabetic patients. In earlier work on autoimmune diseases such as rheu­ matoid arthritis (RA) and lupus, Dr. Reiss and her group identified in such patients the specific inflammatory components present in the circulatory systems that impair their cells’ ability to metabolize cholesterol and, therefore, allow lipid accumulation in the artery, where it can lead to obstruction and heart attack. This research contributed to our understanding of the mechanisms through which several commonly used pain medications (COX inhibitors) elevate the risk for stroke and myocardial infarction. It now appears that methotrexate, a different type of drug used to treat RA, may actually improve cells’ ability to process cholesterol in those patients, and the Cardiovascular Inflammation Reduction Trial (CIRT) study, funded by the National Institutes of Health, aims to determine if it may have a similar effect on diabetics who already have had a heart attack. Winthrop will be a CIRT Super Site, not only monitoring patients in the study, but also contributing additional research. “We have the ability to do more because of our research capabilities,” says Dr. Reiss, who also is an Associate Professor of Medicine at the Stony Brook University School of Medicine. “We can perform analyses that are much more detailed and so can contribute further information to the study.”
  50. 50. Winthrop-University Hospital :: 2012 Annual Report Winthrop’s Clinical Trials Center, which and our experts are serving on a national communication system that will facilitate will be relocated to the new Research panel developing clinical practice guide­ follow-up after discharge. This project and Academic Center, and departments lines for treating the condition. stems from Winthrop’s participation in throughout the hospital are conducting the New York State Digital Health Accel­ dozens of clinical trials in a range of Patient-centered research erator Program, an initiative to help fields, including cardiology, oncology As part of our overall focus on quality, early- and growth-stage companies and nephrology. various patient-centered research proj- bring leading-edge technology to the ects are underway that seek to deter- healthcare community. Winthrop has emerged as a regional mine the effectiveness of treatments. referral site for patients with Sjögren’s Researchers collaborate with patients to Scholarship and research are vital com- Syndrome, a chronic autoimmune disease gain insight into how useful the educa- ponents of Winthrop’s mission. As we that affects an estimated four million tion and instructions they were given are expand our research capabilities and Americans, including tennis champion in a “real world” setting. It is essential create synergies with clinical care and Venus Williams, and for which there is for healthcare providers to understand medical education, the communities we no cure yet. the patient’s perspective and adjust to serve will continue to have access to the their needs as much as possible. best care available. A cohort of some 100 Sjögren’s patients is being followed by Winthrop researchers, In another patient-centered initiative, we are piloting a telephonic patient Page 48
  51. 51. Tommy Scudero: “Everybody came together to help me. The nurses and everyone at the hospital were fantastic. I’m so grateful to have my ‘boring’ life back!” For Tommy Scudero of East Williston, there is nothing more precious than the simple routines of daily life, an appreciation he developed following a near fatal cardiac arrest. Despite a history of cardiac issues, including a triple bypass operation, Mr. Scudero, age 54, was doing well until one winter evening when he collapsed while getting ready for bed. “He just went down,” explains his wife, Johanna. “I tried to make him respond to me but he wouldn’t.” The local volunteer ambulance corps arrived within minutes of his wife’s phone call and provided emergency treatment for a life-threatening arrhythmia enroute to Winthrop’s Emergency Department. Physicians determined that in his precarious condition, Mr. Scudero was a candidate for the Induced Hypothermia Protocol, a relatively new treatment for patients who experience cardiac arrest. It involves slowly reducing the body’s temperature to 92° F in order to preserve as much brain function as possible and improve the chances for recovery. The next two days were crucial to achieving the protocol’s benefits, as the ICU team slowly raised Mr. Scudero’s temperature back to the normal 98º F. It was an emotional time as he began to awaken. Although Mr. Scudero was experiencing short-term memory loss, his family and the ICU team were overjoyed to see his positive response to treatment. Mr. Scudero improved steadily during the next few days, regaining his memory. His cardiologists then began to uncover the cause of his cardiac arrest. Mr. Scudero had experienced ventricular fibrillation, a lethal heart rhythm. With the implantation of a cardiac defibrillator, Mr. Scudero’s heart now beats properly, and he was back at his job some four weeks later. “Something like this makes you think,” Mr. Scudero says. “Everybody came together to help me. The nurses and everyone at the hospital were fantastic. I’m so grateful to have my ‘boring’ life back!”
  52. 52. Winthrop-University Hospital :: 2012 Annual Report performance highlights Financial Highlights 2012 $1,021,993,270 Operating Income $918,227,315 $15,712,004 Operating Revenue 2011 $20,480,894 1.54% Operating Margin 2.23% Source: Winthrop-University Hospital Economic Impact 2012 “Healthcare is becoming increasingly complex as we manage a system that includes the hospital, outpatient surgery Population statistics centers, and a vast network of physician practices. This is compounded by the Number of Employees Salaries, Wages & Benefits Supplies Capital Spending Leases and Rentals 6,900 $584.0 $247.6 $40.0 $17.2 Employees Million Million Million challenges of emerging payment models. Source: Winthrop-University Hospital In order to be prepared, we must be Million Winthrop is a major driver of the Nassau County and broader Long Island economy. more connected than ever to ensure a seamless revenue cycle. Connectivity Inpatient Payer Mix will allow us to navigate the complex YTD December 2012 regulatory and reimbursement environment.” Work Comp/No Fault 1.5% Self Pay/Other 2.2% Palmira M. Cataliotti, CPA, FHFMA Senior Vice President and Chief Financial Officer Medicare/Medicare HMO 34.7% PPO/Commercial Medicaid/Medicaid HMO 14.6% Source: Winthrop-University Hospital Winthrop maintains a balanced payer mix. Revenues have grown and margins are solid, even with increased expenses devoted to additional staffing to enhance care and improve patient flow. Page 50 47%
  53. 53. Defining Healthcare and Much More Number of Medical Staff Number of Employees 8000 1,400 1,600 1,550 1,500 1,850 2000 7000 1500 6000 5,665 6,619 6,891 2011 6,217 5,993 2012 5000 1000 4000 3000 2000 500 1000 0 2008 2009 2010 2011 0 2012 Source: Winthrop-University Hospital (based on available beds) 95.9 2009 2010 While other institutions have had to trim staff, Winthrop continues to increase nursing and medical personnel to support added programs and services. WUH Percentage of Occupancy 92.1 2008 Source: Winthrop-University Hospital 93.6 90.1 91.5 WUH Total Patient Contacts 90.2 (inpatient/outpatient E&M’s) 1,000,000 1000000 800,000 800000 600,000 2007 2008 2009 2010 2011 600000 2012 Source: Winthrop-University Hospital Occupancy rates hold steady, and although there has been a slight decline in discharges, it has been more than offset by increases in outpatient visits. 400,000 2007 2008 2009 400000 Margins (in millions) $850 6.1% 2.9% $484 Stony Brook St. Francis NUMC South Nassau Winthrop $922 NSUH Manhasset (percent) $1,768 $387 2012 2011 Source: Winthrop-University Hospital Revenue $441 2010 5.6% 2.1% ew York State (HANYS) Institutional Cost Report (ICR) 2011 Stony Brook St. Francis NSUH Manhasset NUMC South Nassau Winthrop (7.1%) Source: Healthcare Association of New York State (HANYS) Institutional Cost Report (ICR) 2011 (17.5%) Page 51 Source: Healthcare Association of New York State (HAN
  54. 54. giving community Winthrop is about involvement Page 52 commitment volunteerism legacy Winthrop-University Hospital :: 2012 Annual Report
  55. 55. Defining Healthcare and Much More As Winthrop-University Hospital forges ahead to meet the complex needs of our diverse patient population, philanthropic dollars help accelerate our innovative growth in the areas of research, education and technology. In the following pages, we gratefully acknowledge the benevolence of those who have contributed to our annual and major campaigns, special events and programs. These selfless donors make it possible for Winthrop to bring the highest level of care possible to residents of the Long Island region. ▲ Research is the engine of innovative patient care, a belief strongly held by John H. Treiber, business executive, volunteer leader, philanthropist and member of the Winthrop-University Hospital Board of Directors since 2000. Through their family foundation, Mr. Treiber, his wife, Carol-Ann, and his daughters, Megan and Kim, have made a $1 million gift to Winthrop’s Research and Academic Center Capital Campaign. The Center, currently under construction, will bring together under one roof our science and academic missions. The 95,000-square-foot, five-story facility will house laboratories, academic lecture halls and clinics, which will facilitate benchto-bedside research, cross-fertilization of ideas and access to the most current information available. The Treiber family’s generosity will no doubt facilitate breakthroughs in science and patient care. Page 53
  56. 56. Winthrop-University Hospital :: 2012 Annual Report  Theresa Patnode Santmann, a successful businesswoman and philanthropist, has committed more than $1 million to fund Winthrop’s Amyotrophic Lateral Sclerosis (ALS) research program. Ms. Santmann became interested in funding ALS research after her husband was diagnosed with the disease, which attacks nerve cells responsible for controlling voluntary muscle movement. In reviewing the current state of ALS research, Ms. Santmann learned of Winthrop’s impressive work in this field and chose our program to receive her gift, thereby furthering our research and bringing new hope to many living with ALS.  Thanks to an unprecedented gift of nearly $700,000 from the John and Janet Kornreich Charitable Foundation, patients in Winthrop’s Neonatal and Pediatric Intensive Care Units are benefitting from the most sophisticated bedside cardiac monitors available today. These continuous monitoring devices are valuable tools that instantly provide essential infor­ ation about a patient’s physiological m con­ ition to the care team and enhance our d ability to provide the highest quality of care. Pediatric patients at Winthrop already have benefitted from previous Kornreich Founda­ tion gifts which include entertainment systems in our Cancer Center for Kids and The Children’s Medical Center. The hospital experience of our youngest patients and their families has certainly been enhanced through the generosity of the Kornreichs. Page 54
  57. 57. Defining Healthcare and Much More The Guardian Society We pay special tribute to our loyal donors who have included the Hospital in their estate plans. These remarkable gifts help to ensure that our mission of providing superior healthcare in a teaching and research environment continues for generations to come. Sustaining Benefactors We honor the profound commitment of our dedicated donors who have continuously supported the Hospital since the beginning of the 21st century, giving total contributions of $10,000 and above from 2000 to 2012. Ms. Katherine J. Aitkens Mr. W. Eugene Kimball $1,000,000 + Neurological Surgery, PC Mr. Edward Appoldt Mr. John Hjalmar Kober Mrs. Amy Hagedorn Mrs. Loraine Bernhard Mr. and Mrs. John H. Krumpe Mr. John A. Bower Mr. John Kunkle Mr. and Mrs. Nathan J. Mistretta New York Community Bank Foundation Mr. and Mrs. Robert H. Buescher Mrs. Frances V. Lesch Mrs. Beryl L. Burr Mr. Joseph H. Lyons Mrs. Jeanette Campbell Mr. George E. Mallouk Ms. Dolores Cantore Mr. Bruce Marano Ms. Augusta Clark Ms. Mae Mattmann Fenton Ms. Ethel Ruth Combes Mr. Joseph R. McLees Mr. William J. Corley Mr. Samuel U. Mitchell Mr. John T. Cronin Mr. and Mrs. James D. Mooney, Jr. Mr. Alfred T. Davison Mr. Roy C. Morehead Ms. Louise R. deDombrowski Herbert Moskowitz, MD Ms. Mabel M. Degnan Mrs. Marguerite D. Murphey Ms. Constance B. DeMeo Rev. Thomas F. Murphy Mr. George P. Denny, Jr. Mr. and Mrs. Alexander Nadich Ms. Nita C. Dietel Mr. George K. Ommundsen Mr. William E. Dillmeier Mr. Winthrop B. Palmer Mr. and Mrs. Harold M. Duryea Ms. Elizabeth S. Paulding Mr. Emanuel Dym Mrs. Maria Pritchard John and Janet Kornreich Charitable Foundation, Ltd. Ms. Ellen F. Emery Mr. Albert Rene Stanley A. Landers, Esq. The Adikes Family Foundation Mr. Monroe Erichson Mrs. Veronica B. Renken American College of Physicians Mrs. Lillian B. Feulner Ms. Ruth A. Roeser Mrs. Frances V. Lesch Amgen, Inc. Ms. Iris C. Gabrielsen Ms. Arline F. Rohn Mr. and Mrs. Ronald H. McGlynn Mr. Warren Galli Mr. Leon A. Rushmore, Jr. Mr. and Mrs. John D. Miller Aon Hewitt Mr. Anthony Gallo Ms. Marie F. Rushmore Mrs. Floreine J. Winthrop Boston Scientific Foundation, Inc. Ms. Lillian E. Gerold Ms. Madeline E. Russo Ms. Miriam M. Goldstein Mr. William J. Schaff Ms. Helen K. Gooden Ms. Barbara Schoepfer Mrs. Sarah R. Hadden Mr. and Mrs. Charles P. Smith Mr. Lothian K. Hanson Ms. Ida May Smyth Ms. Sally Hautmann Ms. Margery Smyth Mr. William C. Hautmann Martin Spatz, MD Mr. and Mrs. C. Leroy Hendrickson Nassau Anesthesia Associates, PC Mrs. Maria Pritchard Theresa Patnode Santmann Foundation, Inc. Martin Spatz, MD Mr. Robert Winthrop Winthrop-University Hospital Auxiliary William E. and Maude S. Pritchard Charitable Trust Mr. Daryl M. Rosenblatt and Mrs. Susan J. Miller Drs. Scott and Lisa Schubach SK Children’s Charities Mr. Horst Spengler Mr. and Mrs. Charles M. Strain Syde Hurdus Foundation, Inc. The Treiber Family Foundation, Inc. $500,000 + Mr. and Mrs. John H. Treiber The Gladys Brooks Foundation Mr. and Mrs. H. Willets Underhill Charlie’s Champions Foundation Winthrop-University Hospital Medical Staff Mrs. Theodora W. Hooton Jay’s World Childhood Cancer Foundation $100,000 + Abbott Nutrition Botto Mechanical Corporation Bower Law PC $250,000 + Mrs. Jeanette Campbell Abbott Laboratories Mr. and Mrs. J. Peter Coll, Jr. Mr. and Mrs. S. Michael Apollo Cordis Corporation The B & G Organization LLC Daiichi Pharmaceutical Corporation Bristol-Myers Squibb Edward Smith Mineola Lions Club Mr. Horst Spengler Mr. and Mrs. Robert H. Buescher Ethicon Endo-Surgery, Inc. Mr. Harold Herman Ms. Mead W. Stone Mr. Warren Galli Farrell Fritz, PC Ms. Mabel Heuss Mr. George L. Titus Mr. Eric Krasnoff Formed Plastics, Inc. Mr. Hamilton R. Hill Ms. Meta Troue Michael Magro Foundation, Inc. Ms. Ella L. Hilmer Mr. and Mrs. H. Willets Underhill Mr. and Mrs. Darryl Mallah Furey, Kerley, Walsh, Matera & Cinquemani, PC Miss Dorothy B. Hoag Ms. Eloise R. Valentine Ms. Dorothy A. Vogel Diane and Darryl Mallah Family Foundation Garfunkel Wild, PC Mrs. Patricia Hoffman Mrs. Thelma U. Hutton Mr. Leonard Wagner Mr. and Mrs. Joseph L. Mancino Mr. and Mrs. Frederick P. Leuffer, Jr. Ms. Adeline Impellitteri Mr. Lester K. Waterhouse McKeen Fund LifeStar Response Corporation Mr. Antonio Ingargiola Ms. Isabel Werner Mr. Robert G. Merrill The Fay J. Lindner Foundation Mr. Arthur J. Johnsen Mr. Robert Winthrop The Miracle Foundation The Pat Lyons Foundation Edward J. Kelly, MD Glen Oaks Club, Inc. Page 55

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