FREE Health Screenings for Women at Caledonian

Saturday, March 25 from 11:00am-3:00pm
   
The Caledonian Health Center And The Parkview Tenants Association

Invites You to Join Us at Our

We Love Women Health Fair Event
"Empowering Women of All Ages Through Health Care and Education"

Saturday, March 25
11:00am - 3:00pm
at
Caledonian Health Center located at
100 Parkside Avenue in Brooklyn & Directions

Free Health Screening and Information:

    * Asthma
    * Cancer Awareness
    * Cholesterol
    * Community Services
    * Dental Oral Health
    * Diabetes Management
    * Domestic Violence
    * Healthy Heart
    * Health Insurance
    * HIV/AIDS

Plus

    * Refreshments
    * Raffle

For More Details
Call 718-940-5637 or email us at rlm9004@nyp.org [2]


Sponsored By: The Parkview Tenants Association, The New Caledonian Health Center and its Community Health Partners, Arbor WeCare Program , CAMBA, Caribbean Women's Health Association, CitiHealth Training Center, Inc., Haitian Centers Council,, Ifetayo Cultural Arts, Native Black American Women, NYS Civil Service, New World Creations Resource Center, NY College of Health Professions, Diaspora, NYSNA, CIR, 1199,Pfizer and HEALTHFIRST

FREE Health Screenings for Kids at TBHC

Wednesday, February 22 from 3:00pm-6:00pm
   
The Children's Health Center at TBHC invites you to join us at the

"We Love Kids"
Health Fair Event

Wednesday, February 22
3:00pm - 6:00pm
at
TBHC's Children's Health Center located at
121 DeKalb Avenue in Brooklyn & Directions

Free Health Screening and Information:

    * Body Mass Index (BMI)
    * Dental Health
    * Child Safety
    * Immunization History (Bring in your child's immunization record and have it reviewed by our staff to ensure your child's immunization is current)
    * Health Insurance (Learn the In's and Out's of ensuring health care coverage for your child regardless of status)

Plus

    * FREE TOY GIVE-AWAY for Tots
    * Raffle for Knicks Tickets

For More Details
Call 718-940-5637 or email us at rlm9004@nyp.org [2]

FREE Seminar: Women and Heart Disease

In conjunction with National Women¹s Heart Health Day, The Brooklyn Hospital Center will be providing a free seminar.

There will be four health information presentations for women:

Heart Attacks & Chest Pain in Women
by Cardiologist Nisha Pillai, MD

Women with Diabetes & Heart Problems
by Endocrinologist Pushpalata Siroya, MD

Risk Factor Modification & Prevention
by Fellow Cardiologist Zaruhi Babayan, MD

Hormonal Replacement Therapy
by OB-GYN Chief Resident Shirley Vanmilder, MD

Cardiologist Sai Veeramachaneni, MD, FACC, FACP will host this most important seminar about the new #1 killer of women in America today ­ heart disease. Heart disease has surpassed breast cancer as the #1 cause of death in women so it is very important that women become knowledgeable about this disease. All woman are encouraged to attend.

Refreshments will be served.

For More Details
Call the Community Outreach Department at 718-250-6515 or email us at roc9023@nyp.org [5]

Too Much of a Bad Thing: TBHC Press Conference Targets Brooklyn’s Diabetes Epidemic

Diabetes and New York City don’t get along together. More than a third of the city’s adult population either has diabetes or prediabetes (imminent risk of diabetes). The situation’s even worse in Brooklyn, says Dr. Richard Becker, MD, president and CEO of The Brooklyn Hospital Center.

Ed Belkin, Aletha Maybank, MD, MPH, Congressman Edolphus Towns, NYS Assemblyman Darryl C. Towns, and Dr. Richard B. Becker, President and CEO of The Brooklyn Hospital Center

“We’ve got the second-highest diabetes rate in New York City after the Bronx. That’s why we’ve got to fight this disease every way possible, first of all through prevention but also by making sure our residents have access to the most up-to-date medical therapies out there.”
 
Helping to keep Downtown Brooklyn plugged in to the latest breakthroughs in diabetes treatment, The Brooklyn Hospital Center hosted Congressman Edolphus Towns (D-10), Assemblyman Darryl C. Towns (54^th Assembly District) and representatives from the Pharmaceutical Research and Manufacturers of America (PhRMA) for a press conference this December which reported on 183 new medicines in human clinical trials or awaiting approval by the FDA.

 “Developing new drugs to treat diabetes here in New York City will help address one of the major diseases affecting our community,” said Congressman Towns, who discussed his own battle with the disease at the event.

But Towns added that no drug therapy, no matter how effective, is worth much if the people who need it most can’t afford access. Uninsured and financially-struggling patients can receive the diabetes medications they need through the Partnership for Prescription Assistance (www.pparx.org [7]  or 1-888-4PPA-NOW), an organization sponsored by America’s pharmaceutical research companies. The PPA has helped almost two hundred thousand patients in New York State and six million more nationwide.

More information about Diabetes from our Website:

• Take a Diabetes Assessment [8]
• Type 2 Diabetes Guide [9]
• TBHC Department of Endocrinology [10]

1199SEIU Live Videocast: 2nd Annual Symposium on HIV-AIDS (A Six-hour Symposium)

Presented by the Institute for Continuing Education of the 1199SEIU Training and Upgrading Fund.

LIVE VIDEOCAST at The Brooklyn Hospital Center
Saturday, April 29, 2006 from 8:30am - 3:30pm

 REGISTRATION INFORMATION
To register and for more information please call 212-894-4390, email us [12] or visit
www.1199etjsp.org [13] here

ACCREDITATION INFORMATION
Accredited for pharmacists, physician assistants, nurses,
respiratory therapists, dietitians, radiologic technologists.
Social workers, lab technologists, and other healthcare
professionals are also invited to participate.

FEES
FREE for 1199SEIU Training Fund members and HHC pharmacists, dietitians and lab techs.
All other participants will be charged a modest fee of $12 per credit.

2005 Founders Ball to Benefit Geriatrics Unit

Each year, The Brooklyn Hospital Foundation hosts the Founders Ball, an annual event held primarily for fundraising purposes. This year, the proceeds of the 2005 Founders Ball will benefit a specialized and comprehensive Geriatric Unit. The geriatric population is the fastest growing population in the country. Concurrent with this rising population is an ever-increasing need for comprehensive care addressing both medical and psychosocial concerns. This enhanced unit will provide a multi-disciplinary continuum of care, and thereby strengthen services provided to patients during hospitalization. The unit will also be designed so that all furnishings, equipment, nutrition, and medical supplies are consistent with the needs of the elderly patient.

According to Dr. Mahnaz Ahmad, Chief of Geriatrics, The Brooklyn Hospital Center (TBHC) is in dire need of a Geriatrics Unit, which is sorely lacking in the hospital and in the community at large. Explained Dr. Ahmad, "The construction of this unit is going to be from a grassroots level - we need to break down the walls and rebuild. This remodeling will ideally include non-glare floors, special lighting, new bathroom fixtures suited for the elderly, and lower beds, among other essential items. This is a major environmental, architectural, engineering and remodeling renovation for The Brooklyn Hospital Center."

Dr. Ahmad added, "Right now, the patients are scattered throughout different floors and units within the hospital. It's important to teach the Nursing Staff the proper care for our elderly population and have the ability to provide our geriatric patients with the quality care that they require. However, because there isn't a definite Geriatrics Unit and patients are housed in different sections of the hospital, there are constant changes - staff members and nurses are different from day to day; shifts change - it's very difficult to get any sense of consistency when administering medical care to these patients. We need the consolidation of a unit.

Furthermore, Dr. Ahmad noted, "Our hospital is affiliated with at least 29 different nursing homes. Adding a Geriatric Unit will be a major attraction to TBHC - having a team designed and dedicated to the elderly population's needs will benefit the community immensely."

According to statistics, 13% of the American population is age 65 and older. By 2030, 25% of the population will fall into this age category. Currently, the life expectancy is 73 in males and 80 in females; life expectancy in 2050 will be 80 in males and 86 in females. Explained Dr. Ahmad, "The population is living longer, and we therefore need to accommodate this growing population for the present and for our future by providing appropriate facilities immediately. Other hospitals already have these units - it is logical that TBHC does this as well, especially with the current population's life expectancy and the community's need for a proper Geriatric facility. Our demographics are affiliated with so many nursing homes; we need to improve the care that we offer to this sector of the population. It's not a 'one-size-fits-all' arrangement where the facilities and the staff that we have are able to accommodate their needs. This section of the population - this age group - has very specific needs and requirements. TBHC has to tailor our care to fit the needs of the elderly population."

On a closing note, Dr. Ahmad remarked, "Every element of this remodeling has to be on-site, consolidated into one specific unit, including staff members - we will require our own social workers, physical therapists, nutritionists, and so on. Overall, we need the care, the attention and the manpower to launch the Geriatrics Unit so that it is as successful as can be."

********

We are proud of the successful fundraising efforts of The Brooklyn Hospital Foundation's Founders Ball over the decades, and are anticipating the launch of the Geriatric Unit for the benefit of both our hospital and our community. The faculty and staff are looking forward to offering the same quality care to this segment of the population that has made The Brooklyn Hospital Center renowned throughout the community. We are eager to provide the finest in medical expertise and the latest in technology in our Geriatrics Unit - the same type of excellent care that we are able to provide throughout the rest of our hospital will also be available to this vital part of our community.

2005 Graduate Recognition Ceremony

2005 Graduate Recognition Ceremony

Click here to view pictures from the
2005 Graduate Recognition Ceremony

For your convenience, pictures from the 2005 Graduate Ceremony photos are available online at Kodak's official web site www.kodakgallery.com [17]. The Kodak website will allow you to view and print selected images. If you need additional assistance, please contact The Brooklyn Hospital Center's Outreach Department at 718-250-8325.

Below is a list of The Brooklyn Hospital Center's 2005 Graduating Residents and Fellows. Please note that names with a * indicate Chief Resident and names with ** indicate Fellow.



Department of Dentistry/Oral & Maxillofacial Surgery
Division of General Dentistry

Jose Napoleon Andrickson, D.D.S.
Carlos Bou Assi, D.M.D.
Elie Bou Assi, D.M.D.
Rhina Elliot, D.D.S.
Bryant A. Jones, D.D.S.
Rami S. Kano, D.M.D.
Justin C. Mull, D.M.D.

 

Department of Dentistry/Oral & Maxillofacial Surgery
Division of Oral & Maxillofacial Surgery

* Chirag N. Desai, D.M.D.

 

 

Department of Emergency Medicine

 

Dion Dominique David, M.D.
* Roel Dizon Farrales, M.D.
Linda Florence Hahn, M.D.
* Manon Kwon, M.D.
Arlene Veronica McTeer, M.D.
Rajesh Mittal, M.D.
Jennifer Traylor Donson, M.D.

 

 

 

Department of Family Practice

* Vijayalakshmi Mamedi, M.D.
* Sasikala Sannapareddy, M.D.
Natarajan Venkatayan, M.D.

 

 

 

Department of Internal Medicine

* Umad Ahmad, M.D.
Shahin Ahmed, M.D.
Hani Adiep Benyamin Ajaipi, M.D.
Alla Bogorodovsky, M.D.
Mazoltuv Borukhova, M.D.
Pearl P. D'Sa, M.D.
Xinqing Fan, M.D.
Basir Ul Haque, M.D.
* Maria del Pilar Hernandez, M.D.
Alhakam Hudaihed, M.D.
Samer Khaled Mahmoud Khaled, M.D.
Uma A. Kunda, M.D.
Vinod Kumar Kurupath, M.D.
Predrag Petar Mitrevski, M.D.
Magdy S. Mostafa, M.D.
Sameer Husainuddin Nagamia, M.D.
Vivek Vasudevan Nair, M.D.
Thejaswini K. Reddy, M.D.
Dahlia E. Reid, M.D.
Inamulhaque M. Saboor, M.D.
Baljit Singh Sappal, M.D.
* Malvinderjit Singh, M.D.
Gagandip Bajwa Singh, M.D.
Glen W. Sorrentino, M.D.
Patricia Tanya Wade, M.D.
Linus Myint Lwin Yoe, M.D.
Peymon Zarreii, M.D.

Department of Internal Medicine
Division of Cardiovascular Diseases

** Emilio Del Priore, M.D.
** Nisha Unnikrishnan Pillai, M.D.

Department of Internal Medicine
Division of Gastroenterology

** Maurice Elihu, M.D.
** Hussien Abdelrasoul Elsiesy, M.D.
** Nader Mirhoseni, M.D.

Department of Internal Medicine
Division of Pulmonary Diseases

** Rana Yusuf Ali, M.D.

 

 

Department of Obstetrics & Gynecology

* Lauren Amy Feingold, D.O.
* Kim Camille Florence, M.D.
* Ulrika Linne'a Annette Holm, M.D.
* Shahla Ighani, M.D.
* Shazah Khawaja, M.D.

 

 

Department of Pediatrics

Leonard I. Firer, M.D.
Pradeep V. Garikiparthy, M.D.
Anita Kishen, M.D.
* Raveendra Babu Orugunta, M.D.
Meena Poddar, M.D.
* Zafar Abdul Quadir, M.D.
Sunita Satwani, M.D.
Mohan Kumar Thummalapalli, M.D.
Madhu D. Voddi, M.D.
Ella Zavolunova, M.D.

 

 

Department of Pharmacy

Mijiroghene Okobiah, Pharm.D.
Padma Sivaraju, Pharm.D.
Shaffeeulah Bacchus, Pharm.D.
Veronica Oviedo, Pharm.D.
Sarah Dedeyan, Pharm.D.

 

 

Department of Surgery

* Fredrick M. Poblete, M.D.
* Christine P. Te, M.D.
* Joseph SJ. Layson, M.D.

2005 Nursing Recognition Day Ceremony

For your convenience, pictures from the Nursing Recognition Day Ceremony are available online at Kodak's official web site www.kodakgallery.com [17]. The Kodak website will allow you to view and print selected images. If you need additional assistance, please contact The Brooklyn Hospital Center's Outreach Department at 718-250-8325.

href="http://www.kodakgallery.com/Slideshow.jsp?Uc=o7kckx9.awp27lt9&Uy=-horse9&Upost_signin=Slideshow.jsp%3Fmode%3Dfromshare&Ux=0&mode=fromshare&conn_speed=1" target="_blank">Click here to see photos

On Tuesday, May 10, 2005, The Brooklyn Hospital Center's Department of Nursing held its Nursing Recognition Day Ceremony. The following is a list of recipients who were recognized during the event:

Registered Nurse Recipients:

Cynthia Wilkins - 10B
Anna Hippolyte - Erasmus - 9B
Marcia Williams - Operating Room
Marilyn Dawson - 8W
Lorna Wagstaffe - Endoscopy
Paula Sanford - 8B
Christine Stahl - Dialysis
Nelia Lopez - 7W
Joyce Hurst - Radiology
Marie Douge - 7B
Corrine Brown - Emergency Dept.
Hazel Hicks - CPCU
Pearl Orakwue - Ambulatory Care
Mary-Ann Chiacchiaro - CSCU
Claire Haynes - Utilization
Judith Alleyne - MICU
Rosalind Boyche - Anesthesiology
Yanick Johnson - Pediatrics
Catherine Law - Williamsburg Clinic
Elizabeth Liwanag - NICU
Rita Gonzalez - La Providencia Clinic
Lisette Scarlett - 4WOB
Edouarade Morisset - Manhattan Center
Hazel Dickerson - Labor & Delivery
Betty Thomas - Home Health Services
Yvrose Salomon - SICU
Claudette Davis - Family Practices
Tita Fabunan - PACU

Friends of Nursing Awards Recipients:

Administrative Recipient - Jonathan Weld, Chairman of the Board of Trustees 
Physician Recipient - Dr. Harry Dym, Chairman of Dentistry 
Departmental Recipient - Mr. Joseph Caravaglio, Director of Environmental Services

2007 Graduate Recognition Ceremony

CLICK HERE TO SEE PICTURES
FROM THE
2007 GRADUATE RECOGNITION CEREMONY [21]

For your convenience, pictures from the 2007 Graduate Ceremony photos are available online at Kodak's official web site www.kodakgallery.com [17]. The Kodak website will allow you to view and print selected images. If you need additional assistance, please contact The Brooklyn Hospital Center's Outreach Department at 718-250-6515.

A Day in the Life Of The President & CEO

On Tuesday, September 9, Samuel Lehrfeld, President and Chief Executive Officer of The Brooklyn Hospital Center, opened his door for a day of job shadowing - an effort he made to support TBHC HEARTBEAT in its endeavor to bring the Hospital Family together by featuring a day in the life of one of its employees. In each ensuing publication, another person and their job responsibilities will be highlighted.

On a typical day, Mr. Lehrfeld is behind his desk by 7:30 A.M. On this particular day, he was there at 7:00 A.M. to prepare for an 8:00 A.M. meeting of the Finance Committee of the Board of Trustees.

Hardly had he settled in when Rick Braun, Executive Vice President for Administration and Finance, appeared at his door to meet with him. As Rick was leaving, Dr. Romulo Genato, Chairman of the Department of Surgery, stuck his head in to ask for a few minutes of Mr. Lehrfeld's time. This meeting concluded just minutes before the Finance Committee meeting began. The finance Committee meeting concluded at 9:30 , after a thorough review and evaluation of the Hospital's financial position. This was followed by a five minute coffee break before proceeding with his day.

At that time, Mrs. Anne Goonan, Senior Vice President for Nursing and Patient Care Services, appeared for her daily meeting with Mr. Lehrfeld to deliver a 24 hour report on the prior day's nursing and clinical issues, and the 24-hour advance plan.

This meeting was immediately followed by an unscheduled meeting with Tom Grosso, Senior Vice President for Human Resources, to discuss issues of concern that fall under his responsibilities. After that meeting concluded, Dr. Wilfrido Sy, former Chairman of the Department of Nuclear Medicine, appeared for a meeting with Mr. Lehrfeld to discuss issues relative to Magnexx, an imaging company. That meeting concluded at 10:50 AM .

At 11:00 AM , Nancy Petterson, Director of Institutional Planning, appeared for yet another unscheduled meeting on the day's calendar, to discuss planning issues. Before that meeting had concluded, Mike Delicce appeared to ask Stara, Mr. Lehrfeld's Executive Secretary, if it was possible for him to get a few minutes of Mr. Lehrfeld's time to discuss issues he was working on. Since Mr. Lehrfeld never turns anyone away from his door, Mike was told to wait for the present meeting to end and he would see him.

Next on the day's agenda was lunch with a Trustee. Mr. Lehrfeld has been meeting individually with each of the Trustees to give them an opportunity to know him better, as well as for him to know the Trustees as individuals. This is also an opportunity to learn what concerns the Trustees may have about the Hospital. He then had to rush back to the Hospital to prepare his address to the Department Heads at their monthly meeting.

This was immediately followed by a meeting in his office to discuss possible new business opportunities for the Hospital - a meeting intended to find means of generating extra income. This meeting concluded at 5:00 P.M. leaving Mr. Lehrfeld about 45 minutes to look over his mail and return phone calls before going to the Caledonian Health Center to meet with that Community Advisory Board. The Community Advisory Board meeting adjourned at 7:30 PM , exactly twelve and a half hours after his day began, which is very typical. It is not unusual for Mr. Lehrfeld to have to attend an event outside the Hospital in the evening hours championing the Hospital with members of the community, local and national politicians, or other leaders in the healthcare industry.

As the President and Chief Executive Officer, Mr. Lehrfeld never misses an opportunity to meet with anyone who has an interest in our Hospital. Each meeting has the potential of providing an opportunity for a new business venture; his philosophy: every person he meets matters to him - each suggestion, each report, each grievance provides a door to improvement.

Now we have at least an idea of what A Day in the Life of the President is like.

And the Winner of the Caring Heart Award goes to....

The Pastoral Care Advisory Committee was challenged beyond expectation! The members' task was to review the twenty nominees for the coveted Caring Heart Award 2004, and choose the recipient. The fact of the matter was that all twenty deserved this great honor.
The Caring Heart Award is presented each year by the Department of Pastoral Care to a staff member who treats patients as if they were family. Staff members are eligible to submit the names of colleagues who, in their opinion, are worthy of the award. To show you the enormity of the challenge faced by the Pastoral Care Advisory Committee, let's highlight the recipient and then showcase some of the other nominees.

Angelica P. Braithwaite, Neonatal Nurse Practitioner
Angie has been working at TBHC since June 17, 1974, over thirty years of dedicated service! She specializes as a Neonatal Nurse Practitioner, and shares herself in the children's clinic. She graduated from Erasmus High School , right here in Brooklyn , along with Barbra Streisand, Neil Diamond, and, of course, our own Dr. Michael Cabbad.
Children seem to cling to Angie, and their mothers love her. She is like an angel since she travels faster than an angel with wings. She says she has many people to help and so little time to touch all their lives. But the ones she does, and that's a heap, are blessed by her expertise, love and compassion. We join in saying the words spoken by her best friend when she heard Angie's award: "You go, girl!"

Here's a snapshot of some of the other nominees who are winners in their own right:

Karen Congro, Dietician/Nutritionist
Karen has served the TBHC community for the past sixteen years. She is the founder and present inspiration behind the Wellness Club, a gathering of more than seventy people from the community who want to learn how to live healthy lives. Karen takes a holistic approach with this group, teaching participants how to further their own physical, nutritional, emotional, and spiritual health. And she makes it all fun! David, a long-time member of the club, says about this dedicated woman: "She always takes time to listen. She will go the extra mile." Congratulations on your nomination, Karen!

Anne Goonan R.N., Senior Vice President for Nursing and Patient Care Services
Anne celebrates her silver anniversary at TBHC this year. Imagine, twenty-five years of loving, life-giving service. She's a local girl who made good, having been born less than a mile from TBHC. She is a hard worker who spends countless hours attending to the needs of her nurses and the rest of the staff. Anne has great faith in God's ability to lead her, and she is verbal about the importance of spirituality in her life and work. Her nominator said this about her: "Anne has a lot of heart for her nurses. She gives hugs, knows names, is warm and comforting, and will take care of you." We love you back, Anne!

Nelly Karlin, Registered Nurse
Nelly received four nominations for this award, more than any other candidate. She is a nurse in the Pediatric Hematology/Oncology Department, and she loves those kids! A doctor who nominated her said: "She takes children and their families with grave illness under her wings and offers solace and comfort through their trials and tribulations." Another nominator marveled: "Nelly even invited a child from a dysfunctional family to her home for Christmas and bought him presents." A final testament to her love follows: "She always smiles, no matter how much is on her plate." Nelly, may the angels continue to smile on your loving and compassionate nature.

Can you see now why the selection committee had such a difficult time to choose the winner? They are all winners and we are proud to have them among us!

Brooklyn Hospital Welcomes A New Residency Program

On June 30, 2004, the Conference Center at The Brooklyn Hospital Center was full of mostly energetic, and perhaps slightly apprehensive, new residents. Amongst this group were a few select pharmacists. It was unveiled that these pharmacists were the inaugural class of Pharmacy Practice Residents. These pharmacists are participating in an organized, directed, postgraduate training in a defined area of pharmacy practice. Training focuses on sharpening the judgment necessary for competence in the provision of direct patient care. The program lasts for one year and may be followed by specialty residencies, fellowships, or entrez into a multitude of career opportunities. While residency training is optional for pharmacists, the current nationwide standard for hospital pharmacy practice involves residency training.

At the end of the first year of this program, the American Society of Health-System Pharmacists (ASHP) will survey the program for accreditation. These accreditation standards require that pharmacy practice residents become competent in patient care. Residents must gain exposure to and participate in an effective and safe medication-use process. Such exposure is deemed a service commitment by ASHP. To be effective, service commitments should be met in an integrated and systematic manner. Residents must be responsible for caring for a wide variety of patients and developing drug information skills.

Service commitments are often met in the form of rotations or blocks devoted to a practice area or patient population. Some residency programs may meet this requirement through longitudinal patient care experiences. At The Brooklyn Hospital Center, the Pharmacy Practice Residents have a mixed experience of traditional rotations and longitudinal experiences. Each resident spends two months working with the Internal Medicine service, one month each of the adult critical care areas, one month in the Emergency Department, one month with the Infectious Disease service, one month working on safe medication practices and policies. Additional months are devoted to electives in Cardiology, Nutrition, Drug Information, or other areas of individual interest. Each resident also devotes one afternoon per week to a longitudinal ambulatory care experience. Currently, they are involved in an Anticoagulation Clinic, Asthma Center , HIV Adherence Clinic. A Cardiovascular Risk Reduction Clinic (smoking cessation and dyslipidemia management) is also underway. Each of these clinics function under what is known as "collaborative drug therapy management" and involves having a patient's disease state managed by a pharmacist under a physician's supervision through the use of a established protocols.

Pharmacy Practice Residency programs are not new. Such programs have been in existence for over twenty-five years. Currently there are almost 400 programs nationwide. Nineteen programs exist in New York State ; ten in the New York City area. Most programs recruit anywhere from one to six or more residents. With five residents, the Brooklyn Hospital program is the second largest in New York State . Most of the larger programs include "specialty residents"; currently this is not the case here.

The overall goal of the residency program is to help promote the concept of pharmaceutical care within the hospital. Pharmaceutical Care is a patient-centered, outcomes oriented pharmacy practice that requires the pharmacist to work in concert with the patient and the patient's other healthcare providers to promote health, to prevent disease, and to assess, monitor, initiate, and modify medication use to assure that drug therapy regimens are safe and effective. The goal of Pharmaceutical Care is to optimize the patient's health-related quality of life, and achieve positive clinical outcomes, within realistic economic expenditures.

The motto of this dynamic Pharmacy Practice Residency Program is "The Remedy is Experience" . To gain this experience, each resident works under the supervision of Drs. DiGregorio, Berrios-Colon, and Nogid, in conjunction with the Hospital's attending and house-staff physicians. Under the affiliation agreement with Long Island University , the residents also work with pharmacy students in the hospital and also have teaching responsibilities on campus.

One of the advantages of deploying five residents has been the ability of the Department of Pharmacy's Division of Pharmacotherapy Services to extend its clinical services around the clock through a Pharmacotherapy Resident-On-Call program. The residency on-call program was designed to offer a supportive environment in which the resident is held accountable for pursuing optimal outcomes of drug therapy. The program provides opportunities for the resident to engage in independent decision-making, care for a wide variety of patients, and manage acute illness. Extensive support and performance assessment are provided by preceptors.

Both patients and residents stand to benefit from the on-call program. Services are available overnight, on weekends, and on holidays. The responsibilities of the on-call resident encompass those of a pharmacist caring for individual patients. During late evenings, nights, weekends, and holidays, the primary pharmacist or the clinical pharmacokinetics service may not be available to assess and respond to supratherapeutic serum drug concentrations. The on-call resident is then assigned to provide such services. While all pharmacists provide drug information, detailed consultation is sometimes necessary. Such consultation is provided by the resident and includes recommending drug therapy, assessing adverse drug events, recommending specific drug administration techniques (e.g., electrolyte infusion), screening for drug interactions, recommending treatment for drug toxicity or poisonings, and identifying solid oral dosage forms. The resident is exposed to emergency patient management primarily through direct participation in adult and pediatric resuscitation efforts.

It may be impractical for an institution to have clinical pharmacists available 24 hours a day, but having an on-call resident monitor selected patients (e.g., those expected to become more ill or others requiring particularly close attention) can extend a pharmacy department's ability to provide intensive care consistently. This model resembles the medical house-staff cross-cover model. Before leaving for the day, the primary pharmacist may inform the on-call resident of anticipated serum drug concentrations, as well as pending results of cultures and other laboratory tests that may require close monitoring. The resident provides the requested service during the on-call shift and, on the following day, informs the primary pharmacist about changes in the patient's condition and any interventions. This contributes to a continuity of high-level care.

Each pharmacy resident participates in the on-call program regardless of the focus of his or her residency. On-call services are provided in single 24-hour shifts beginning at 8:00 AM each day. The on-call resident remains in the institution overnight and carries additional pagers, each devoted to a defined role or on-call activity. All pharmacy residents have 24-hour access to drug information, resources. They are expected to contact a pharmacist (preceptor) should they need advice.

All pharmacy residents are considered house-staff officers and receive many of the same benefits as their medical resident colleagues. Pharmacy residents are provided an assigned on-call room in the house-staff on-call area, a cafeteria stipend for each on-call shift, and appropriate attire (e.g., scrubs). During the initial orientation sessions, residents are introduced to departmental and drug policies and attend sessions on pharmacokinetic monitoring principles and policies for all drugs assessed by the therapeutic drug monitoring laboratory. To increase the resident's comfort with emergencies, there are meetings devoted to cardiopulmonary resuscitation, including simulations requiring the provision of medication from an emergency drug cart. Pediatric emergencies are also reviewed. Residents also complete the examination for adult cardiac life support (ACLS). Upon certification as an ACLS provider, the resident is eligible to begin on-call shifts.

In addition to these patient care activities, each Resident also participates in a variety of projects designed to improve the overall level of care provided by the Department of Pharmacy Services. Examples of these projects include: pharmacoeconomic analyses of new medications that are proposed for use in the hospital, implementation of safety measures to prevent medication errors, development of emergency preparedness plans for the provision of medications during a crisis, development of a system to promote the use of oral medications in place of injectable medications, obtaining thorough medication histories on patients as they are admitted to the hospital, providing medication information to patients upon discharge from the hospital, and a variety of research projects, to name a few. Not only do these activities enhance the care of our patients, but many of these "best practices" have been associated nationwide with an overall cost-savings for health-care institutions. On average, it has been reported that hospitals that provide this level of pharmacy service are able to lower their drug costs by over $3700.00 per occupied bed per year.

The residency program is administered jointly through the Department of Pharmacy's Division of Pharmacotherapy Services and Long Island University 's Arnold and Marie Schwartz College of Pharmacy. The program is under the direction of Robert V. DiGregorio, Pharm.D., Director of Pharmacotherapy who is also a full-time faculty member from the neighboring Arnold & Marie Schwartz College of Pharmacy. Working with Dr. DiGregorio are Evangelina Berrios-Colon , Pharm.D. and Boris Nogid, Pharm.D., Clinical Coordinators for Ambulatory Care Pharmacotherapy and Inpatient Pharmacotherapy, respectively. Both Clinical Coordinators are graduates of Long Island University and graduates of nationally accredited residency programs. This team of pharmacotherapists have implemented such services as: an anticoagulation clinic; asthma center; automatic substitution of certain medications for more cost-effective drug therapy; clinical monitoring of critical care, internal medicine and infectious diseases patients.

This year's residency class includes Drs. Shaffee Bacchus, Mijiro Okobiah, Veronica Oviedo, Padma Sivaraju, and Sara Dedeyan.

Questions or requests for more information on pharmacotherapy services or the Pharmacy Practice Residency Program should be directed to Dr. Robert DiGregorio at (718) 250-8182.

Caledonian Health Center

The Caledonian Health Facility continues to move forward with its partnering efforts through local community-based organizations (CBO's). The Haitian Center Council, the Haitian Women's Program, and CAMBA continue to be partners with the Caledonian Health Center , working closely with the PATH center to address the needs of individuals with HIV and AIDS. As our relationships with organizations expand, the Caledonian Health Center is looking to work more closely with our partnering CBO's to address the primary care needs of a larger number of their constituents. Primarily, these organizations have been instrumental in providing case management and other support services needs for PATH patients. As Caledonian moves forward, however, we anticipate through internal forums and councils that we will be able to service a larger number of community residents and program recipients.

Additionally, the New York College of Health Professions has developed a solid student base and programmatic curriculum which continues to grow. The New York College of Health Professions has been a leader in holistic health care education for over 25 years. The College offers undergraduate and undergraduate degree programs in Massage Therapy, Advanced Asian Bodywork (BPS), Acupuncture (BPS/MS) and Oriental Medicine (BPS/MS) as well as a Continuing Education Program in Holistic Nursing for Registered Nurses; Financial Aid is available if the student is qualified. The New York College of Health Professions operates under a charter from the Board of Regents of the University of the State of New York through the New York State Education Department. It is also certified by the Accrediting Commission for Acupuncture and Oriental Medicine, and is endorsed by the New York State Nurses' Associate Council and the American Holistic Nurses Association.

Finally, discussions and architectural drawing have been rendered for the development of the IFETAYO Cultural Arts Facility , which has had its administrative office located at the Caledonian Health Facility since September 2004. Discussions around construction are ongoing, and we are moving forward with this program. The IFETAYO Cultural Arts Facility, headed by Executive Director Sister Kwayera Archer-Cunningham, provides learning experiences through African heritage-based cultural arts programs aimed at children and young adults. Complete with dance, drama, poetry, and rites of passage programs, the IFETAYO Cultural Arts Facility is uniquely positioned to enhance the cultural learning needs of community children. Interested individuals can call (718) 856-1123 for more information.

The Caledonian Health Facility is also working with La Providencia, Williamsburg and Manhattan Avenue sites to share mutual issues of concerns and to identify strategic opportunities for reaching out to the community. Mr. Eric Canales has joined Caledonian as the Community Outreach Coordinator for the Caledonian D&TC. It will be a key responsibility of his to foster and nurture the relationships between the CBO's and the Caledonian sites. Mr. Canales has already begun to work with the Manhattan Avenue Health Center and the Greenpoint community, specifically the Polish Slavick Cultural Center, an area that some of our providers have deep ties with. To help move this process forward, the off-site leadership is scheduled to meet with the Greenpoint, Bushwick and Williamsburg HIV/AIDS care network along with a consortium of 45 CBO's, including other assorted grassroots coalitions in the greater Brooklyn area.

Caledonian Health Center Strategic Plans, Strategic Partners

The Caledonian Health Facility continues to move forward with its partnering efforts through local community-based organizations (CBO's). The Haitian Center Council, the Haitian Women's Program, and CAMBA continue to be partners with the Caledonian Health Center , working closely with the PATH center to address the needs of individuals with HIV and AIDS. As our relationships with organizations expand, the Caledonian Health Center is looking to work more closely with our partnering CBO's to address the primary care needs of a larger number of their constituents. Primarily, these organizations have been instrumental in providing case management and other support services needs for PATH patients. As Caledonian moves forward, however, we anticipate through internal forums and councils that we will be able to service a larger number of community residents and program recipients.

Additionally, the New York College of Health Professions has developed a solid student base and programmatic curriculum which continues to grow. The New York College of Health Professions has been a leader in holistic health care education for over 25 years. The College offers undergraduate and undergraduate degree programs in Massage Therapy, Advanced Asian Bodywork (BPS), Acupuncture (BPS/MS) and Oriental Medicine (BPS/MS) as well as a Continuing Education Program in Holistic Nursing for Registered Nurses; Financial Aid is available if the student is qualified. The New York College of Health Professions operates under a charter from the Board of Regents of the University of the State of New York through the New York State Education Department. It is also certified by the Accrediting Commission for Acupuncture and Oriental Medicine, and is endorsed by the New York State Nurses' Associate Council and the American Holistic Nurses Association.

Finally, discussions and architectural drawing have been rendered for the development of the IFETAYO Cultural Arts Facility , which has had its administrative office located at the Caledonian Health Facility since September 2004. Discussions around construction are ongoing, and we are moving forward with this program. The IFETAYO Cultural Arts Facility, headed by Executive Director Sister Kwayera Archer-Cunningham, provides learning experiences through African heritage-based cultural arts programs aimed at children and young adults. Complete with dance, drama, poetry, and rites of passage programs, the IFETAYO Cultural Arts Facility is uniquely positioned to enhance the cultural learning needs of community children. Interested individuals can call (718) 856-1123 for more information.

The Caledonian Health Facility is also working with La Providencia, Williamsburg and Manhattan Avenue sites to share mutual issues of concerns and to identify strategic opportunities for reaching out to the community. Mr. Eric Canales has joined Caledonian as the Community Outreach Coordinator for the Caledonian D&TC. It will be a key responsibility of his to foster and nurture the relationships between the CBO's and the Caledonian sites. Mr. Canales has already begun to work with the Manhattan Avenue Health Center and the Greenpoint community, specifically the Polish Slavick Cultural Center, an area that some of our providers have deep ties with. To help move this process forward, the off-site leadership is scheduled to meet with the Greenpoint, Bushwick and Williamsburg HIV/AIDS care network along with a consortium of 45 CBO's, including other assorted grassroots coalitions in the greater Brooklyn area.

Caledonian Health Fair Offers Free Flu Vaccine

On Saturday October 16th 2004, the Caledonian Family Health Center hosted its 2nd annual Health Fair as a Diagnostic and Treatment Facility. The Health Fair was held in both the front parking lot as well as in the ambulatory care suite where community residents were screened for blood sugar levels, blood pressure, and cholesterol levels. In addition, oral screenings were conducted as were hearing tests. Distribution of the flu vaccine accounted for some of the success of the Health
Fair as community members came out to receive free vaccinations. In addition to health screenings, Caledonian was supported by many of its new community based organizations and partners who set up tables and distributed literature and information on the services which they provide. Organizations such as CAMBA, the Haitian Women's Program, the IFETAYO Caribbean Aids Fund, 1600 WWRL radio, Health First and the New York Presbyterian Community Health Plan provided support and sponsorship. The music and moon bounce entertainment for children was sponsored by Health First and rounded out the event. The Caledonian Health Center would like to express its thanks and appreciation for all of the support that they received from its sponsors and The Brooklyn Hospital Center.

Caledonian's Outpatient Dental and Oral Surgery facility

The past year has seen a great deal of growth and expansion with the Caledonian Health Center's newly-opened Outpatient Dental and Oral Surgery facility. The new nine-chair facility is now open everyday, Monday though Friday from 9 a.m. to 5 p.m., offering comprehensive dental and oral surgical services.

According to Dr. Dym, Chairman, Department of Dentistry and Oral Surgery, Felipe DeJesus II is the capable Outpatient Dental and Oral Surgery facility's Office Manager and Administrative Coordinator of the Caledonian Site. Mr. DeJesus went to school at the State University of New York at Stony Brook, and has been with the facility for approximately one year.

In addition, the facility is proud to feature many fine physicians and staff members. Born in Taiwan and raised in Flushing , Queens, Dr. Edward Yuan is Caledonian's Dental Facility Director. Adds Dr. Dym, "He is an excellent restorative dentist in addition to being an educator. Ed is deeply dedicated to the program and recently married." Dr. Ricardo Boyce has also recently joined our team at Cale. Originally from Panama city and raised in the south side of Chicago , Dr. Boyce is a member of the American Dental Association, American Academy of Oral Medicine, New York State Dental Association, and the Second District Dental Society. Explains Dr. Dym, "He has quickly acclimated to the facility and its patients. In addition, Maureen (Pam) Savory, our front desk registrar, is another integral part of our Cale team. Poised, calm and professional, she makes all patients feel welcome and at ease."

The Caledonian Health Center 's Outpatient Dental and Oral Surgery facility now boasts:

    * Two full-time general dental attendings
    * Two general practice residents (ADA-approved general practice program)
    * A teaching center for post-graduate endodontic students from NYU Dental School
    * A teaching center for senior NYU Dental Students
    * Part Time Dental Hygienist/Dental Education

The newly-appointed dental suites run on an appointment basis to help significantly lower waiting time. The facility is manned by expert general dentists as well as specialists in Oral Medicine, Oral & Maxillofacial Surgery, Endodontics and Implantologists. "The Dental and Oral Surgical Department is committed to extending state-of-the art therapy to the patients we treat and in turn, has established a comprehensive implant restorative program for our patients, in addition to our many other services," explains Dr. Dym. "The implants are placed by our Senior Oral & Maxillofacial Surgery Residents with direct supervision by our Attending Staff at greatly reduced outpatient fees. All implants placed at our dental facilities are ultimately restored by our general dentists."

Additionally, the site functions as an educational facility with New York University Dental Students assigned for an educational opportunity and experience, alongside the American Dental Association-approved Oral & Maxillofacial Surgery and General Dentistry practice Residents. Dr. Dym explains, "The collaborative effort (between Cale and New York University ) helps to recruit capable residents from NYU dental school to go through our resident program, as well as increasing productivity and the academic climate of the current program."

Furthermore, the facility has received two significant grants from the Littauer Foundation that has enabled the Cale Health Center to purchase state-of-the-art dental equipment. The site also features:

    * Oral medical specialists
    * Oral & maxillofacial specialists
    * Root canal specialists
    * Periodontal specialists
    * Bleaching and teeth whitening

Explained Dr. Dym, "We also have the ability to treat all aspects of patients with oral pathology as well as patients in need of specialized jaw surgery (known as orthognathic surgery).The facility is also capable of treating patients with mental, emotional & physical handicaps, and is utilized as a referral site for many federal state & city health care agencies. In addition, we also have a very active HIV clinic with a dedicated hygienist, Ms. Irena Katrikh, who works closely with Mr. Dan Sendsik of the Path Center ." Dr. Dym notes that patients with compromised medical/health histories and even those with dental phobias are all handled and fully treated in the new facility. The site also has the ability to treat patients who require sedation/general anesthetics if necessary. Dr. Dym also added, "We also recently acquired a specialized laser teeth-whitening system - ZOOM II® - which we are offering to our community patients at a greatly reduced cost."

Dr. Dym noted that the facility has doubled its volume over the last year - they are currently seeing approximately 500 patients per month, roughly 6,000 patients a year. With this rapid increase in patient volume, explained Dr. Dym, the number of dental assistants has grown to four full-time people. "We are proud to proclaim that these four assistants - Ada Fulmore, William Gilmore, Carla Morgan and Dolores Winston - are graduates of the combined TBHC/1199 Federal Waiver Trainee Program, initiated through the combined efforts of HR Administration and the Dental & Oral Surgery Department."

"The Caledonian Health Care Facility and Dental Clinic is a combined product of Mr. Samuel Lehrfeld and Jonathan Weld's vision and foresight into paving new health inroads in the community, and for recognizing the vital importance that quality dental care means to one's overall health & image," explained Dr. Dym.

"Though all beginnings are difficult, I feel that our new dental facility will become a paradigm for community dental care, and I am deeply proud of the work and contributions of our dedicated dental & oral surgery team. The success of our facility is directly related to their dedication & hard work."

In retrospect, Dr. Dym added, "Finally, we know that the facility is top-notch, since many of the Board of Trustee members have not only visited the facility, but are also active patients."

Creating The Paperless Paper Trail with Electronic Medical Records

This spring, The Brooklyn Hospital Center began implementing a comprehensive Electronic Medical Record (EMR) system that will make patient care an almost entirely paperless process.

In fact, the only printed material most patients and their caregivers will interact with will be the plastic, barcode-printed ID bracelet worn by patients throughout their stay.

President & CEO Dr. Richard B. Becker cuts the ribbon on a new Electronic Medical Record (EMR) System

“Throughout the year we’ll be transitioning from a hand-written system into a far more standardized, electronic approach to record keeping,” said Paul Albertson, the Center’s executive vice president and chief operating officer.

From admission to discharge, all data related to patient care such as medical history, allergies, test orders and results, assessments, and progress notes will be collected through a single computer interface rather than a paper file or one of the many stand-alone computer systems long in use throughout the Center.

According to Albertson, using a single electronic portal to track patient care is becoming an essential component of twenty-first century medicine. “Lengths of stay in hospitals have gotten dramatically shorter in the past two decades—which is good news—but in this more concentrated space of time patients often have a lot more testing done, receive a wider variety of medications, and undergo far more complicated interventions.”

And they will see many more caregivers, perhaps as many as a hundred throughout their in-patient stay, including specialists, residents, nurses and other healthcare associates across all three shifts.

“What you end up with are lots of ‘hand offs’ from one caregiver to another,” said Albertson. “With so many individuals looking at different aspects of the patient’s health, a vital piece of information might get lost or misinterpreted.”

It’s a common complaint heard throughout America’s hospitals—the more medical science and technology have advanced, the more specialists and sub-specialists are required, many of whom may speak with a unique vocabulary and point-of-view.

Affectionately known as a "COW," this Computer On Wheels can be rolled into a patient's room for easier data collection But this Tower of Babel scenario can be greatly mitigated when a single electronic record is used for patient data collection. With EMR, previously unconnected pieces of information can be viewed as an organic whole.

This means safer, more comfortable, healthier patients.

It also translates into happier, less anxious patients. When records are kept electronically, both nurses and doctors spend less time with the chart and more time at the bedside. Patients tend to pick up on this quickly and appreciate it. They feel more empowered because they’re better informed.

The same holds true for the caregivers themselves, who through EMR have the tools to understand how they’re performing against nationally accepted benchmarks, such as the twenty-five metrics of care identified by Medicare.

“Patients benefit when everyone who has contact with patients feels personally responsible for their welfare,” said Dr. Lisandro Irizarry, chairman of Emergency Medicine. “EMR systems like the one we’re introducing make it crystal clear whether or not Best Practice standards are being met, both on an individual and department level. That’s when things get really exciting, because now you have clear, well defined goals for improving quality of care, not just a vague mandate to improve.”

But improving care is not the only benefit of EMR. It also contributes to The Brooklyn Hospital Center’s goal of serving all residents of Brooklyn and greater New York, in whatever hospital, clinic or physician’s office they happen to be treated.

Vice president of information systems Irene Farrelly said, “Our EMR system will be highly interoperable, which means the data we collect will be shared with other EMR systems as patients move through various treatment venues.”

Free flowing communication among the wider community of physicians is especially critical given the nature of the Center’s catchment area. Many residents either are elderly or don’t speak English as a first language, which increases the likelihood of miscommunication. EMR reduces risk because it remembers everything for you.

According to Paul Albertson, “It’s a high-tech example of what our organizational motto Keeping Brooklyn healthy is all about.”

Dr. Stephen Carryl in The Network Journal

Department of Surgery [31]

The Network Journal's Annual Best Black Doctors Issue

The Network Journal Communications Inc. was founded in 1993 by Aziz Gueye Adetimirin. The magazine is dedicated to educating and empowering Black professionals and small business owners. This issue features Dr. Stephen Carryl, Chairman of the Department of Surgery and Director of the Surgery Residency Program at The Brooklyn Hospital Center.

Below is an excerpt from the cover story, written by Angela Johnson Meadow

Dr. Carryl is one of a growing number of medical professionals of color who volunteer their services in needy areas of Africa and the Caribbean.

“For years, we had a big problem getting doctors to commit their time,” says Carryl, who uses his vacation time to participate in health missions. “A lot of that has changed in the last five years.”

“Now, every mission we’re limited by the number of people that can be accommodated, not the number of people interested in going,” Carryl says.

To find out more about Dr. Stephen Carryl, please read the entire article at The Network Journal [32].

Free Health Screenings at Brooklyn Hospital Center/Kiwanis Club of Bedford Stuyvesant Health Fair Saturday, March 20th

Brooklyn, NY-- The Kiwanis Club of Bedford Stuyvesant and The Brooklyn Hospital Center to offer free glucose, blood pressure, cholesterol screenings and giveaways at family health fair Saturday, March 20, 2010 at 609 Dekalb Avenue from 10 a.m. to 2:30 p.m. at 609 Dekalb Avenue. To raise awareness about diabetes and provide wellness information for the community, the event will feature a presentation on diabetes for children 12 and up with their parents, followed by a Q & A session. It will also offer information on asthma, cancer prevention, HIV/AIDS awareness, and access to Medicare, Medicaid, and other insurance entitlements for the uninsured or underinsured. For additional information, contact the Kiwanis Club of Bedford Stuyvesant at 718-622-3888 or TBHC Community Outreach at 718-250-8344.

Graduation For Trainees of the Breast-Feeding Peer Counseling Program

The New York State Department of Health - WIC Program provides grants to WIC Programs for breast-feeding initiatives. One of those initiatives is the breast-feeding peer counseling program which is aimed at increasing the rates and duration of breast-feeding as a means to reduce infant mortality rates.

The breast-feeding Peer Counseling program is a ten week training program offered to WIC participants or community health educators who have positive feelings about breast-feeding. A breast-feeding peer counselor is a mother who has breast fed one or more infants for several months, has successfully completed the peer counseling training program and is competent to provide breast-feeding guidance and information to WIC participants. A breast-feeding peer counselor can also be a father or a community advocate/educator who has positive feelings about breast-feeding and is committed to providing guidance and support to WIC participants after successfully completing the training.

The Brooklyn Hospital Center offered a Breast-feeding Peer Counselor Orientation on July 26, 2003 at the Caledonian Campus. Prior to the orientation, invitations were sent out to the WIC pregnant and breast-feeding mothers, and potential community candidates. Thirty-four candidates attended the orientation, twenty one participated in the training, and nineteen graduated.

The training was provided by Diana Vargas, MSN, IBCLC and Gessy Matthelier (Breast-feeding Coordinator). Training sessions were done in two groups, a morning class and an evening class to accommodate working parents. Sessions covered included but were not limited to: Communication skills, Breast Anatomy and Physiology, Breast-feeding Positions, Contraindications of Breast-feeding, Expression, Pumping and Storage of Breast Milk, Myths and Cultural Beliefs, Medication and Breast Milk, and Child Nutrition.

To evaluate the knowledge and skills gained, pre and post tests were given at each session. Evaluations were also distributed to all trainees. Teaching tools included slides, videos, breast-feeding equipment, brochures and breast-feeding tools. Training classes were conducted from October 1, 2002 through December 19, 2002 .

The Breast-feeding Graduation Ceremony took place on Friday, July 18, 2003 . Fourteen (14) peer counselor graduates attended the ceremony. Two New York State Department of Health - WIC officials also attended. Ms. Leticia Ajodah, the breast-feeding Coordinator for the NYSDOH - Metropolitan region spoke about the history of the breast-feeding Peer Counseling Program and Ms. Patricia Garrett "NYSDOH - breast-feeding Coordinator" from Albany gave an oversight on the role of the peer counselors.

In attendance were Samuel Lehrfeld (President and CEO of The Brooklyn Hospital Center), Richard Braun, Jr. (Executive Vice President and Chief Financial Officer), Anne Goonan (Senior Vice President of Nursing and Patient Care Services), and Robert Cooper (Director of Outreach Programs). The Brooklyn Hospital Center Angelic Choir performed and one of the peer counselors presented a poem she wrote on Breast-feeding. The breast-feeding Peer Counselor song was performed by Ms. Jeaneane Welch from the Bedford Stuyvesant Family Health Center - WIC Program.

Breast-feeding Peer Counselors provide guidance, encouragement and support as well as up to date information on breast-feeding and lactation to pregnant and lactating women in the WIC clinics and the communities. Peer counselors are familiar with common problems encountered by breast-feeding women and are trained to anticipate when and why these problems might occur so they can teach the mothers how to prevent their occurrence or resolve them quickly if they occur. To learn more about the Breast-feeding Peer Counseling Program, call the WIC Program at (718) 940-5244 or (718) 250-8126.

Breast-feeding Peer Counselors

    * a mother who has breast fed one or more infants for several months
    * can also be a father or a community advocate/educator who completed training
    * has successfully completed the peer counseling training program
    * are trained to anticipate when and why these problems might occur
    * can teach the mothers how to prevent their occurrence or resolve them quickly if they occur.
    * Provide guidance, encouragement and support as well as up to date information on breast feeding and lactation to pregnant and lactating women in the WIC clinics and the communities

ICANL Deems TBHC Accredited Nuclear Laboratory

an appointment with the Department of Nuclear Medicine
   
The Brooklyn Hospital Center located in Brooklyn, NY, was granted accreditation by ICANL. The facility is one of the first hospital-based nuclear medicine laboratories in the United States, Canada and Puerto Rico to receive recognition for its commitment to high-quality patient care and its provision of quality diagnostic testing. This prestigious accreditation proves that nationally accepted standards are met, and that the personnel involved in patient care are well qualified through certification and continuing education.

The Nuclear Medicine Department of The Brooklyn Hospital Center has always been a center of excellence in providing quality care to our patients. Our goal is to deliver efficient diagnostic and therapeutic procedures requiring the use of radiopharmaceuticals to all patients who require such procedures. We are fully equipped with three modern dual head gamma cameras, one single head gamma camera, and a state-of-the-art thyroid uptake probe, which is used for a full range of studies, including cardiac imaging.

Our Board Certified Attending Physicians, In Suk Seo, MD, Director of Nuclear Medicine; Kenneth Ong, MD, Acting Chief of Cardiology; and Alain Fedida , MD , Co-Director of Nuclear Cardiology, provide all services. The entire staff - including Nuclear Medical Physicist, Ronald Kappes MS, Chief Technologist; Angelina Almonte, CNMT, RT (N), and all of the other well-qualified technologists - strive to offer exceptional care to our patients, and are determined to maintain a high quality standard of care.

More than 10 million nuclear medicine imaging and therapeutic procedures are performed each year in the United States . The imaging procedure is effectively used in a broad range of medical specialties, from pediatrics to cardiology to psychiatry, to safely diagnose and even treat disease. In children, nuclear medicine tests are used to evaluate bone pains, injuries, infection or kidney and bladder function. In adults, the test is used to identify and treat hyperthyroidism (Graves Disease), as cardiac stress tests to analyze the heart, bone scans for orthopedic injuries, lung scans for blood clots, and liver and gall bladder procedures to diagnose abnormal function or blockage.

There are more than 100 different nuclear medicine tests available, which are capable for diagnosing or ruling out diseases in every major organ system in earlier stages than other available medical procedures. None requires surgery or additional diagnostic evaluations. According to the Society of Nuclear Medicine, more than 3,900 hospital-based Nuclear Medicine departments currently operate in the United States . The Intersocietal Commission for the Accreditation of Nuclear Medicine Laboratories (ICANL) accreditation program evaluates the quality of critical elements of Nuclear Medicine facilities, offering a voluntary method for laboratories to demonstrate the level of care provided to patients.

The ICANL was established with the support of the American Society of Nuclear Cardiology, the Society of Nuclear Medicine, the Society of Nuclear Medicine Technologist Section, the American College of Cardiology, the American College of Nuclear Physicians, and the Academy of Molecular Imaging (formerly known as the Institute for Clinical PET). The ICANL provides a peer review mechanism to encourage and recognize the provision of quality nuclear cardiology and nuclear medicine diagnostic evaluations by a process of voluntary accreditation. A non-profit organization, the ICANL is dedicated to ensuring high quality patient care and to promoting health care.

Participation in the accreditation process is voluntary. Accreditation status signifies that the facility has been reviewed by an independent agency that recognizes the laboratory's commitment to quality testing for the diagnosis of heart disease.

Improvements to the TBHC Medical Library

The Brooklyn Hospital Center 's (TBHC) Medical Library, located on the third floor North Pavilion, has recently acquired some improvements, particularly in regards to their computer systems and literary resources. These upgrades were possible primarily due to the monies collected from the 2003 Founders Ball.

According to Mr. Narciso Rodriguez, Director, Medical Librarian, TBHC has received a new software system called 'OVID'. The software allows staff to browse through seventy-two different medical journals, including The New England Journal of Medicine (in full text), and is available on all seven computers in the library, as well as on other PCs within the hospital. The entire journal may be read via computer, and most of the journals are available dating back a decade through the present. Mr. Rodriguez added that the library is funding the software services by small contributions collected from different departments within TBHC.

Another software system, known as "Up-to-date", was acquired through a donation from the company itself. The company sends the library CDs every 3 months so that TBHC can save money and perform the upgrades themselves. The library will receive a review from "Up-to-date" in six months to continue the service, but Mr. Rodriguez explained that the government-funded Metropolitan New York Library Consul (also known as "Metro") would most likely pick up the funding for this program. Metro is an organization that helps libraries throughout New York State .

The "Up-to-date" system provides a valuable service to all clinicians throughout the hospital. The purpose of "Up-to-date" is for researching the latest medical conditions - the user simply types a condition or symptom in the search engine, and the system pulls up the very latest information regarding the query. Although only one computer has been furnished with this program in the library, there is a possibility that an additional computer may also be upgraded with the software.

In addition, a third online resource has been added to the library, called 'Stat!Ref' . This software program includes forty different medical books available online for research purposes, and like OVID, is also accessible on most computers throughout the hospital.

Furthermore, the library is also upgrading its computers. Mr. Rodriguez explained that the library would be receiving five new computers, which will replace the outdated PCs. Ultimately, there will be a total of seven new computers in the library for the hospital staff's usage.

Kidney Stones (Nephrolithiasis)

One of the most humbling physical experiences humans have had to endure since the beginning of recorded history involve the suffering caused by an attack of kidney stones, termed renal colic. The pain has been variably described as being equivalent to childbirth without anesthesia or getting stabbed repeatedly in the back with a large sharp knife. Ironically, it is when the stone is passing that the pain from the stone is most intense with larger immobile stones often asymptomatic. In the past and in many developing countries still, these stones and pain can cause kidney damage and ultimately death. Today this is very rare in patients who are seen by a urologist and treated appropriately for the kidney stones. Although physicians have developed very sophisticated technologies to treat stones some of the most basic questions such as why we form stones remain unanswered in most cases.

How did this happen?
Patients often wonder, how does a hard firm rock get inside their kidney. The natural laws of physics and chemistry help to explain this. Just as under the right conditions water can crystallize and become ice, under the right conditions in the kidney, substances such as calcium that would normally be dissolved in urine can clump together and crystallize. The body does secrete natural inhibitors of this but under the right, or perhaps more appropriate, the wrong conditions these inhibitors can be overwhelmed and crystallization of these previously dissolved substances can happen rapidly and go unchecked. Still much remains unknown and waiting to be discovered. For example, some patients will only form stones in one kidney, other patients who have all the right conditions for stone crystallization never form stones, while other patients who have minimal risks will form recurrent stones. Genetics, anatomy, diet all likely play a role, although their precise contribution is still not completely understood.

Most patients who develop renal colic describe it as an intermittent, excruciating pain originating in their flank and often moving with time to their front side and towards their groin. Patients suffer from pain when the stone falls further into the tube that carries urine, the ureter, and block it. The tube becomes distended with urine behind the stone similar to how plugged drain will overflow with water. This distention activates exquisitely sensitive nerves that carry pain signals back to the brain and ultimately can cause misery. This pain is often accompanied by nausea and vomiting and sometimes by blood in the urine. If an infection also occurs behind the blocked ureter the patient may suffer from fevers and chills and need urgent decompression of the blocked tube. These patients should go to their doctors or the emergency room where they will usually get standard diagnostic tests such as urine and blood test as well as either x-rays, a kidney ultrasound or a CAT scan. Patients will usually be given pain medications and can often be treated as an outpatient. Occasionally, however, they may require a temporary tube to drain the kidney and relieve that pain or to be admitted to the hospital for immediate treatment of the stone.

How do we treat kidney stones?
In the past most patients were advised of two ways to treat stones – either wait until the stones pass or perform open surgery with a large incision to remove the stones. Both of these involved pain or prolonged recovery periods.

Fortunately, today we have many newer technologies to help treat stones. One of the great breakthroughs has been our ability to harness ultrasonic shock waves and focus their energies on breaking stones. There are no cuts to the skin or instruments inserted into the body as the shock waves generator is placed on the skin of the back near the affected kidney. Originally, patients were placed in a large bathtub of water while these shock waves were directed through x-rays at breaking apart the stone. Since then, newer generation of shock wave machines which are used at The Brooklyn Hospital Center have been developed that are more portable and do not require a bathtub. These newer machines also permit more directed energy at the stones with less damage to the nearby tissues. Ultimately, once the larger stone is broken apart by the shock wave machine the hope is that the smaller stone fragments will be able to pass more easily, with minimal pain, through the urine.

For appropriately selected patients who may not want to pass possible painful stone fragments after shock wave, high definition lenses and focused light sources have allowed urologist to enter the urinary tract and follow it all the way up to the kidney where the stones can be directly seen and broken apart using a very small laser fiber. Fragments can be pulverized using the laser leaving only dust behind or, alternatively, removed using a tiny stone basket.

Occasionally, however, patients can develop gigantic, infected stones that occupy the entire collecting system of the kidney – these stones are appropriately termed “staghorn calculi” (see image bottom left). While these stones would have invariably been treated with open surgery in the past, today they are most often removed using a small scope that can be inserted through a half inch cut in the back with much less pain for the patient.

Ultimately, these technological breakthroughs serve the purpose of allowing us to treat all types of kidney stones with less invasive, less painful ways to allow patients to get back on their feet quicker and risk fewer complications.

How Can I Prevent this from happening again?
Many patients who have had a kidney stone often ask if there is any way to prevent stones from forming in the first place. Some stones may be related to the type of medication that patients take and stopping these may help. Other stones may be prevented by changing the acidity of urine to make the environment less hospitable to forming the stones. While urologists have urinary and blood tests that can aid in determining what factors may have predisposed a patient to forming kidney stones, often the exact mechanism is unclear. The large majority of kidney stones are composed of calcium and these stones can be particularly difficult to prevent. General guidelines that have been shown to decrease the chance of forming stones are to reduce the amount of salt in the diet, avoid high protein diets with lots of meat, and increase intake of citrus products such as lemonade, oranges, grapefruit juice as much as possible. While drinking large quantities of water is probably not helpful in preventing stones, it is important for people who have formed kidney stones to prevent dehydration from occurring as much as possible. If these more conservative measures fail and stones recur, patients may be eligible to take generally well-tolerated medications that will reduce the likelihood of forming more stones. Nothing is foolproof, however, and patients who have formed stones and their doctors should remain vigilant for any signs of stone formation and consider periodic screening tests to find stones before they become symptomatic.

For as long as recorded history, humans have suffered through kidney stone
pain. While we still don’t know all the mysteries of these stones, we have fortunately developed modern techniques to help diagnose and treat this ancient condition.

If you have any questions or think you might need treatment for stones, you can contact The Brooklyn Hospital Department of Urology at (718) 250-6880.

Kids Stuff

LIST OF ARTICLES AND POEMS

    Sickle Cell Program's Goal Achieved
    Sleeping Wind
    Sadanadan
    Ice Cream Party held at the Pediatric Inpatient Unit
    Pediatrics Shines on Summer

Sickle Cell Program's Goal Achieved
The past year has been a very gratifying and productive year for the Pediatric Comprehensive Sickle Cell Program at The Brooklyn Hospital Center (TBHC).

The program has been in existence for 11 years and has been dramatically enhanced due to a grant awarded to TBHC from the Department of Human Resources and Services Administration (HRSA). We have successfully achieved many of our goals that we have set out to accomplish by the close of this funding year.

The principal goal of the HRSA Sickle Cell Grant is to educate community members and service providers as well as the community at risk for sickle cell trait and disease. The program takes a rigorous, proactive approach to health education, outreach, community awareness and advocacy. Educational seminars and informational workshops are provided to clinics, schools, community and faith based organizations. Educational information is provided to caregivers and extended family members.

We have re-established the Support Group Program at the hospital, improving upon it by adding a much needed teen group. The first Tuesday of every month, families dealing with the on-going stress Sickle Cell Disease have a "safe" place to go where they share food and conversation. Scheduled guest speakers keep the group informed on a variety of important issues such as stress management techniques, nutrition and utilizing existing social services. We strongly believe that support groups are a very integral part in a comprehensive care program for our patients.

Genetic counseling and testing are provided to parents of newborn infants identified with sickle cell trait. Comprehensive care for those identified with the disease are treated by a dedicated Pediatric team of board-certified Pediatric Hematologists, RN's, Geneticists, Child-Life Specialists and Social Workers. This comprehensive team approach remains critical to the success of the program which is to minimize the devastating impact that sickle cell disease has upon the communities we serve.

 

The Pediatric Department helps children discover themselves - their talents and skills. This is a poem written by one of the Pediatric patients:

Sleeping Wind

    Wind, help my child to sleep.
    Blow swiftly so you can carry her away to sleep.

    Carry her Brother Rain Forest
    Where the birds and animals play
    Wind, carry her
    Into the sky so she can stand on
    Sister Cloud up high

    Wind, do not carry her into the wet roaring of the hard pain.
    Wind, carry her into a sleep
    Where she can dream a beautiful dream

                - Faith Lambert

Sadanadan

    Sadanadan is like a flower up in the sky.
    She shines bright in the night.
    She is like a bird singing in the sky.
    Cherp, cherp, cherp,
    She is like a dimond in the light.
    She's like a star in the dark sky.
    She's like a heart in my body.
    She's like a soft pillow.
    She's like a brown teddy bear.

Ice Cream Party held at the Pediatric Inpatient Unit
On Thursday August 14th, the pediatric inpatient unit was treated to an ice cream party. Thanks to the generosity of Uncle Louie G's, and the Administration department, the children, families and staff were treated to a refreshing treat on a hot summer day.

Vanilla, chocolate and strawberry ice cream and lemon and strawberry ices were passed out to everyone. Children who could not make it to the playroom were well taken care of with a bedside delivery. As we were cleaning up the lights went out and a day that none of us will soon forget, the Blackout! Word spread of the left over ice cream and ices and staff from various floors and departments came up for a nice treat to help get through the long hot day.

Pediatrics Shines on Summer
This summer, pediatrics has been consistently busy as well as having many new projects on the horizon. The Child Life Program received a grant of $7,020 from the Starlight Children's Foundation to purchase musical equipment. With the help of Target stores, we will be picking up 45 radios, which will be placed on individual shelves to be built by TBHC staff at every bedside on the inpatient unit, the PICU, treatment rooms and in the ER. We will also be purchasing earphones, CD's and tapes to be provided to the families for use while they are here. We also plan to buy musical instruments such as guitars and shakers for the children to use when we have guests come and perform in the playroom.

In late September, Hemophilia Resources of America will be sponsoring an educational day for families who have a child with hemophilia. It will be held in TBHC cafeteria and open to anyone with a child who has hemophilia. There will be separate sessions for parents and children as well as fun activities and refreshments.

The pediatric comprehensive sickle-cell program also continues to flourish. We now offer monthly support groups for parents who have a child with sickle cell disease and a teen support group for teens with sickle cell disease. Both are running successfully and hope to continue in the future and open up to anyone within the community.

Mobile Health Van Set to Serve this Fall

We are happy to announce that The Brooklyn Hospital Center and New York University 's Steinhardt School of Education, Division of Nursing are set to launch a new program to provide healthcare services in the community using a mobile health van. This program is called Brooklyn Community Health Partners (BCHP) and the mobile health van is scheduled to begin providing services this fall. BCHP was launched in June 2002, when the Division of Nursing received a 5-year grant from the Health Resources and Services Administration (HRSA) of the Department of Health and Human Services.

The mobile health van was constructed in Cincinnati , Ohio by Armor Mobile Systems. Its construction was made possible by a grant awarded to The Brooklyn Hospital Center from The Starr Foundation. The van will travel to pre-selected locations in the areas surrounding The Brooklyn Hospital Center.

The BCHP van will be 35-feet with two examination rooms and an onboard reception area. It will be staffed by nurses, nurse practitioners, and nursing students, as well as physicians and medical students.

National Cancer Survivors Day at TBHC

Saturday, June 4, 2005 was a day of celebration at The Brooklyn Hospital Center, as 240 cancer survivors, their relatives, and friends celebrated "National Cancer Survivors Day" The survivors ranged in age from 80+ to 5 years old.

When you stepped into the hospital cafeteria you thought you where on Bourbon Street, in New Orleans. The sounds of New Orleans jazz, decoration in the Mardi Gras theme were everywhere. The survivors really got into the theme of the day by wearing masks, beads as they participated in a Mardi Gras parade. As the survivors where ushered into the cafeteria the cheers from their supporters and staff could be heard throughout the hospital.

Borough President Marty Markowitz visited the celebration and spoke about how wonderful it was to see so many people celebrating life.   One of the young survivors a 9 year boy had just been released that day from the hospital, but he was well enough to share in celebration. The young survivors were treated to magic show, and face painting.   It was a great day enjoyed by all.

Nets Players Chris Douglas-Roberts and Terrence Williams Read to Young Patients at The Brooklyn Hospital Center

BROOKLYN, NY (January 26, 2010)--NETS players Chris Douglas-Roberts and Terrence Williams joined NETS mascot Sly and Denise Shearer, Manager of Special Events at EmblemHealth, to cheer up pediatric patients at The Brooklyn Hospital Center.  During the visit, the players read Curious George Goes to School by Margret and H.A. Rey. The players gave autographs and, together with Ms. Shearer and Sly, posed for pictures, and handed out toys provided by EmblemHealth and the NETS.   

“We are delighted to be able to bring some cheer to the pediatric patients at The Brooklyn Hospital Center,” said EmblemHealth President and COO Frank Branchini.  “The NETS players are inspiring role models for children of all ages, especially for these children who face medical challenges.”

“We appreciate teaming with our partner EmblemHealth to provide an enjoyable and memorable experience for the children at The Brooklyn Hospital Center,” said NETS Vice President of Community Relations Petra Pope. “As our move to Brooklyn draws closer we continue our goal to build a significant community presence in the borough and to introduce more Brooklynites to their future team.”

“This is a wonderful day for our pediatrics patients,” said Kenneth Bromberg, M.D., FAAP, Chairman of Pediatrics at The Brooklyn Hospital Center.  “We are thrilled to welcome the NETS and EmblemHealth to The Brooklyn Hospital Center.”

About EmblemHealth:

EmblemHealth, Inc., through its companies including Group Health Incorporated (GHI) and HIP Health Plan of New York (HIP), serves 3.4 million people and provides affordable, quality health care coverage through a range of attractive options. Members have a choice of networks, including access to over 106,000 quality doctors and other health care professionals and most of the leading hospitals across the tristate region. For more information, visit  www.emblemhealth.com [42].

The Brooklyn Hospital Center:

Founded as the borough’s first voluntary hospital, The Brooklyn Hospital Center (TBHC) has been keeping Brooklyn healthy since 1845.  Today, it is a 653-bed teaching hospital, offering basic and specialized medical care, sophisticated diagnostic and therapeutic services, cutting-edge technology, and specialized surgery to over 500,000 patients annually.  Located in the heart of Brooklyn’s downtown revitalization district, TBHC is a part of the NewYork-Presbyterian Healthcare System and the Brooklyn academic and clinical affiliate of Weill Medical College of Cornell University [43].  TBHC  has fully accredited, independent residency programs in Emergency Medicine, Internal Medicine, General Surgery, Obstetrics and Gynecology, Pediatrics, Family Practice, General Dentistry and Oral and Maxillofacial Surgery, and trains more than 250 physicians each year. For more information, visit www.tbh.org [44].

New Clinics at TBHC to Better Serve the Community

Over the last year, The Brooklyn Hospital Center has established several enhanced patient services within the hospital to serve our community's various health needs. TBHC is proud to announce the following new services for our patients:

Comprehensive Diabetes Center
According to Ramesh S. Gulrajani, M.D, Chairman, Department of Internal Medicine, the Diabetes Center began based on a need within the hospital and the community: " A nutritionist has been hired to work alongside the Departments of Medicine, Family Practice and Pediatrics. The nutritionist will work to provide dietary consults initially but this is slated to become a full-blown Diabetes Center where comprehensive care will be provided and all sub specialists will be available to both private patients and clinic patients. These sub specialists will include podiatrists, nutritionists, endocrinologists, and so on." Dr. Gulrajani added, "Even patients without insurance may qualify for a sliding-scale fee."

Dr. Gulrajani explained, "This Comprehensive Diabetes Center is especially important because of the high rate of diabetes in the community. Our goal is to have the Center established by year's end in the Maynard Building , Suite 7 - F and in the clinic building".

Asthma Center
The Asthma Center , called "Breathe Free Brooklyn", is also crucial to the Brooklyn community because the incidence of asthma is quite high, according to Dr. Gulrajani. "A comprehensive asthma center will provide care by lung specialists. In addition, patient education services will be provided by the Pharmacy Residents as well as Respiratory Therapists. Because proper patient education has shown to decrease patient admission and ER visits, the overall well-being of our patients will be improved, and patients can be referred for educational purposes only. At TBHC, we have all of the facilities and expertise to meet the needs of the asthma population. Because of this we are capable and willing to provide this comprehensive service sorely needed by our patients and physicians".

When asked to describe the process of how a patient might seek assistance, Dr. Gulrajani explained, "A person may be self referred or by our physicians for treatment and/or education. They will then see a pulmonologist following their initial consultation where they will receive asthma education. Each patient's requirements will be tailored to meet their specific needs depending on their situation; the same goes for our pediatric patients and physicians."

Smoking Cessation Service
This one is called 'Smoke Free Brooklyn'. TBHC has set up a service geared especially towards those who want to "kick the habit". According to Dr. Gulrajani, "The population of adult smokers has gone up at an alarming rate, particularly among women. At TBHC, we decided to embark upon this area, offering services in both our private practices and clinics. Patients can be referred to TBHC by their own private or by one of our physicians in the hospital, or they can make an appointment directly for themselves. Once they meet for a consultation, they will be provided with a comprehensive education, important information concerning their addiction, and medications to aid them in the smoking cessation process. Medications include Nicorette©, nicotine patches, Zyban© and so forth. Dr. Gulrajani also added that the service also provides group therapy: "It (group therapy) encourages patients to continue trying to quit. This service has been in place in the hospital for approximately two months. We also refer people who might request any other support services, such as hypnotherapy or other alternative methods of quitting. So far, we have had a very good success rate - we have provided a valuable service to the community through the services we have set up at TBHC." 

The following is a list of contact information for each service: 

Breathe Free Brooklyn 
Appointments: (718) 250-6100 
Clinic patients: (718) 250-8200  
Pediatric patients: (718) 250-8671 

Smoke F ree Brooklyn 
Appointments: (718) 250-6100 
Clinic Patients: (718) 2 50-8200

Nutritional services/Comprehensive Diabetes Center 
Appointments: (718) 250-6100 
Clinic Patients: (718) 250-8200                                 

New Member of Ambulatory Care at Caledonian

Dinah Surh, MPH is a native New Yorker who loves the opportunities and challenges of providing healthcare for our ethnically diverse communities. Dinah has over twenty years of direct senior ambulatory care management experience in large hospital-based and community-oriented primary care networks, on both a facility and corporate-wide basis. These settings have provided her the opportunity to create and facilitate the implementation of many innovative primary care and community-based programs in the large urban neighborhoods of New York City. She has forged partnerships with many community and faith-based organizations to improve health. She is a graduate of Barnard College of Columbia University with a Bachelor of Arts in Sociology. She received her Master of Public Health degree from the School of Public Health at the University of California at Berkeley . She started her career at the NYC Health and Hospitals Corporation (NYC-HHC) where she worked for nearly twelve years with management responsibility for ambulatory care services at several HHC facilities, and served as Corporate Director for Primary Care at their headquarters in Manhattan . From 1993 2005, Dinah worked at Lutheran Medical Center with responsibilities for their Federally Qualified Community Health Center Network (FQHC), playing a key role in doubling the number of visits from 300,000 to 600,000 annually. She established a focus on cultural competence, patient and staff satisfaction, and fiscal performance. She was promoted from Director of Operations to Senior Vice President and Interim CEO of the ambulatory care network. She implemented a September 11th Fund insurance product in Brooklyn and Manhattan for displaced workers and their families affected by the September 11th tragedy by providing health insurance and care for over 1,000 families. In addition, she obtained federal funding to launch a Healthy Connections Center that provides bilingual crisis counseling and outreach for those affected by September 11. Dinah has a passion and commitment to increase access for the medically under served and medically uninsured.

Dinah has held the office of Treasurer, Vice President, and is currently President-Elect of the Board of Directors of the New York Association for Ambulatory Care (NYAAC). She is also a frequent speaker on local, state and national ambulatory care forums including radio, satellite television and web-casts.

As Vice President for Ambulatory Care Services at The Brooklyn Hospital Center and the Caledonian Diagnostic and Treatment Center, Dinah believes that identifying and sustaining partnerships is crucial to obtaining the resources needed to ensure the total health and well-being of our community residents. She is looking forward to providing leadership and promoting teamwork to ensure the provision of high-quality healthcare and community-based services, while reducing ethnic health disparities in Brooklyn .

New PCAP Program, Comenzando Bien

Click here to schedule an appointment with the PCAP department

Comenzando Bien Program
The Prenatal Care Assistance Program at The Brooklyn Hospital Center (TBHC) always seeks to advance and improve on existing conditions under the direction of Egondu Onuoha, PCAP Director. Although PCAP currently services all women who are pregnant with prenatal education via the PCAP team, they know that expanding prenatal care educational outreach to the community is very important.

Ms. Onuoha is therefore introducing a new program at TBHC's Caledonian site called Comenzando Bien. This program is sponsored by the March of Dimes, and specifically designed for Spanish-speaking women. It provides prenatal education to expectant mothers. Members of the PCAP team provide extensive classes in various areas such as pregnancy and personal health, breastfeeding, labor and delivery, postpartum care, and family planning options. Classes are primarily conducted by the nurse and midwife. Other speakers will include the Social Worker, HIV counselor, Breastfeeding Coordinator, Nutritionist and Health Educator. The Comenzando Bien Program is open to all Spanish-speaking prenatal women, not just for those who attend The Brooklyn Hospital Center. The classes are conducted in an informal and relaxed setting, with bilingual speakers. Classes begin on September 14, 2005 and run through October 19, 2005 . Participants receive a gift, participate in a graduation ceremony, and receive a certificate at the end of the program. For further information, please contact (718) 250-8397.

PCAP Overview & Current Events: The Prenatal Care Assistance Program covers pregnant women without health insurance or Medicaid with free comprehensive care from the beginning of pregnancy, up until two months after delivery (within a particular income guideline). Pregnant women are eligible regardless of their immigration status. There is no age requirement and minimal documentation is needed. The PCAP services provide free pregnancy test, routine and prenatal laboratory tests, prenatal vitamins and medication if needed, sonograms, dental care, health education classes, social services support, nutritional consultation and counseling, medical care and delivery, hospital care for mother and child, postpartum care up to 8 weeks after delivering, and visiting nurse services; the baby's health care is covered for a year after birth.

The Prenatal Care Assistance Program plays a very significant role for the expectant mother and her developing baby within the womb; its purpose is to help decrease infant mortality within lower economical communities. These communities consist of teenage mothers, women of lower economical status of all ages, and working women who have lower wages and are either minimally covered by insurance or not covered at all by their employer. Many of the prenatal women within PCAP are citizens of the U.S. However, a vast majority of pregnant women that are eligible for PCAP are undocumented and come from countries all over the world, such as England, France, Russia, Poland, Africa, India, and the Caribbean. These women find themselves in difficult and stressful situations - often many of the women that come no longer have support from their partners or families and have nowhere to turn. In most cases, they are in a foreign country and do not know how to navigate the system.

LOCATION
The Prenatal Care Assistance Program is located at The Brooklyn Hospital Center within The Women's Health Center - OPD Third Floor.

    * The Brooklyn Hospital Center 121 DeKalb Avenue (718) 250-6520
    * Williamsburg Family Health Center99 Division Avenue (718) 599-6200
    * Manhattan Avenue Health Center 960 Manhattan Avenue (718) 349-8500
    * Caledonian Community Health Center 100 Parkside Avenue (718) 940-5239
    * La Providencia Family Health Center 1280 DeKalb Avenue (718) 455-9000.

The Brooklyn Hospital Center's Prenatal Care Assistance Programs extends gynecological and prenatal care services for women of all ages and cultures, regardless of immigration status. Our staff speaks bilingual languages - English, Spanish, French/Creole, Polish, Russian and Arabic. Please call the above numbers for more information.

New Shining "Star of Life" Ambulance Written by Marilyn Capuano

Although we see the "Star of Life" almost every day, it is one of those things that blend into our everyday life and we don't give it much thought. You may not even be able to recall where you see it; it is on the emblem of the uniforms worn by all certified Emergency Medical Technicians and Paramedics and on every ambulance used to provide emergency medical services.

There are six points to the star, each representing an aspect of the Emergency Medical Services System. They are:

    * Detection
    * Reporting
    * Response
    * On Scene Care
    * Care in Transit
    * Transfer to Definitive Care

The Staff on the Star represents Medicine and Healing. The Snake represents an ancient Greek symbol for Eternal Life.

At The Brooklyn Hospital Center, we are proud to be part of the New York City Fire Department - Emergency Medical Services 911 Ambulance System. We run two ambulances, 48-Sam, our advanced life support ambulance, and 31-Eddie, our basic life support ambulance. In cooperation with our partners, TransCare, who has provided this service, we began running a brand new ambulance on Tuesday, August 2, 2005. This new ambulance will enhance our efforts in providing emergency medical services to the communities we serve.

Our ambulance service began at the Caledonian Hospital several years ago, and was transferred to The Brooklyn Hospital Center in 2002. The seamless transition from the pre-hospital care provided on the streets and in the ambulances in transit to the Hospital, to Emergency Room care, is something we can all be proud of. Our triage nurses, staff nurses, and doctors working in the ER work in unison with the EMTs and Paramedics bringing in the patients. It is this seamless transition that can be credited with saving the lives of many Brooklyn residents with the "Star of Life" symbolically shining over them.

New Simulation Laboratory Equals Real Gains for The Brooklyn Hospital Center

The same question pops into the mind of nearly every patient being treated by a young doctor or surgeon: How many times has he or she performed this procedure? Could I be the first? Though medical residency education has always been structured so that you are never in fact “the first,” new simulation technologies have come online that provide residents and student nurses with more—and more varied—clinical experience than was ever thought possible, all before ever seeing a single patient.

The Brooklyn Hospital Center has created a simulation laboratory equipped with this state-of-the-art technology, which lets students practice interventions on highly realistic, computer-controlled mannequins and other materials that replicate human tissue and biological systems.

 According to Chief Academic Officer Benson Yeh, MD, the simulation lab—located right in our Downtown Campus—represents a paradigm shift occurring in medical education taking hold throughout the country.

“It used to be taken for granted that nearly all residency-level education needed to happen in the traditional way,” said Yeh, referring to the time-honored process of following the course of illness and recovery throughout the arc of a patient’s hospital stay.

“But new technologies have turned that model upside down. Some procedures can be taught almost exclusively in our simulation lab, thus avoiding patient risk. It’s a win-win situation for patients and medical students.”

The high fidelity of today’s simulation technologies opens up two important educational doorways.

“Simulation labs are great for helping students learn procedural competencies like inserting a central venous catheter line or performing laparoscopic surgery,” said Dr. Yeh. The technology gives residents the chance to practice an intervention dozens or even hundreds of times. They can even replay a video of their own work on a computer.

But as helpful as it is for developing fine motor skills, medical simulation really shines when it comes to teaching students how to make complex diagnoses and treatment choices, both of which require weighing multiple pieces of information either simultaneously or in quick succession.

“It’s not enough for a student to recognize that a patient is in distress,” said Dr. Yeh by way of example.

“You have to consider the age and gender of the patient, his or her vital signs, prior medical history, and so on. All of these data points guide the decisions a doctor makes from moment to moment, with each new piece of information or change in the patient’s condition potentially leading to a new branch of choices. Simulation laboratories like ours help students acquire these judgment skills. You can’t get this from a conventional academic setting.”

  Hospital Center resident simulates pediatric intervention.Despite the great potential for competency building, it’s interesting to note the technology has other, unexpected, educational uses. While no technology in and of itself can teach compassionate healthcare, the simulation lab provides “real opportunities for doctors and nurses in training to see the world through the patient’s point-of-view,” said Nurse Christine Fothergill-Cox, Director of Nursing Education for The Brooklyn Hospital Center.

This may require a bit of clever misdirection, however.

A student may enter a simulation thinking the objective is just fine tuning a clinical skill, but the real goal of the session may be to reveal how attentive the caregiver is to a patient’s level of pain. “Students come away understanding that it’s not enough to give great care technically,” said Fothergill-Cox. “You also have to help your patients avoid any unnecessary discomfort.”

One of NYC's Most Promising in Plastic and Reconstructive Surgery at TBHC

New York Magazine asked the top doctors in the city to name their most promising young colleagues practicing in the field of plastic surgery. Dr. Wendy-Ann Olivier is among them.

Dr. Olivier has been a part of TBHC family since September 2001 in the Division of Plastic and Reconstructive Surgery. Her Clinical Areas include:

• Microsurgery
• Breast Reconstruction
• Complex Wounds
• General Reconstruction
• Cosmetic Surgery

Dr. Olivier attended medical school at Duke, general surgery at the Hospital of the University of Pennsylvania , and a plastic-surgery fellowship at NYU Medical Center Institute of Reconstructive Plastic Surgery, where she studied under Joseph McCarthy.

The Brooklyn Hospital Center would like to commend Dr. Wendy-Ann Olivier for being noted as one of the most promising plastic surgeons in the October issue of New York Magazine.

Painting a Perfect Picture

here to schedule an appointment at the PATH Center
   
Kenneth Mitchell, Peer Educator in The PATH Center, is painting a mural on the wall of the PATH Family Program at Caledonian - a gift to the children who are seen in PATH. Karen Thompson, the Program's Coordinator, asked Mr. Mitchell if he would consider lending his talent. 

"I felt honored that she chose me to do it," Mr. Mitchell said. "I wanted to give back something extra, because so much has been given to me. This is my second home, my family. Everyone here has become family to me." 

Mr. Mitchell has been a PATH patient since 1999. He graduated from the Music and Arts High School, the School of Visual Arts, and the Arts Student League. Until he was diagnosed with HIV, he was a textile designer and painter. He says that with his diagnosis, he re-evaluated his place in life, learned to take care of himself, and wants to help others do the same. That is why he became a Peer Educator in The PATH Center and, more recently, a Treatment Education/Adherence Counselor at CAMBA, a community agency near Caledonian. 

At night, Mr. Mitchell is studying to become a CASAC - a Certified Alcohol and Substance Abuse Counselor. "There is a strong connection between substance use and compliance with care," he says. "I wanted to paint something for the PATH children that represents the neighborhood - multicultural, including African-American, Asian and Caucasian children - so whoever walks in the door can identify. It also helps children take their minds off the fact that they're in a hospital - they feel more relaxed and cheerful. 

Mr. Mitchell described his mural, explaining, "There are bodegas, but also greenery. There are kids playing baseball, balloons, a fruit stand - just a simple, friendly look." Mr. Mitchell says his experience with The Brooklyn Hospital Center - and his health outcomes - have been very positive: "My HIV viral load went down from 300,000 to less than 100, and my T-cells went up from 98 to 866." 

On a closing note, Mr. Mitchell added, "Every encounter I've had in this institution has been a good one. Everyone I talk to gives me something. Everything about being here has been a phenomenal experience. There's no day I wake up that don't want to come here - this is my home. I have a real sense of belonging." 

    Those interested in viewing the mural may phone The PATH Center 's Caledonian office: 718/940-5930 - thank you!

Path Center Honored by NYC Department of Health

The PATH Center and its Medical Director, Dr. Leonard Berkowitz, were among the HIV service providers honored with Community Partnership in Public Health awards on Friday, November 12, 2004. The ceremony took place at the NYU Kimmel Center and was opened by the New York City Commissioner of Health, Thomas R. Frieden, MD, MPH.

PATH was one of 29 agencies honored for its work in "raising community awareness regarding STDs/HIV, promoting risk reduction, and STD/HIV screening."

Patient Satisfaction

The Power of the Word -

            Kindness is a language which thedeaf can hear and the blind can read

                    - Mark Twain

What to Know
How patients perceive care plays a very important role in the health care industry. In a competitive market, patients want and expect better health care. Patient satisfaction affects how well a hospital can gain and maintain market share. It also has a direct impact on patient health outcomes.

At TBHC, improving patient satisfaction is part of our overall Strategic Plan. Meeting our patient and customer needs and exceeding expectations daily is our value.

All patients who receive any service in TBHC receive a customer satisfaction survey. Outpatient surveys are done internally, but the specific service staff and inpatient surveys are done with the help of a vendor, Press Ganey. Utilizing Press Ganey also gives us an opportunity to compare ourselves with other hospitals including our competitors and find best practices.

The survey results are received quarterly. Service chiefs, department heads and unit managers review the results, share the information with their staff, and find practical ways to improve patient satisfaction scores with a special focus on the 11 questions in the survey that are considered as "Priority Focus Areas". The reason for the survey's particular title is due to the fact that they have the highest correlation to overall satisfaction of the patients, in comparison to the results of other surveys.

Based on the information we have discussed, you may be wondering - what is the plan?

Who Will Be Involved?
As some of you may already know, the Department of Organizational Development has started a training program on customer service. Many of you have already received the training, and many of you will be involved in the next couple of months.

Show 'em your Smile!
In the next month, you will be seeing some new posters going up on the units and in the hallways. TBHC is proud of our staff and wants to raise the patients' awareness of this survey. If you would like to pose for the pictures, please contact the Department of Quality Management at extension 8957.

Free Lunch!
As part of recognizing the great work of the units and the departments, Senior Management will be presenting a trophy to outstanding units and departments. Also part of the reward will be free lunch vouchers and certificates to local stores.

Education?
The department of Quality Management has held several open-educational sessions for all staff. The department plans to hold several more. We are interested in getting your feedback and planning more sessions for the folks at night - let us know!

Improving patient satisfaction is a continuous process - we want to be the best and better at everything we do!

For further questions, call Anu Iyer (718-250-8957), Quality Management.

Patricia A. Winston, RN MS Named Chief Nurse Officer at The Brooklyn Hospital Center

BROOKLYN, NY -- Patricia A. Winston, R.N., M.S. has been named Chief Nurse Officer (CNO) at The Brooklyn Hospital Center (TBHC) in an announcement by Richard B. Becker, M.D., the hospital’s President and CEO.

“If there is such a thing as a born nurse, then Ms. Winston fits that description,” says Dr. Becker.  “Along with her extraordinary background, Ms. Winston brings TBHC extensive experience and expertise in management, oversight and strategic development of quality patient care. We are delighted to have her in this key role.”
In her new position, Ms. Winston will manage TBHC’s nursing staff of nearly 600, focusing on quality of care and patient satisfaction.

Prior to joining TBHC, Ms. Winston spent the past three years as CNO for Universal Health Services, Inc. in King of Prussia, PA and at The George Washington University Hospital, where she served as a member of senior leadership.

Before that, Ms. Winston spent eight years at Catholic Health East (CHE), a 10-state, not-for-profit, multi-hospital system based in Newtown Square, PA. There, she served as Vice President, Patient Services/CNO for St. Francis Healthcare Services, where she managed patient care services throughout the regional healthcare center and became CHE’s first Magnet Fellow.  Among her many accomplishments there, Ms. Winston decreased nurse vacancy from 26  percent to seven percent, improved nurse patient ratios, developed and implemented performance improvements and indicators, and improved employee morale and patient satisfaction.

The daughter of a nurse, Ms. Winston began as a food server and nursing assistant during high school.  She began her career at Christiana Care Health Services, an 1100-bed tertiary care system in Christiana, DE.  Over 14 years, she held many positions including clinical nurse, and rose through the ranks to become Clinical Director of Medical, Surgical and Rehabilitation Nursing, Director of Patient Care Services, and, finally, and Vice President of Patient Services/Associate Administrator.

Ms. Winston graduated from Nursing School of Wilmington, DE with a RN diploma.  She holds Bachelor of Science Degrees in Professional Arts and Nursing; a Master’s of Science Degree in Healthcare Administration from West Chester University in West Chester, PA; and served as a Johnson & Johnson Wharton Fellow at the University of Pennsylvania.  Ms. Winston is Board Certified in Nursing Administration (NEA-BC) and a Fellow of the American College of Health Care Executives (FACHE).

The Brooklyn Hospital Center:

Founded as the borough’s first voluntary hospital, The Brooklyn Hospital Center (TBHC) has been keeping Brooklyn healthy since 1845.  Today, it is a 464-bed teaching hospital, offering primary and specialized medical care, sophisticated diagnostic and therapeutic services, cutting-edge technology, and specialized surgery to nearly 300,000 patients annually.  Located in the heart of Brooklyn’s downtown revitalization district, TBHC is a member of the New York-Presbyterian Healthcare System [55] and the Brooklyn academic and clinical affiliate of Weill Medical College of Cornell University [43].  TBHC has fully accredited, independent residency programs in Emergency Medicine, Internal Medicine, General Surgery, Obstetrics and Gynecology, Pediatrics, Family Practice, General Dentistry and Oral and Maxillofacial Surgery, and trains more than 250 physicians each year.

Pediatric Reverse Trick or Treat

Friday October 29th, 2004 Pediatrics celebrated Halloween on the inpatient unit with our reverse trick or treating. This happens when members of other departments come and bring a trick or a treat to ALL the hospitalized children. The kids love having visitors come to see them and brighten their days. The parents are also excited, especially the parents of that one baby celebrating his or her first Halloween. This year we had a face painter, some costumes and also encouraged families to bring in their own costumes from home. The nurses and doctors on the pediatric floor love being able to feel part of the festivities and see The Brooklyn Hospital Center family come together to brighten the lives of our children. Thank you to the departments that participated this year. We look forward to seeing EVERYONE next year!

Pediatrics Sets Up Distinct Means to Orient New Residents

Where can you find a 92-year-old carousel, a tortilla factory, and the gravesite of the first African American woman physician to work in New York City? In Brooklyn, of course! These are just some of the things 10 neophyte pediatricians learned about their new home borough on June 25. The physicians, all of whom start their pediatric residencies at The Brooklyn Hospital Center this July, participated in a Brooklyn Treasure Hunt as part of their orientation.
Two teams traveled throughout Brooklyn gathering items as diverse as a handful of sand from Brighton Beach, a napkin from Junior's, and a sample of Jacques Torres chocolate. Each team was provided with Metro cards, maps (courtesy of the Brooklyn Tourism office at Borough Hall), water bottles and digital cameras to record their adventures. The event was launched from the steps of Borough Hall by Brooklyn Borough President, Marty Markowitz, who issued a proclamation declaring June 25 to be The Brooklyn Hospital Center Pediatric Residency Day.
"This year's first year group comes from China, the Philippines, and Romania among other places and does not yet know about the cultural richness of Brooklyn," said Dr. Susan Gottlieb, Chief of Child Development and the creator of the Treasure Hunt, "This activity will introduce our new doctors to the incredible diversity of people and places in our borough."
"We hope that this experience will translate into an increased sensitivity to and appreciation of the different backgrounds of the children and families they will be taking care of during their training," Dr. Ken Bromberg, Chairman of Pediatrics added.
At the end of the day, two tired but exhilarated groups of residents returned to the hospital with their treasures and were treated to a celebratory ethnic feast. All agreed that the Treasure Hunt should become a permanent part of the orientation program. Dr. Ritu Walia spoke for her colleagues when she said, "It was a wonderful experience. We learned about Brooklyn and about each other."

Physical Therapy Helps Bride Walk Down the Aisle

In today's society there are still workers at The Brooklyn Hospital Center who are fulfilled by the labor of their love in helping patients to recover and resume the life they once knew or helping them to come as close as possible to the life they once had. The success of the patient does not solely rely on the worker, but is dependent on the patient as well. The Brooklyn Hospital Center, which is located in the Fort Green section of Brooklyn, is one hospital that was blessed with Mrs. Safiya Spellman and staff members who made a difference in her life.

Mrs. Spellman, a 31 year old resident of Brooklyn, NY, is well known in The Brooklyn Hospital Physical Therapy and Occupational Therapy Departments. She was diagnosed with Guillain-Barre Syndrome in January 1998, a few months after the birth of her son. According to the World Book Dictionary, Guillain-Barre Syndrome is an idiopathic, peripheral polyneuritis occurring between one and three weeks after a mild episode of fever associated with a viral infection or with immunization. This is followed by symmetrical pain and weakness which affect the extremities, and paralysis may develop. Prior to her diagnosis Mrs. Spellman was an independent individual with ambulation and activities of daily living (ADL). Her illness left her with decreased muscle strength in both upper extremities, and an inability to ambulate due to paralysis in both lower extremities; as a result she became wheelchair dependent. She also required some assistance to care for herself. Besides, Guillain-Barre syndrome, Mrs. Spellman has high blood pressure, asthma and is an insulin dependent diabetic. She has been hospitalized on numerous occasions because of asthma, respiratory failure and uncontrolled diabetes (300-500), and this has caused a lack of attendance in physical therapy, thereby, delaying her progress. She also has increased hypersensitivity and parasthesias in her right upper extremity and a decrease inability to bear weight during transfer activities. The Issue Approximately a year ago Mrs. Spellman was placed on oral medication and an insulin pump which administers 11.5 mg of insulin per hour; this new treatment made a drastic difference in controlling her blood glucose level. This has enabled her to attend physical therapy on a regular basis, thereby facilitating her progress. As a Physical Therapist Assistant, I had the opportunity to treat Mrs. Spellman here at The Brooklyn Hospital Physical Therapy Department. Mrs. Spellman's physical therapy treatment consisted of strengthening exercises of both upper extremities to facilitate transfers, stretching to facilitate flexibility and the use of the tilt table for standing. She also received Occupational Therapy for desensitization of both hands, and ADL training, such as dressing and grooming. Mrs. Spellman also was evaluated for, and trained in the use of a custom motorized wheelchair for independence and mobility.

The Motivation 
| Mrs. Spellman's goal has always been to be able to walk again. She became more determined to achieve her goal after she became engaged on July 2003. Soon after her engagement, Mrs. Spellman informed one of the previous therapists Heather Smart, about her engagement, and her desire to be able to walk down the aisle. After reviewing all the possibilities, Ms. Smart contacted Tulio Rivera from Hanger Prosthetics and Orthotics and discussed the possibility of a brace that would facilitate Mrs. Spellman to ambulate, and on July 10, 2003 Mrs. Spellman was assessed for a reciprocal gait orthosis (RGO). Mrs. Spellman received the RGO brace on February 25, 2004 and this was the beginning of the training process for ambulation.

The Process
The initial process for donning and doffing the RGO brace, and gait training was time consuming, but it was well worth it. Initially, her ability to transfer from sitting to standing in the parallel bars required maximum assistance of two to three people, which also include locking the brace at the hip and at the knees. She required maximum assistance of two to three people to ambulate in the parallel bars, including tactile and verbal cues to maintain upright posture and for weight shifting. She also required assistance for advancing both lower extremities. One of these assistants was Tony Garcia, PT Aide. He made her day more cheerful by filling her time at therapy with laughter and encouragement, and by showing that he cared. He was a great motivator.

The difficulty that she initially exhibited with ambulation did not last very long because she had personal motivation and the motivation and dedication of a devoted staff who was willing to help her achieve her goal to ambulate so that she would be able to walk down the aisle at her wedding. Mrs. Spellman, developed the necessary skills needed, and she was able to master the technique for ambulating with the RGO brace very quickly. She then progressed to ambulation with a standard walker requiring moderate assistance of two people, and assistance for advancing only the right lower extremity. On her last visit prior to her wedding, Mrs. Spellman remained dependent with donning and doffing the RGO brace. Sit to stand transfers from the wheelchair to the standard walker required maximum to moderate assistance of two people, and this included locking the brace at the hip and at the knees. She demonstrated the ability to ambulate with a standard walker and the RGO brace approximately 90 feet in five minutes with close supervision, and requiring no assistance for advancing the lower extremities.

The Result
On September 18, 2004 Beata Nowak, PT, Brian Goonan, PT and I were privileged to attend Mrs. Spellman's wedding ceremony, and we were all ecstatic with tears in our eyes as we watched her walk down the aisle with her father on the right and her brother on the left. They both walked casually beside her with no apparent physical contact. She looked radiant in her gown as she walked with a standard walker which had been decorated with the same beautiful material as her dress. She walked approximately. 100 feet, and stood for about 15 to 20 minutes for the ceremony, and demonstrated the ability to ambulate another 100 feet with her husband as the bridal party followed behind her. Approximately 20 to 30 minutes later she reentered the room and walked another 100 feet and was able to pose standing for pictures. She has indeed demonstrated increased ambulation distance, as well as endurance beyond what I had expected.

The People
The Brooklyn Hospital Physical Therapy Dept. does have staff that show they care and Mrs. Spellman can attest to that. Her success story demonstrates what the power of determination and support can do. Mrs. Spellman is now a motivation and an inspiration to the staff as well as other patients who come to the Physical Therapy Department for therapy. I recall one patient in particular after seeing Mrs. Spellman walk with the RGO brace stated "I will never complain again". Mrs. Spellman was extremely motivated, and she worked with a staff which was more than willing to help her. Mrs. Spellman's family is supportive in assisting her in her daily task of standing in the hydraulic standing device, and ambulating with the RGO brace, which she does at home. It has been a privilege and a challenge to have the opportunity to work with Mrs. Spellman, and I had no doubt in my mind about her capabilities and her desire to achieve her goal, because of the dedication of staff members. Mrs. Spellman is indeed an inspiration to us, and she has taught me one valuable lesson-that one can achieve his or her goal once they have the faith, the desire, and the motivation to work towards achieving that goal, and with the help of others, like Beata Nowak, Tony Garcia and myself, the patients who I come in contact with, that goal can be attained. 

Quilting Party for Pediatric Hematology/Oncology Dept. Written by Phoebe Steinhoff

an appointment with the Pediatric Hematology/Oncology Department

As a child, I never liked going to the doctor's office. It always seemed like an impersonal place, where they could hurt you without a moment's hesitation. The doctors were always aloof and business-like. The only part that made it worth it was the sticker or toy I got at the end of my appointment. When I turned fifteen, I was diagnosed with ITP, or idiopathic thrombocytopenia, a common childhood illness and for me, an autoimmune disorder. After a hospital stay, treatment and another doctor's office, I was referred to the Pediatric Hematology and Oncology department at The Brooklyn Hospital Center. After a few visits, it was clear that this doctor's office was different than what I was used to.

Dr. Sadanandan and the team of doctors, nurses, and students who work there have made their office very friendly. They always remember who you are, and make you feel welcome. Even though people are always coming and going, patients feel like they've been welcomed into a big, busy family. When Dr. Sadanandan told me she wanted to do a project with all the kids, I was excited to help out. She knew she wanted a quilt, and with my art experience, I helped make it happen. We ordered supplies and cut squares. One Saturday, we had a big quilt-making party that all of the patients and their families were invited to. Everyone decorated a square and ate pizza. All of the people from the office were there, and it felt kind of like a family reunion. The squares were so beautiful, and the kids loved it! Now the office will have art that all of the patients and employees have made, welcoming new and old "family" members.

This was the first project I've ever had the opportunity to lead. I really don't want to take credit for it, because all of the people in the office helped so much, and it would have been impossible if all of us weren't involved. I go to Parsons School of Design, and it was great to be able to bring my art into this doctor's office. Everyone there has helped me and now that my disease isn't really serious, it's nice to have a reason to come back and to have something to give them in return.

Radiology Receives Prestigious Accreditation

here to schedule an appointment with Radiology Oncology     

Earlier this year, the Department of Radiation Oncology at The Brooklyn Hospital Center applied for a renewal of our accreditation by the American College of Radiology (ACR). In Radiation Oncology, we have always tried to provide excellent care to our patients. We sought to obtain this accreditation because we believe that this is the most prestigious accreditation in Radiation Oncology.

In September, our department received a renewal of ACR accreditation for three more years, the maximum time of accreditation for any institution. This prestigious accreditation proves that nationally accepted standards are met and the personnel involved in treating our patients are well qualified, through certification and continuing education. The accreditation also shows the equipment is appropriate for the delivered treatment, and the quality assurance and safety guidelines are met or exceeded by the Department. As of this time we are the only Radiation Oncology department in Brooklyn with ACR accreditation. We plan on continuing to uphold the high standards of practice we have proven to provide.

The goal of the Radiation Oncology department at The Brooklyn Hospital Center is to provide a high level of quality services to the patients in our community and to our referring physicians. Through compassionate delivery of an excellent standard of care, the Department aims to meet the needs of the communities served. Radiation Oncology strives to maintain the best medical practice with technology, education, and a collaborative team approach to healthcare delivery.

We have integrated nutritional support, social work and have access to psychological counseling for our patients in order to provide total support for the cancer patient at the Brooklyn Hospital.

Through Pediatric Oncology we provide access to randomized trials for our pediatric patients through the Children's Oncology Group and be hope to be participating in randomized trials for adults in the future. As a department we are actively involved in community outreach with activities as I Can Cope, Man to Man and Look Good Feel Better. We participate in the Surgical and Gynecologic Oncology tumor boards.

The objective of radiation therapy is to provide local and regional control of a tumor via ionizing radiation. Treatment planning requires determination of the tumor site and extent in relation to normal tissues. The attending radiation oncologists, Sun H. Huh, MD and John P. Vakios, MD, specify the dose desired to adequately cover the tumor volume as well as set limits to the doses which will encompass critical structures. These specifications are important so that the tumor is treated while trying to limit side effects to normal tissues. The radiation physicist (Thomas Lowinger), and dosimetrist, Miriam Weinstock, then design potential treatment deliveries, which satisfy these requirements, and a final plan is then selected by the radiation oncologist. Actual treatment delivery is carried out by the licensed radiation therapists, John Bohnik, Ahmad Hamid, Deborah Maharaj, and Judy Nikosey, lead by our chief radiation therapist, Suhail Mubeen. In addition to the regular staff, students from New York Methodist School of Radiation Therapy train at our department during various clinical rotations. Some of this school's best graduates have sought to Under the supervision of the attending radiation oncologist, the patients daily care needs are assessed and carried out by the radiation oncology nurse, Carol Oliver. The plan of care includes assessment, treatment planning, treatment, patient and family education, and follow-up after completion of treatment. The secretary, Nuvia Mejia-Idrees, and the medical clerk, Marjorie Andrade, are responsible for initiating and maintaining proper patient flow; they are the first point of contact with both referring physicians and patients and do an excellent job.

We are also involved in educating Medical Physics students from Columbia University Medical Center train under the tutelage of Thomas Lowinger, PhD, the Chief Medical Physicist.

For external beam therapy, the radiation therapists operate a GE Oldelft simulator in order to obtain the original parameters for setting up patients on a daily basis. We also have a high-energy linear accelerator and a Varian 2100c linear accelerator, equipped with a Multi-Leaf Collimator for the practical conformation to the treatment field, for daily patient treatments. CT scans obtained from the GE Lightspeed CT scanner are used for the planning of conformal radiation therapy treatments.

A variety of external beam radiation therapy treatments, including total body irradiation and total skin electron irradiation, can be performed for our patients. On average, 35 to 45 patients are treated per day in our department, both for cure and/or palliation. In addition to our external radiation treatments, we perform over 100 radioactive Iodine prostate seed implants annually at the Hospital, the most of any single institution in Brooklyn and a variety of radioactive gynecological implants. We are involved in the treatment of benign diseases such as keloids, heterotopic ossification, and pterygium.

Resolution 2004

VOLUNTEER SERVICES
Hazel Stephen, Coordinator:

"To rejuvenate the volunteer department at The Brooklyn Hospital Center to include more volunteer community programs, in efforts to mentor young adults who are interested in health care professions."

SURGERY
Dr. Stephen Carryl, Chairman:

"(For) the department of surgery (to) become the premiere department in the hospital!"

GASTROENTEROLOGY
Dr. Kiran Bhat, Chief:

"I would like to see an increase in the awareness of colon cancer; to let individuals know that it is possible to prevent the disease"

PEDIATRICS
Dr. Kenneth Bromberg, Chairman:

- Recognize and publicize the strengths of the pediatric faculty
- Develop or expand programs that meet community needs in the area of Asthma, Sickle Cell Disease, Lupus, Hypertension, and Health Care Advocacy and Health Promotion/Fitness.
- Maintain our significant programs in Oncology, Gastroenterology, Cardiology, Endocrinology, Child Life Program, and other Pediatric specialties.
- Re-establish links with the Pediatric and Family Practice physicians with regard to hospitalization and specialist utilization.

FAMILY PRACTICE
Dr. Maritza De La Rosa, Chairwoman:

Increase our inpatient volume by (1), Developing and participating in community outreach activities which will enable us to provide health care to more patients and their families, (2) Increasing clinical research projects conducted by faculty and residents, (3) Providing more health education to our patients and (4), Improving the cleanliness of the Family Practice Centers, which will help improve patient satisfaction and employee morale.

ELECTROCARDIOGRAM
Catherine Suarez, Supervisor of EKG:

"I do not have a New Year's Resolution for my department. I believe that the improvement of quality of care for patients should be ongoing; not just a pledge at the beginning of the year."

UROLOGY
Dr. Aizid Hashmat, Chairman:

"(To be) the best that we can be for the patients, colleagues, and co-workers."

NUCLEAR MEDICINE/ RADIOLOGY
Dr. Douglas Kiviat, Acting Chairman:

"The best has yet to come!"

CARDIOLOGY
Dr. Narinder Bhalla, Chief:

"To expand services for patients with Non-Cardiac Blood Vessel Disease in cooperation with Vascular Surgery and the Radiology Department."

PATHOLOGY
Dr. Abdul Mannan, Chairman:

"To reach the community and provide Pathology services"

NURSING DEPARTMENT AND PATIENT CARE SERVICES
Anne Goonan, RN, Senior Vice President:

"The Nursing Department will work collaboratively with our healthcare partners to establish and maintain a safe customer friendly environment in which to deliver quality patient care"

Stand up… Stand up! Get off the Couch and Safely into Shape

After a winter spent bulking up on television and comfort food, the arrival of spring has many couch potatoes ready to reform and get into shape. To make sure good intentions don’t end up in injuries, Anders Cohen, M.D., Chief of Neurosurgery and Spine Surgery at The Brooklyn Hospital Center, offers tips for weekend warriors who don’t want to end up flat on their backs.”

“Six-pack abs are not just for looks,” says Dr. Cohen, who was a professional tennis player before he became a neurosurgeon, and has been a sports junkie since the age of seven. “Strong abdominal muscles support the lower back and spine and prevent injuries.  When muscles get lax, people get injured.”

A is for Assess:

Before you embark on an exercise program or a sport, assess your physical condition. This is a good time to get an annual physical.  Look at your weight and cardio fitness to find a baseline for speed, heart rate and body fat, and target goals for improvement.

It takes three:

It takes three weeks to change a bad habit.  So, spending three weeks ramping up for a sport—be it tennis, basketball or golf--will develop strength, flexibility and help prevent injuries.  Start by going to the gym, putting on an exercise video, climbing stairs, or trying something new that will help develop strength, flexibility and cardio-fitness. Dr. Cohen is a fan of Pilates, which supports the core, and Feldenkrais, a cousin of Pilates, to help with flexibility and strengthen muscles that support the spine.

Get sports ready:

“Don’t be relegated to the sidelines by “re-injuries or chronic injuries,” says Dr. Cohen. “These are the injuries that make people give up a sport.  If, for example, you always sprain your ankle, pay attention to strengthening that area.”  Dr. Cohen compares chronic injuries to a tire with a slow leak.   “Once you have an injury, that part of your body is always more susceptible. Pay attention to pre-existing conditions and work on strengthening those areas.”

Get sports specific:

“Professional baseball players used to have spring training because they got really out of shape during the off season,” says Dr. Cohen.  “Now most baseball players and other professional athletes are in great shape year-round, so they use spring training to work on flexibility and timing. But average people also need to morph from winter dormancy by preparing for specific sports.  For example, if you’re a baseball player, you want to start playing catch, alternating distances and angles to increase flexiblity, reflexes and loosen your arm. That’s also a good idea for tennis players since catching a ball and volleying with a tennis racket require the same motion.   Basketball players will want to increase cardio endurance by running up stairs.”

The three “Ps”:

Prepare…prepare…prepare...Avoid injury through preparation.  Spend the first 10 minutes warming up—stretching and loosening up--before any physical activity and spend the last 10 minutes cooling down.

Monitor your progress:

Monitor your progress and physical condition in order to improve.  Keep track of plateaus and look at the approximate length of time you can hold your top level of play, regardless of whether the sport is tennis, basketball or running.   Use your best time as a barometer. “For example if you feel fatigued after 25 minutes of tennis, that’s the new ‘A.’  Your next step is to figure out how to get to ‘B’ by increasing your stamina between sessions.”

Starlight Starbright Brings Smiles to TBHC

The Brooklyn Hospital Center (TBHC) welcomed the Starlight Starbright Children's Foundation of Metro New York this past May 2005. During their visit, Starlight-Starbright had lunch with our administration and shared their vision and goals on how to collaborate and continue their support of The Child Life Program. The mission of the Foundation has remained the same: "Brightening the lives of seriously ill children and their families through innovative programs, services and research that empower, educate, entertain and inspire; never once forgetting that at the core of every serious childhood illness is a child."

Explained Maura Connelly, Director of The Child Life Program, "Over the years, Starlight-Starbright has provided many wonderful programs for TBHC's Pediatrics Department. We have the Barney Hospital Pals program, which educates and supports young children undergoing radiation therapy. We also have educational CD-ROMS to teach and educate patients about Sickle Cell Disease, diabetes and asthma, to name a few. Starlight-Starbright also provides a weekly clown show and a musician, and we have received numerous grants from them. One grant we received is being utilized for music therapy programming, such as bedside radios and musical instruments, and another has funded new television sets that have DVD players at every bedside, in addition to DVDs and PlayStation games. This Foundation has also provided us with tickets to various sporting events, such a Yankee games and Knicks games. All of these services, products and events are free of charge to our children and families, and at NO cost to the hospital."

Recently, Sharp Electronics Corporation and the New York Mets presented to the Child Life Program a new " Fun Center ", which features a flat screen TV, a DVD player and a video game system. "This new system joins the three we already have in use throughout the hospital, and the donation is worth approximately $4,000", according to Ms. Connelly. She added, "Kristen Riccardelli, one of the Child Life Specialists on our staff, attended the Mets game on Friday, May 13, 2005 to accept the donation on behalf of TBHC. Pedro Martinez represented the Mets, and presented Ms. Riccardelli with this generous donation."

Going forward, new signs will be placed throughout various pediatric areas for Starlight-Starbright that will simply read, "Smiles brought to you by Starlight Starbright Children's Foundation". These signs will be placed in the Pediatric Playroom, the Pediatric ED, the Children's Health Center , and Pediatrics Hematology/Oncology Department.

For more information on this organization, please visit: www.starlight-newyork.org [64]For more information on the Child Life Program, please contact Maura Connelly [65], Director of Child Life at mac9061@nyp.org [65]or 718-250-8514

TBHC 2008 Annual Fund Campaign

href="http://www.denarionline.com/sathon_cc/di_survey.asp?COMP_REF=_BROOKHOS&SURVEYCODE=online" target="_blank">Click Here to Give a Tax Deductible Donation Today

Reason to Give

Money raised in this campaign supports programs with significant impact on the health and well being of our community.

How to Give

Make a tax deductible donation now by check, credit card or payroll deduction.

Please make checks payable to:
THE BROOKLYN HOSPITAL FOUNDATION
121 DeKalb Avenue Brooklyn, NY 11201

Make a tax deductible donation by credit card. [67]

For More Details

Call The Brooklyn Hospital Foundation at 718-250-6514 or email us at mms9011@nyp.org [68].

TBHC Appoints New Chief of Orthopaedic Surgery

here to schedule an appointment with Robert Meyerson, M.D., FAAOS    
The Brooklyn Hospital Center (TBHC) welcomes Dr. Robert Meyerson, M.D., FAAOS as its new Chief, Division of Orthopaedic Surgery, Department of Surgery. With over 15 years of clinical and academic experience, Dr. Meyerson brings his orthopaedic expertise to TBHC by utilizing state-of-the-art techniques in arthroscopic and reconstructive joint surgery. "My goal is to build a team of Orthopaedic specialists so that TBHC may emerge as a center of orthopaedic excellence in Brooklyn and New York City ."

According to Dr. Meyerson, "Orthopaedic Surgery plays an integral role in the delivery of healthcare, and its addition to TBHC will provide comprehensive patient care for a variety of orthopaedic conditions - from traumatic injuries to acquired and degenerative disorders." Orthopaedic Surgery now includes the subspecialties of Joint Replacement and Reconstruction, Sports Medicine, Pediatric Orthopaedics, Hand and Upper Extremity Surgery, Foot and Ankle Surgery, Spine Surgery, and Orthopaedic Oncology. Common conditions that Orthopaedic Surgeons treat include fractures and dislocations, back problems such a herniated or "slipped" discs, bone tumors and birth defects of the skeleton, degenerative joint diseases and sports-related injuries. Dr. Meyerson explained that while many of these conditions may require surgery, "80% to 90% of an Orthopaedic Surgeon's practice is devoted to the non-surgical or medical management of injury or disease." Physical therapy remains an integral treatment modality for most orthopaedic problems.

The Orthopaedist also works closely with other health care professionals and often serves as a consultant to other physicians. Many diseases physiologically affect the musculoskeletal system, and therefore the Orthopaedist may play an important role in caring for medical and well as surgical patients. For example, patients with renal failure have difficulty maintaining normal serum levels of calcium and phosphate and may develop renal osteodystrophy, a condition that causes thin, fragile bones prone to fracturing. Many medical conditions may lead to joint swelling, and an Orthopaedic Surgeon may be called in to perform an arthrocentesis or aspirate fluid from the affected joint to aid in diagnosis and/or pain relief. Other previously undiagnosed conditions such as bone cancer or hematologic disorders may manifest themselves as bone pain or an occult fracture. In a more familiar role, the Orthopaedic Surgeon helps deliver emergency care and works as a team player in the management of complex multi-system trauma.

Who he is. 
Fellowship trained in sports medicine, Dr. Meyerson specializes in arthroscopic and reconstructive joint surgery. Rupture of the anterior cruciate ligament or ACL is a common sports-related injury of the knee. This injury occurs in athletes of all ages - from adolescent basketball players to senior tennis enthusiasts - and surgical treatment is no longer exclusive to the younger crowd. According to Dr. Meyerson, "My obligation is to keep older patients healthy, mobile and stable so that they are able to enjoy recreational activities for as long as possible." For surgical reconstruction of the ACL, Dr. Meyerson utilizes an advanced technique, which is not commonly performed in this part of the country. "When an athlete tears his or her ACL, the treatment of choice is to reconstruct their ligament with a tendon graft. Most ACL reconstructions performed in New York utilize a bone-tendon-bone autograft or BTB, which is harvested from the patient's own patella tendon through an incision made over the front of the knee. This provides a strong replacement for the ACL, but also results in a high incidence of anterior knee pain and quadriceps weakness." To reduce the incidence of anterior knee pain, Orthopaedic Surgeons have resorted to allografts or cadaver tendons, which will result in less anterior knee pain but carry with them a higher risk of disease transmission such as HIV. Dr. Meyerson prefers to reconstruct the ACL with a Double-Looped Semitendonosis-Gracilis Autograft (DLSTG), also know as a hamstring autograft. According to Dr. Meyerson, "The DLSTG is almost twice as strong as a BTB, can be harvested through a smaller one inch incision and results in less immediate post-operative pain." By utilizing advanced fixation techniques, the DLSTG now has the most rigid fixation and biomechanical properties that more closely mimic those of the native ACL. The initial hamstring weakness that follows a DLSTG is less disabling than the quadriceps weakness seen after a BTB autograft, and patients can return to activities of daily living sooner. "Patients will frequently report to me how much faster they rehabilitated their knee than other patients they met at physical therapy who had a BTB at or about the same time as their surgery. Even their physical therapists are impressed."

In addition to his clinical practice in Orthopaedic Surgery, Dr. Meyerson currently serves as the Associate Chief of Sports Medicine at St. Vincent 's Hospital - Manhattan Division, and has spent the last 14 years training residents as Coordinator of the Orthopaedic Residency Program and Director of the Anatomy Lab at Kingsbrook Jewish Medical Center. He has also held teaching positions at the Mount Sinai School of Medicine and the Albert Einstein School of Medicine. Furthermore, Dr. Meyerson has presented nationally at the annual meetings for the American Academy of Orthopaedic Surgeons and the American Orthopaedic Society for Sports Medicine, and has served as President of the Brooklyn Orthopaedic Society.

Where he came from. 
Dr. Meyerson was born in Brooklyn and has resided in New York all his life. After graduating from Columbia College , he earned his medical degree at the State University of New York at Downstate and trained in Orthopaedic Surgery at Kingsbrook Jewish Medical Center. He then completed a fellowship in Sports Medicine at the Hospital for Joint Diseases-Orthopaedic Institute.   When asked what brought him to The Brooklyn Hospital Center, Dr. Meyerson explained that during his years at Kingsbrook Jewish Medical Center, he developed strong working relationships with both Dr. Buddhadev Manvar and Dr. Babu Jasty, members of TBHC's Professional Staff. When TBHC decided to develop an Orthopaedic Surgery service, both Dr. Manvar and Dr. Jasty recommended Dr. Meyerson to TBHC's President and C.E.O., Mr. Samuel Lehrfeld. Dr. Meyerson added, "I've always considered Brooklyn to be the center of the universe. The downtown Brooklyn area attracted me because of the tremendous change and development.the sports complex being built next door; Long Island University 's expansion - and orthopaedically, the area is grossly underserved. I consider this to be a great professional opportunity to develop a top-notch orthopaedic program for the hospital that provides comprehensive orthopaedic care for the Brooklyn community." Among the many anticipated improvements, the Orthopedic Surgery office will have a state-of-the-art digital x-ray suite.

Added Dr. Meyerson, "The leadership of the hospital is very doctor-oriented - they have a strong grasp of what it takes to create an environment for physicians where they can provide excellent care for their patients. I am excited to be joining a hospital organization whose administration has such great vision."

TBHC Cancer Support Programs

Click here to learn more about the Cancer Communications Department

The Cancer Communication Department at The Brooklyn Hospital Center offers a variety of support programs to the community of Brooklyn.

I Can Cope is an educational program to empower patients and individuals facing a diagnosis of cancer. They are offered up-to-date information about their diagnosis as well as possible cancer treatments. The program runs about every three months for an eight-week session

The Coping Club has been functioning for about ten years, and includes about thirty active members. They meet once a month as a support group.

The Man-to-Man Program is a support group for men diagnosed with prostate cancer. Meeting once a month, the group has been growing, and currently more than forty men participate.

The Look Good, Feel Better Program is a free program that teaches beauty techniques to women with cancer to help them combat the appearance-related side effects of cancer treatment. This program is offered every two months.

The Outreach Program sponsored by a Susan G. Grant screened about 1,300 women for breast cancer and cervical cancer this past year, and more than 8,000 women were educated about cancer issues. Our outreach worker, Lucy Perez, has made a big impact in the quality of life to the women in our community.

The Cancer Registry records all cancer diagnoses and treatments in order to maintain a fully comprehensive cancer program.
Redes En Acción, sponsored by NCI ( National Cancer Institute), has been involved with community activities for over five years and partners with The Cancer Information Service in the provision of education for cancer awareness. Health fairs, community education meetings and screening programs have been provided in conjunction with the Brooklyn Breast Health Partnership. Nereida Borrero, RN, MSN, GNP directly supervises Network staff activities of Redes En Acción.

TBHC Celebrates Kids Kicking Sickle Cell Anniversary with Awards Ceremony

Recently, The Brooklyn Hospital Center celebrated the Kids Kicking Sickle Cell (KKSC ) program's first anniversary. To mark the occasion, it held an Awards/Belting Ceremony for participants in its martial arts empowerment program. The ceremony was held at The Brooklyn Hospital Center (TBHC) in Fort Greene , Brooklyn on Wednesday, February 9 th at 6 pm in the cafeteria, and honored all of these young heroes for their achievements. Rabbi Elimelech Goldberg, Founder and National Director, and Dr. Susan Gardin, National Program Director, was in attendance, and refreshments followed.

The Brooklyn Hospital KKSC program joins children together in a supportive community where they learn to use the techniques of the martial arts to focus on their inner strengths and capabilities in confronting the pain associated with sickle cell disease.  By teaching breathing, relaxation imagery and karate movements, the children become partners in their treatment and learn to transcend the pain and fear of their disease.  According to Maura Connelly , MS , CCLS, Director of Child Life at TBHC, KKSC is a leader in its field: "When children take part in this program, they also have the chance to socialize with other kids with the same illness."

The KKSC program at The Brooklyn Hospital Center is a pilot project. The first of its kind for kids living with this chronic disease, KKSC opened in February 2004. A second program has since started in Detroit .  Kids Kicking Cancer (KKC), the parent organization, was founded by Rabbi Elimelech Goldberg in Michigan to help ease the pain of pediatric cancer patients, while empowering them physically, spiritually and emotionally. The Kids Kicking Sickle Cell program was established utilizing this same model. The Kids Kicking Sickle Cell program is currently being sponsored by the national Kids Kicking Cancer organization until KKSC is able to raise its own funds. Rabbi Elimelech Goldberg is a Clinical Professor in the Department of Pediatrics at Wayne State University Medical School

TBHC Host Visiting Physicians Team from China

This past year, Mr. Samuel Lehrfeld, President and CEO of The Brooklyn Hospital Center (TBHC), was joined by Mr. Mohammed Shahjahan, Director of Respiratory Care during a trip to Fujian Provincial Hospital in China . The trip had two distinctive purposes - one was to improve TBHC's relations with the Chinese population in the Brooklyn Community, and the other was to present a conference on the healthcare management of patients receiving mechanical ventilation.

In an effort to continue the exchange of information between the two hospitals, TBHC welcomed a visiting team of doctors from China 's Fujian Provincial Hospital on May 25, 2005 to examine and learn the setting of the Critical Care Unit. The team was composed of six doctors and one nurse, and the purpose of their visit was not only to observe, but also to bring what they learned at TBHC back to their health care facilities in China.
Ms. Kathleen Cheng , Patient Care Manager, Cardiac Catheterization Lab Division of Cardiology, explained that Mr. Samuel Lehrfeld coordinated the medical team vist from China, which lasted for a little over three months (they returned to China on August 2, 2005 ). Said Ms. Cheng, "It was my great pleasure to meet and welcome the medical team from China . When the team arrived, I was one of the representatives from TBHC to greet them. Because I speak fluent Mandarin, I became the 'unofficial' translator, conducting tours throughout the hospital and bridging the language gap." Nursing and various medical departments were also involved during their stay at the hospital - Mr. Paul Albertson , Sr. VP, Hospital Operations and Ambulatory Care; Dr. Ramesh S. Gulrajani, M.D., F.C.C.P . ; Anne C. Goonan, RN, CNO, Sr. VP, Nursing & Patient Care; and Reynaldo Rivera, RN, Senior Director of Nursing, were an integral part of their visit during their stay at TBHC.   Ms. Cheng noted that Fujian Provincial Hospital 's teams are going to expand their ICU Unit, adding, "They wanted to review our policies and procedures in our ICU Unit, and in turn, apply what they've learned to their own units upon their return to China ." Due to the modernization in China , Ms. Cheng added, the hospital would like to upgrade and meet the standards of the American hospitals. In addition, the team also visited two other hospitals in New York City area, Bellevue Hospital and Cornell Medical Center.

Fujian Provincial's visiting team also took a tour of TBHC's Pharmacy Department during their stay. Ms. Cheng said that they were amazed by the Robot Dispenser system, particularly because it reduces the man-made errors and manpower used in traditional pharmacies. Additionally, Ms. Cheng stated that they admired the American method of intravenous medication, which comes attached with the drug and the IVs "piggy-backed" with the additional meds. Added Ms. Cheng, "They also remarked that when we administer medication, it is safe and maintains a sterile technique - they commented on our needle system, which reduces the chance of needle sticks."

Ms. Cheng added that by adhering to such simple procedures as proper handwashing and sharps disposal, hospitals are able to reduce disease transmittal from patient to patient and avoid unnecessary accidents. After observing these two basic procedures, the team learned that patient and employee safety is very important in the American healthcare systems.

However, Ms. Cheng commented, "The team found we have one common practice in both Chinese and American hospitals. During every procedure or surgery, China also conducts a "Time Out" to identify the following information before going forward with any procedure: if it is the 1) right patient, 2) right procedure, and 3) the right site."

Ms. Cheng concluded, "In China, medical attention is very costly; everyone can go to the hospital, but not every one will get the same treatment. Medication and medical supplies are very expensive in China. Ultimately, the team hopes that one day everyone will receive the same medical attention in China, regardless of income."

TBHC Hosts "Wear Red Day" Campaign Feb 4, 2005

This coming February 4 th marks the 2 nd annual National Wear Red Day for Women! If you're uncertain as to what the significance of this day is, it is a national campaign where people across America will be wearing red to show their support for women and the fight against heart disease. Join the millions of women, including this year's spokesperson, Grammy award-winning R&B singer Toni Braxton, who will wear red to help raise awareness of heart disease as the number-one killer of women.

People won't be the only ones sporting the color red on February 4 th - landmarks all over the country will 'Go Red For Women', including our own Empire State Building . Other famous landmarks include Graceland , the Niagara Falls , and the Seattle Space Needle, among other national sites that will be illuminated in red to raise awareness for this worthy cause.

Did you know that less than 10% of American women know that heart disease is their leading cause of death, and that one in two women will die from heart disease? Approximately 90% of woman surveyed couldn't even name the common signs of heart attack, such as nausea, fatigue and dizziness. But wearing red is only the beginning - you've got to start living a healthier lifestyle to protect your heart. Your doctor can help you to create a plan to reduce your risk, including a heart-healthy diet, appropriate exercise, and even medication, if necessary. The bottom line? You can protect yourself! For more information about risk factors and ways of preventing heart disease, visit The American Heart Association on the web at www.americanheart.org [74].

Wear Red Day is TBHC 's chance to increase awareness among our employees, friends and families by sharing statistics and information about cardiovascular disease and heart health. Our intent is not only to raise awareness, but to empower women to reduce their risk. Wear Red Day is loads of fun, but more importantly, those who participate will make a real difference in protecting not only our own community, but people throughout America from disability and death from the leading killer - cardiovascular disease.

The Brooklyn Hospital Center encourages employees to show their support by wearing their choice of red business-appropriate attire and join the battle against heart disease in America 's women. All participants will also be asked to make a minimum donation of $5. Participants will receive a Red Dress pin and life-saving information, along with stickers and a receipt acknowledging their participation. More importantly, though, they will experience a heartfelt feeling just knowing that their donations have made a big difference!

Co-Captains
Narinder P. Bhalla, MD
April Lackey [75]
Email: apl9002@nyp.org [75]
Phone: 718-250-6383

TBHC Infusion Center Plans

Proceeds from last year's 2004 Founders Ball are going towards the creation of a new, state-of-the-art Infusion Center . This new Infusion Center will allow our physicians, expert in the care and treatment of both children and adults afflicted with cancer and other allied diseases, to provide patients with treatment in a comfortable and comforting environment.

The plans for the new Infusion Center are designed to treat both pediatric and adult patients. Patients are treated in the Infusion Center for a number of diagnoses, including Leukemia, Sickle Cell Anemia, Lymphoma, Hemophilia and Tumors (bone, solid and ovarian). The Infusion Center will include a nutrition station, clinical exam rooms and private conference rooms. The Center will also provide for the integration of prevention, diagnosis, treatment, rehabilitation and support into existing clinical and educational programs for adults, children and their families.

The Department of Engineering has presented plans that illustrate the complete layout for the new facilities, which will be located on one of the original sites of TBHC's infrastructure. This area is located in the heart of the hospital on the 1 st Floor, North Pavilion section, and has been rebuilt over the years to accommodate the community's growing needs. The Brooklyn Hospital Center is subsequently proud to be embarking on its installation, as we further extend our facilities to meet the requirements of our patients during our 160 th anniversary. Both adults and children will have separate facilities; however, both sections are close enough in proximity to share resources. Additionally, this new facility will consolidate our cancer care services into one cohesive unit; it will also be centrally located on the first floor for our patient's convenience. Furthermore, the Center will include a children's play area, which will provide a place for young patients to spend time with their families in a child-friendly atmosphere.

The addition of the Infusion Center will be yet another milestone in The Brooklyn Hospital Center's accomplishments, and we would like to thank and acknowledge everyone who has worked together to prepare for the Center, in particular Dr. Asha D. Nayak, Hematology and Oncology Physician; Paul Albertson , Senior Vice President of Operations; Paul Wong, Director of Engineering; Dr. Arunbhah Patel, Director of Hematology and Oncology; and Dr. Swayam Sadanandan, Associate Chairman, Chief Division of Pediatric Hematology and Oncology. We look forward to this invaluable addition to our community, as the Infusion Center will provide patients and their families the expert care and peace of mind that is our commitment - and our tradition - for over a century and a half.

TBHC Introduces the Clinician Desktop

In late 2004, The Brooklyn Hospital Center's (TBHC) Information Systems initiated a project to create a Clinician Desktop PC. This system was implemented to "bridge the gap" between where we currently are with information technology and where we envision TBHC in the next few years.

Irene Farrelly, Vice President of Information Systems, explained the process: "We acquired fifteen PCs through HUD funding, and created a sample PC desktop with a series of icons that provides access to various system environments. These systems included Cerner Radiology for finalized radiology and nuclear medicine reports, Cerner Pharmacy for patient medication profiles, Eagle patient inquiry, Internet access, Milliman Guidelines, and the creation of a public viewing area on our Intranet, QMS. This public area contains access to the Administrative Policy and Procedure Manual, the Nursing Manual, the hospital's Medication Formulary, Abbreviation and Exclusion Lists, HIPAA Policies, Key Personnel Directory, JCAHO information and other items as provided to us for posting on this site. We have also included a 'Read Me First' icon on each desktop which contains information about the features on the clinician desktop, the applications available, and how to use them. As new features are added, information will be updated on the QMS server and be immediately available on the desktop."

"In March, working with Rey Rivera, Senior Director of Nursing, we began deployment of these PC's, hired three college students to train physicians and nursing staff on the access and use of each of these systems, and began scheduling training sessions. At present, training is held twice a week, Tuesdays and Thursdays, from 12:30 p.m. to 5:00 p.m. in both the Information Systems Training Room for physicians and the Nursing Computer Lab for the Nursing Staff. As part of the one-hour training session, each attendee completes a Clinician Desktop Access Request form in order to obtain user IDs and passwords, which are required for system use."

"To date, approximately 350 physicians and nursing staff have been trained. In addition, we have provided the Cerner Radiology and Pharmacy icon at Caledonian, Williamsburg , Manhattan Avenue, and La Providencia to enable their staffs to display finalized radiology results as needed. We have also provided Cerner in various locations at the Downtown Campus and Maynard on request."

In March, Information Systems has also placed an OVID icon on each clinician desktop, in the medical library, in both training centers, and other PCs as requested in clinical department areas. OVID is a subscription service that provides for access to medical journals on the internet.

TBHC Medical Team Helps in Honduras

Fundación Amor a Honduras is an organization that helps people with low incomes in need of medical care and treatment, and operates with donations from the U.S. Dr. Alexis Reyes, President of the organization, met Jeovanni Rivas, Director of Biomedical Engineering (Comprehensive Equipment Management Corporation) from The Brooklyn Hospital Center during a recent visit to his aunt in Honduras. At this meeting, the two addressed the limited amount of available medical equipment in the country. As Mr. Rivas's aunt was in need of an internal pacemaker, he was able to purchase a pacemaker with the assistance of TBHC - Paul Albertson, Sr. Vice President/Operations, Gary Moore, Director of Surgical Support Services, and Medtronics.

As a result of their meeting, Dr. Reyes and Mr. Rivas discussed a patient with porphyria, a rare disease. The patient, a young girl named Mayra Cruz, was in a coma with very little hope of survival. Dr. Reyes requested assistance in obtaining the right medication for this patient, since this was not available in Central America or Mexico . Mr. Rivas again enlisted the help of TBHC team. Paul Albertson , Norberto Alberto, Assistant Director of Pharmacy, and Dr. Eva Berrios-Colon, PharmD, Clinical Coordinator, Ambulatory Care Pharmacotherapy were able to obtain the medication (called Panhematin©) through Ovation Pharmaceutical at no cost, and shipped it directly to Honduras. Fortunately, Miss Cruz came out of the coma after the first treatment. A progress report has been sent to all parties involved - at present, Mayra is still recuperating in the hospital, but no longer in the ICU. TBHC would like to thank all of the staff members involved in the cooperative efforts in getting the medication to Miss Cruz in Honduras, particularly Dr. Allen, Ms. Kimberly Lulei, and Ms. Jeanine T. Schabes of Ovation Pharmaceutical Company for their generous donation.

Mr. Rivas added, "The way the hospital reacted - by reaching out to this young girl on such short notice - is commendable, and TBHC looks forward to working with Fundación Amor a Honduras in the future. As for me, it is significant to be part of such a generous effort on behalf of the Latino community. TBHC knows no boundaries when it comes to their outreach and support to all ethnicities and cultures. I am proud to be a part of the TBHC family."

TBHC Pediatric Resident Treasure Hunt

The second annual Department of Pediatrics Residents' Brooklyn Treasure Hunt took place on Friday, June 24, 2005. Council member Leticia James presided over the kick-off ceremony at the hospital.

Two teams, comprised of 6 incoming PL-1s each, scoured the borough looking to find such items as a handful of sand from Brighton Beach , how condonopsis pilosulanannf is used, and the price of a batida at Las Rosas bakery. The goal of the event was to familiarize these new residents with Brooklyn 's richness and diversity as well as to promote the teamwork that they will need over the next three years. Judging from the residents' comments, both goals were realized. One resident remarked, " Brooklyn is awesome." Another stated, "I got to know my colleagues better."

The treasure hunt is a pet project of Brooklyn resident Susan Gottlieb, M.D., Chief of Child Development and Associate Program Director, who conceptualized and implemented it with the support of fellow Brooklyn enthusiast Ken Bromberg, M.D., Chairman of Pediatrics. Dr. Bromberg said, "It is great to have such an innovative program to showcase the uniqueness of our borough." Added Dr. Gottlieb, "It takes a lot of work to organize this but it is really worth it to see the residents' reactions. This is one of my favorite days of the year."

{Click here to see more photos from the residents adventure [80]]

TBHC Physicians Provide Medical Care in Haiti

According to Dr. Lubin, the doctors visited for one week, providing free and much-needed medical care to all age groups in the area, including patients as young as three months as well as senior citizens. However, the majority of the patients were middle-aged, and their breadth of ailments was vast. The doctors treated many types of complications, such as trauma and burn victims, gunshot wounds, ailments due to congenital defects, and life-threatening illnesses. The doctors were able to cover numerous clinics and address different areas in the hospital, beginning Sunday afternoon just hours after their arrival. The patients who visited the clinic on Sunday generated forty-seven additional cases that the doctors added to their schedule. Resident Joseph Chang, Emergency Medicine, covered clinic screenings while the doctors were in surgery & attending patients.

During their stay, the doctors stayed at housing provided for clinicians who travel abroad. Dr. Lubin noted that they were well-received and provided for. He also added that although Creole was commonly spoken (Dr. Lubin is fluent in Creole), there were many natives who spoke English; as a result, there weren't any language barriers, which was helpful during the screening and treatment process.

When asked how the community is notified of the doctors' visit, Dr. Lubin said that the hospital publicizes the information through the clinicians in hospital. Dr. Lubin explained, "The hospital has a system where the teams prepare throughout the year. The clinic schedule their patients based on the doctors' arrival. They basically prepare for the visiting doctors and clinicians, and schedule their patients accordingly. It is a very well-organized program."

The doctors prepared for their visit by collecting medications that they anticipated they would be using from drug representatives and pharmaceutical companies. The clinics in Haiti had some supplies available, but in general, they were very limited - they were lacking such basic supplies as band-aids and syringes. The doctors anticipated that this would happen, so they brought such needed medications as narcotics and anesthetics. Dr. Lubin added, "TBHC Pharmacy Department made a nice contribution to this cause - Warren Lakoff, Director of Pharmacy, provided the medications we needed. We had a list of meds and except for controlled drugs, (Mr. Lakoff) was able to provide everything else that we needed."

Normally, homeopathic care (natural treatments or remedies, usually derived from roots, herbs and plants) is all that the people of Haiti can afford, explained Dr. Lubin. It is a cultural as well as a socioeconomic situation, as Eastern medicine more commonly utilizes natural treatments and organic substances to treat illness when nothing else is available; many countries have practiced homeopathic care for thousands of years. "There is a lack of everything, so they take full advantage of what is made available to them. However, the people are very receptive to what we have to offer - especially when there are urgent cases - that require Western medicine (which usually entails surgery)." Dr. Lubin added, "When the doctors are faced with treating life-threatening illnesses in the clinics, such as AIDS and malaria, the internist would see the patients for consultation and treatment."

At the end of their visit, the doctors felt extremely grateful for their experiences in Haiti . Dr. Lubin is a native of Haiti himself, and hasn't been back to the island for over 30 years - this trip was the first time he had returned to his homeland, so it held a personal significance. Everything that he had heard about the country - the misery, the suffering, the poverty - was all painfully apparent. However, Dr. Lubin described the people of the community fondly, recalling, "The people themselves certainly made you feel their gratitude - they are a very proud people. Their smiles, their reactions, and their attentiveness to our needs as guests in the country truly showed such sincere appreciation that we wound up thanking them - it touched you in a way with feelings you didn't know existed within you. It was truly a life-altering experience."

Dr. Lubin added, "In spite of the country's poverty and poor living conditions, you didn't see anger or bitterness - they somehow manage. You see their good nature and their goodwill - they are such hard-working people and everyone works together in a cooperative fashion; there is a really strong sense of community. They are also an industrious people, as far as finding solutions to their everyday problems on a daily basis."

On one such occasion, Dr. Lubin encountered an elderly man who was moved when he realized that he spoke his native Creole: "This gentleman was over 80 years old, and when he realized I spoke the language and then interacted with me, he seemed truly touched. He said that after seeing so many doctors over the years, I was the first native son that came back - he said he now has such a sense of hope that after 83 years of life, he is now ready to die with the hope that his country's future is in safe hands." On another occasion, during Dr. Carryl's departure, local community members said, "They will fan time itself so that the doctors will return faster". The doctors anticipate that they will have a bigger team to bring to Haiti on their visit next year to meet the vast needs of the Haitian community.

TBHC Physicians Provide Medical Care to Hurricane Katrina Victims

This past September, doctors, nurses, and other health professionals from all over the United States went to New Orleans to assist in the aftermath of the greatest natural disaster to ever hit the United States, Hurricane Katrina. Representing The Brooklyn Hospital Center (TBHC) were Dr. Irizarry, Chairman of Emergency Medicine Department, and Dr. Raymond Harvey, from the Department of Family Practice.

Dr. Irizarry is currently on deployment for Hurricane Rita DMAT NY-2 (Disaster Medical Assistance Team) as its Chief Medical Officer. He was dispatched by Federal Emergency Management Agency (FEMA) in response to Hurricane Katrina, and is currently assigned to West Jefferson Medical Center . According to Dr. Irizarry, "The function of DMAT is to provide acute medical care for the vaccination/innoculation process (primarily for Tetanus and Hepatitis A & B) to treat the citizens of New Orleans . We are one of the many teams that have been dispatched to New Orleans , where we see on average approximately 1,200 - 1,500 patients per day. We are one of six "level-one" DMAT teams in the country, and one of the largest DMAT teams. A "level one" team means that we are fully self-sustainable - we have our own medical supplies, operative supplies, food and water. Our team has a very rapid response rate; we responded in 4 ½ hours to Hurricane Katrina."

The National Disaster Medical System (NDMS), under the direction of the U.S. Department of Homeland Security and FEMA, fosters the development of volunteer teams, called Disaster Medical Assistance Teams (DMATs). A DMAT is a group of professional and paraprofessional medical personnel (supported by a cadre of logistical and administrative staff) designed to provide emergency medical care during a disaster or other event. DMATs are principally a community resource available to support local, regional, and State requirements. However, as a National resource they can be federalized to provide interstate aid. Dr. Irizarry has been a member of the DMAT team for approximately two years. To date, DMAT teams have treated over 115,000 patients in various field hospitals, clinics and other medical sites in response to the aftermath of Hurricane Katrina.

As is the case with any catastrophic situation, there have been many obstacles for the medical teams during their trips to the disaster areas. According to Dr. Irizarry, "We have faced major obstacles in New Orleans regarding our day-to-day living environment. Because the water supply was contaminated, we brought down a water filtration system along with bottled water. Our sleeping accommodations were compromised also, so we slept wherever we could set up our cots. It is certainly exhausting work - our clinics are functioning twenty-four hours a day, providing fully functioning pharmaceutical care, acute medication and chronic care for patients. Because the environment can become very stressful for the medical staff, we are grateful to have a member of our team who is trained in Critical Incident Management and mental health issues to assist our team. They are able to provide us with counseling to work with us through our day-to-day concerns, and help our team to cope on an emotional level".

Looking ahead, Dr. Irizarry said that the DMAT groups would continue to be called upon throughout the nation for help. "We will have to be intermittently deployed on a rotating basis so that we can continue to aid in the recovery efforts. There are still parts of western Louisiana and Texas where 40%-50% of the communities are still without power".

However, when asked to describe the positive experiences he has had, Dr. Irizarry explained (with regard to DMAT), "There is an exceptional quality of function and training on this team, with members from NY, NJ and Connecticut . We have the capability to provide immediate medical care once we are dropped off at a site - this allow us to assist the population to the best of our abilities, and that, in turn, has been a very positive experience for us as a team."

Dr. Harvey reported to the Emergency Operations Command Center in Baton Rouge , Louisiana , at the Jimmy Swaggart Center on September 4, 2005 . His first assignment was a 12-hour shift at PMAC ( Pete Maravich Assembly Center ), a sports arena located on the campus of Louisiana State University and operated by the Illinois Medical Emergency Response Team in cooperation with local officials. The facility included x-ray machines, laboratory access, a fully functioning ICU, a full range of specialists, from nephrologists to orthopedic surgeons, and a fully stocked pharmacy and pharmacists to run it. "The Illinois team did a tremendous job in a very short time. This should be looked at as a model for future disasters," explained Dr. Harvey.

Dr. Harvey described the group's experience, explaining, "The staff we had was perfect for a family practice-style clinic, and it was a very similar arrangement to what we have here at The Brooklyn Hospital Center. We were able to establish and maintain record keeping, write prescriptions, dispense medication, and give immunizations. We saw patients 24 hours a day who were suffering from skin rashes, dehydration, heat exhaustion, athlete's foot, severe diarrhea, and other ailments associated with a disaster of this kind. This was a simple clinic, and at times very stressful. However, we were glad to provide comfort to the people we saw, and maybe even make them laugh a little bit."

Ten days after the hurricane, Dr. Harvey and Gail Ciesielski, RN from Lawrence , Kansas had an opportunity to assist in a boat evacuation. Said Dr. Harvey, "Some of the survivors didn't need our help, but others were in a badly weakened state, especially the elderly. One of the victims - a cardiac patient who was completely dehydrated - required immediate attention, so we administered IV fluids right in the boat. The water engulfing New Orleans is full of sewage and debris, making it very dangerous for people who are still stranded in their homes."

In retrospect, Dr. Harvey said, "I was fortunate that I had the opportunity to help, because I know a lot of people wanted to take part in the recovery efforts. This is only the beginning - many people are going to need assistance for a long time. Now comes the hard part."

TBHC Podiatry Runs 24/7

To chedule an appointment with the Dept. of Podiatry please call 718 250-8753



You may not notice as you go through your daily routine, but there is a great deal of activity up on the 8 th floor in the Maynard Building at The Brooklyn Hospital Center (TBHC). In addition to General and Orthopedic Surgery (featured in the last issue of Heartbeat magazine), you will find the Division of Podiatric Medicine and Surgery.

Reorganized as a Division under the Department of Surgery over one year ago, Podiatry has grown to become a 24-hour-per-day, 7-day-a-week service, providing consultative services to the ER, Inpatient Floors, Outpatient Clinics and Private Practice patients in the Maynard Building.

Dr. Bryan Makower assumed the responsibilities of Chief about a year and a half ago, and has seen utilization of his Divisions services expand over five-fold. "We have been exceptionally busy in the operating room and in the clinics," Dr. Makower explained.

With over 20 years of practice experience, Dr. Makower came to Brooklyn Hospital as a Podiatrist, Board Certified in Podiatric Surgery as well as in Podiatric Orthopedics and Medicine. He has recently joined TBHC staff from Downstate Hospital in Brooklyn , where he developed and ran a post-graduate training program leading to Certification in Podiatric Medicine and Podiatric Surgery. As Chief of the Division and Residency Director at University Hospital of Brooklyn, Dr. Makower built up a great volume of patients. Between his responsibilities as clinician and educator, he was able to open the community's eyes to the need for preventative and proactive Podiatric Care.

"Brooklyn has one of the highest concentrations of diabetic patients in the country. Podiatric preventative care, as well as patient education, has been shown in numerous studies to decrease the number of non-traumatic lower extremity amputations. Prevention of foot ulcers is one of our major responsibilities", he adds. "We as Podiatrists are in a unique position to be able to understand the forces on the foot in conjunction with a diminished neurovascular status. We develop strategies, including shoes and braces, to redistribute weight bearing to prevent abnormal, excessive forces."

Dr. Deanna Duran has recently joined the Podiatric staff. She has extensive experience in dealing with abnormal biomechanics and forefoot reconstructive surgical procedures. Dr. Duran has practice experience in New Mexico , where she worked on Indian Reservations to help diminish lower extremity amputation rates.

"Wound care is a new, complex and rapidly changing field", says Dr. Duran. "We utilize medical, surgical and nursing principles to resolve previously untreatable wounds. This is an area where multiple specialties can come together to salvage feet and legs where in the past the only answer was amputation".

Another of Dr. Duran's interests is Sports Medicine. "By optimizing the biomechanics of the foot, we can improve performance and prevent injury. Evaluation of the child's foot at an early age is also of extreme importance," adds Dr. Duran.

In addition to diabetic preventative foot care, Dr. Makower has an active practice treating common foot ailments and deformities, including heel spurs, bunions, corns, hammertoes and ingrown nails. Flatfoot deformities are addressed, as they often lead to serious arthritic conditions, preventing normal and pain-free walking later in life.

Dr. Makower is also very happy to have recruited Dr. David Gordon, who has recently completed one of the most rigorous and well-respected training programs in New York . Dr. Gordon, who has already developed a method of joint replacement that will be used in the treatment of osteoarthritis across the country and the world, has extensive training in reconstructive rear foot surgery and in trauma of the foot.

Dr. Makower and his staff are on call to the adult and Pediatric Emergency Rooms on a 24/7 basis. They each have extensive experience in dealing with a variety of situations, from ingrown nails and lacerations to complex fracture dislocations. Along with advanced technologies available at The Brooklyn Hospital Center, traumatic injuries can be fully evaluated with imaging modalities, stabilized, reduced and repaired. Severe limb-threatening infections can be evaluated, and our team is capable of initiating limb salvage.

Appointments for Podiatry can be made through the four off-site clinics, as well as the OPD at The Brooklyn Hospital Center. Private patients are seen at 240 Willoughby Ave. (8 th floor Maynard Building ) three days per week by calling 718 250-8753. Consults may be called through the Operator at TBHC or through the private practice number, 718 250-8753, which is covered 24/7. All insurances are accepted, and appointments are suggested.

In addition, Dr. Makower would like to add that he is going to be available for patients to visit at the clinic in the evening hours.

TBHC Spotlight on Dr. Andras Fenyves

Dr. Andras Fenyves was born in Hungary . He attended Semmelweis Medical School in Budapest , Hungary and while in school, worked as a part-time ambulance paramedic to support his family. He was inspired by his father as well as his grandfather, who were both physicians. Dr. Fenyves graduated in 1995 and moved to The United States, where he enrolled in the Internal Medicine Residency Program of New York Medical College Metropolitan Hospital . Following his residency training, he worked as a hospitalist physician with Central Brooklyn Medical Group. During his residency training, Dr. Fenyves received the "Most Outstanding Senior Resident" award and the Dean's honor award for a scientific paper competition during his medical school years.

Dr. Fenyves has been practicing as a hospital physician for 7 years, taking care of acutely-ill hospitalized patients and notes that he has always enjoyed the challenge of the fast-paced, complex role of the inpatient physician. He was appointed to lead a hospitalist program for the Health Insurance Plan of New York and Cogent Healthcare, Inc. Here at The Brooklyn Hospital Center, he has demonstrated his leadership of the Utilization Review Committee and has been involved in many aspects of Inpatient Utilization at the hospital. In June of this year, he accepted the position to lead The Brooklyn Hospital Center's Clinical Resource Management Department where he is responsible for improving efficiency and reducing unnecessary delays in inpatient care. By reducing needless delays and hospitalization days, TBHC is able to provide better service for the very ill patients in need of acute hospital care.

A resident of Brooklyn , Dr. Fenyves is married and has four children with whom he enjoys horseback riding on a weekly basis. He also likes, among many others, the music of Tchaikovsky and Rachmaninoff in addition to Broadway musicals and the classic rock group Dire Straits. On a personal note, Dr. Fenyves says, " Brooklyn has always been close to my heart - I have lived in the neighborhood since my arrival in this country. Although I have worked in other hospitals, The Brooklyn Hospital Center has always been my primary hospital - it feels like home. I am happy to be celebrating my tenth anniversary as a resident of the United States working at The Brooklyn Hospital Center."

TBHC Tsunami Relief Fund

The hearts of our staff were touched by terrible tragedy and loss of tens of thousands of lives due to the tsunami in Asia. It spurred us to action. "How can we sit around enjoying life when so many are suffering?" was a question heard on the patient units, the cafeteria, and the hallways. "Let's take up a collection and in this way show our love and support for the victims of this disaster."

Immediately, without the delay of committees or red tape, the Administration gave the green light to place collection jars at the cash registers in the cafeteria. The cafeteria staff cooperated beautifully in this project. Over the course of several weeks the dollars, quarters, dimes and nickels added up to more than $1,000.

This money has been donated to charitable funds working with victims of the tsunami.

We were careful to select aid agencies whose administrative overhead was minimal and where we knew the majority of the money would go directly to the victims most in need.

Once again our staff showed their true colors.people of compassion, generosity and action. Let us continue to offer financial support and to pray for the victims of the tsunami.

TBHC Visits Grenada in Collaborative Leadership Effort

This past year, representatives from the country of Grenada and The Brooklyn Hospital Center (TBHC) met on two occasions. The first meeting with the Prime Minister, Dr. The Right Hon. Keith C. Mitchell, MP, included presenting the country of Grenada with an ambulance; the second meeting was to explore opportunities of working together. This meeting included the Minister of Health of Grenada, Senator Hon. Ann Davids-Antoine and staff, Dr. Carol McIntosh SLRHC, Carriacou Health Services, and several clinical and administrative Brooklyn Hospital Center representatives, including Paul Albertson, Sr. Vice President/Operations at TBHC; Jeovanni Rivas, Director of Biomedical Engineering (and a 2 year volunteer to Grenada); Deborah Wright, RN, ANP, Wound Care Specialist; and Sharon Hasfal, RN, ANP, also a critical care nurse from Lenox Hill Hospital. At the end of this meeting, Dr. McIntosh invited TBHC staff to Carriacou Health Services in Grenada to assist with best practices in health care. The TBHC staff happily accepted her invitation and embarked on their trip in July 2005, visiting the following locations: General Hospital of Grenada, St. George's University, the Minister of Health, and the Carriacou Health Services. Medical students from the University of St. George have long rotated through the TBHC and more recently, there has been discussion with Dr. Carol McIntosh about collaborating with the leadership of the Carriacou Health Service.

Explained Mr. Rivas, "I started working with the Grenada group as a volunteer two years ago.  I have been participating in medical visits in Grenada ever since. A group of doctors and a contractor decided to build an ambulatory care center ( Carriacou Charity   Health   Center ) for people with needs.  As a Comprehensive Equipment Management Corporation employee and Director of Biomed for The Brooklyn Hospital Center, I have been able to experience the needs first-hand of this Caribbean country during my visits.  For the last several years, we have been able to donate medical equipment that has been discarded by the hospital and, along with the assistance of our Biomed staff, we have restored them for utilization in Grenada . We wanted to help Grenada as much as possible, so we asked the country's Prime Minister and Minister of Health to visit The Brooklyn Hospital Center to appeal for further assistance. We then met with the Senior Management at The Brooklyn Hospital Center to request additional aid. With Mr. Albertson's assistance, we have been able to put together a request for Wound Care and a Diabetes Symposium that will take place during the last week of October and in the first week of November in Grenada."

In particular, the TBHC staff and the Grenada representatives discussed wound care management, an important issue that needed to be addressed. Dr. Mitchell stated 90% of the wounds he sees are from diabetics, and that by the time the patients come to the hospital, they are usually so advanced that they require debridement (surgical excision of dead, devitalized, or contaminated tissue and removal of foreign matter from a wound) or worse, amputation, and there are only limited prosthetics available. Through better education, self-management, and better monitoring in the community health centers, it is possible that the incidence of debridement could be significantly lessened. Ms. Wright's and Ms. Hasfal's discussions with the nursing staff on wound management reflected gaps in current practices in the country, versus what is considered appropriate wound care management in the United States. For example, staff use of undiluted hydrogen peroxide actually exacerbates the wound rather than healing it. Furthermore, there is no vascular surgeon available to perform bypass surgery in lieu of amputation, and no angiography equipment to evaluate vascularity.

Explained Debra Wright, RN, "Despite all of the disparities and the conditions they work in, the nurses are extremely professional and caring, and they were quite receptive to our suggestions. Both the nurses and nursing students are looking forward to the educational conference that we are about to put together for them - they expressed their excitement to us. They are also very short-staffed, but this does not see to deter their commitment to their profession."

Ms. Wright added, "Ms. Hasal and I worked with a group of nursing students where we had an opportunity to role play a scene to illustrate the proper way to discuss diabetes with patients, once they are diagnosed with the illness. The staff nurse told us that their patients are not compliant, and that they have a very difficult time dealing with them. For example, when they would announce to their patients that they were afflicted with diabetes, they would simply say, "Your pancreas is damaged". This would scare the patients to the point where they would actually refuse treatment. Instead, we tried to teach them alternate solutions, such as "Your body requires insulin to be utilized for energy. Right now, it's not making enough and that's why you are feeling tired. We can give you medications that you have to take daily to make you feel better, etc." In other words, we taught the nursing students proper communication skills - you need to bring it down to the patient's level with a humanistic approach. It's just as important to have the ability to communicate properly with your patients as it is to treat them."

In addition, Ms. Wright has prepared an educational flyer on diabetes and wound care symposium to further educate the nurses & nursing students. Since press time, she has attended a special Wound Care treatment conference in Chicago to learn state-of-the-art treatment procedures and manage chronic wounds, with an emphasis on prevention of amputations related to diabetic complications. In response to the lack of proper facilities and outdated treatment methods, TBHC introduced a proposal that would expand the symposium to include a concentration on diabetes management. This would include the development of a consensus for wound care management (clinical protocols) that is sanctioned as approved standards of care for Grenada , prior to the symposium.

TBHC Welcomes New Senior VP of Nursing

Mrs. Opal Sinclair-Chung has recently joined The Brooklyn Hospital Center (TBHC) as Senior Vice President, Chief Nursing Officer. A senior healthcare executive with over fifteen years of progressive experience in nursing operations and patient care management, Ms. Sinclair-Chung holds a Bachelor of Science in Nursing and a Masters in Healthcare Administration, with a Minor in Community Health from Long Island University. In addition, she has served as an Assistant Clinical Professor in the Masters of Science Executive Program for Nursing & Health Care Management at Long Island University. She also holds a certificate from the Sarah Cole Hirsch Institute for Best Nursing Practice Based on Evidence from the Case Western Reserve University.

Mrs. Sinclair-Chung has conducted numerous operational and organizational feasibility studies to evaluate nursing services throughout a hospital network, and has demonstrated success in recruiting and motivating staff, as well as in executing operational functions under budget and above standard.

In her last position as the Vice President of Patient Care Services at St. Mary's Hospital, Mrs. Sinclair-Chung planned, organized, implemented, controlled and coordinated all aspects of nursing and patient care activities, and participated in the development of strategic plans, goals and objectives for the 269-bed hospital.

Mrs. Sinclair-Chung is a member of the New York Organization of Nurse Executives; a member of the Brooklyn Nursing Partnership Group, and a member of the Advisory Board Nursing Executive Center. She has also served as a member of the Brooklyn Borough President's Nursing Capacity Team Taskforce. Mrs. Sinclair-Chung is listed as an honored member in the 2004-2005 Empire Who's Who Registry of Executives and Professionals, and is a recipient of Assemblyman William Boyland Jr.'s 2005 Community Service Award. She was a keynote speaker for the graduating class of Bronx Community College, class of 2000 - Alma Mater and the Catholic Medical Center School of Nursing, class of 2002. In addition, she was featured in the May edition of Advanced Nursing in an article entitled, "Nurse Executives Giving Back". Mrs. Sinclair-Chung is married to Derek Chung, M.D. and has two sons, Derek Jr. and Dustin.

When asked what her future goals and visions are for TBHC's Nursing Department, Mrs. Sinclair-Chung explained, "My desire is to deliver excellence in patient care. I want us to deliver the best nursing care possible to all patients who enter our institution. I want them to leave with the impression that TBHC is their premier institution of choice for healthcare." Mrs. Sinclair-Chung said that she wants the nursing staff to be proud of their professional practice and continuously strive to deliver quality in their practice and commitment to caring. Added Mrs. Sinclair-Chung, "We want to design a patient care delivery model that is patient-centered and patient-focused. In order to implement this design, we need to educate and provide the staff with the necessary tools to accomplish the established goals. The first tool will begin with proper customer service skills. Ultimately, this will position TBHC as a leader in healthcare moving into the future. By implementing a model that matches our strategic initiatives, I see The Brooklyn Hospital Center becoming the #1 hospital in Brooklyn."

Mrs. Sinclair-Chung also noted the attributes that drew her to TBHC, explaining, "The notable qualities of TBHC begin with Mr. Samuel Lehrfeld, the Board of Trustees, and his team of Senior leaders. The leaders impressed me with their broad vision of what needs to be accomplished to better serve the community and attain the hospital goals. I was also impressed with the level of commitment and dedication to the community expressed by the medical staff. Another factor that attracted me to TBHC is the fact that the hospital itself is well-positioned for the future of health care in Brooklyn. Its geographical location, its commitment towards excellence, and outreach for the betterment of the community are qualities that I value as Chief Nursing Officer. I hope to continue these trends in my department by focusing on the quality and excellence of our clinical care as well as TBHC's deep-rooted mission, vision, values, and our excellent service. I am very happy to be a part of such a great organization and team and am committed to making a difference."

TBHC installs new mattresses throughout Hospital

Recently, TBHC replaced all mattresses throughout the hospital. According to Debra Wright, RN, Skin Care (formerly Critical Care RN Educator), the majority of TBHC's population is comprised of senior citizens - Ms. Wright explained that the hospital receives nursing home patients from approximately 29 local nursing homes. These patients require long lengths of stay, and once they get to their floors, most require constant bed rest. One of the things that the nurses observed were pressure ulcers (more commonly known as bedsores) found on their elderly patients, due to decreased circulation on the sacrum & heels, which are the most common sites of ulceration.

In order to assess the needs of the patient population, a "Prevalence Of Incidence" study was conducted in October 2004. This study is a way of measuring the percentage of elderly patients who develop these ulcers during their stay in the hospital. The incidence rate looks at the number of patients that have acquired a pressure ulcer(s) in the hospital during a 5-day period. In other words, if a patient was admitted & developed an ulcer within certain time period, they would be part of this statistic.

Based on the study, the incidence rate was 9%, while the national average was only 6%. Ms. Wright explained that TBHC has a higher percentage than the average based on the Brooklyn community's large nursing home population, which then become patients at the hospital.

Explained Ms. Wright, "Our numbers were high - we needed to look at some of the reasons why, and to develop a plan or process to fix this problem - instead of being reactive , we were being proactive ." Next, Ms. Wright explained that they needed to look at the mattress surfaces that the patients were lying on: was there pressure relief or pressure reduction? The answer was neither. Ms. Wright posed yet another question: when did TBHC actually purchase these spring mattresses? Joe Caravaglio from Building Services looked and researched through the hospital's files, but was unable to find any answers. Ms. Goonan, V.P. Nursing, also researched the issue, but couldn't find any documentation. Ms. Wright came to the conclusion that in 1980, she remembers taking her clinicals as a Nursing Student, and TBHC was using the SAME MATTRESSES back then! That dates back to 25 years ago - definitely time for some new mattresses!

In addition to the fact that the mattresses were old and outdated, the nurses tried to compensate by using E-HOB overlay mattresses (or air mattresses) that were bottoming out - they were being placed on top of the mattresses in order to reduce the chance of patients developing ulcers.

With all of the research in place, the search was on to find appropriate mattresses for TBHC's patient population, particularly for the elderly nursing home patients. The final decision was to choose B & G mattresses on December 6 th , 2004 , based on different companies that were reviewed by the Patient Care Managers, Nursing Care Managers, Purchasing Department, and Skin Care Initiative Team. Mattresses were chosen that would provide both pressure relief and pressure reduction.

Two different styles of mattresses were chosen in order to accommodate the needs of the patient population and the procedures they will undergo. The first, a medical surgical mattress, is called the Maxi-Float. The Maxi-Float mattresses are blue in color, and feature the pressure-reduction attributes necessary for preventing pressure ulcers. Pressure Relief mattresses are in Critical Care Areas and are called Acu-Max. These green-colored mattresses are pressure-relief mattresses which provide additional, firmer support - usually these patients are in the unit for a longer stay, so firmer mattresses are required. The mattress is ergonomically sloped to prevent undue pressure on patient's heels.

Ms. Wright would like to thank everyone involved in the process of disposing of and installing the new mattresses, adding, "We worked very hard - this entailed an entire change of beds, including setting up and making the beds with fresh linens.it was a long & difficult process. I would also like to thank the Building Service people who brought the new mattresses up to all of the floors, unloading them, installing them, disposing of the old mattresses, and so on".

Mattresses that were salvageable were donated to a local charity, "Food for the Poor". The remaining mattresses are slated to go to a church in Haiti.

All in all, Ms. Wright noted that the patients of TBHC "were very comfortable and happy with our new mattresses".

TBHC's Nursing Home Liaison

The Angelic Voices of TBHC

We Lift Our Voices High unto the Lord! Vanurance Benjamin, MD, MPH, and President of the choir, founded the Angelic Voices in 1998 at Bronx Lebanon Hospital while a resident. As a child, growing up in Houston , Texas , a musical ministry had always been one of his desires. Coming from a very spiritual background, he explained that "he said a prayer, and it was answered". The choir began singing at hospital functions in 1998. The community opened up its arms, embraced his dream, and allowed the Angelic Voices to sing for them. Brother John Pierce joined the choir as Musical Director in 1999, and has been with the choir ever since.

In 2000, Dr. Benjamin finished his residency at Lebanon Center and joined us at TBHC. With the dream in hand, he organized the Angelic Voices of TBHC at the Caledonian campus. The choir was up and running - singing and ministering to the hospital patients, staff, and community. With the closure of the Caledonian campus, the Angelic Voices came to the Downtown campus and have been entertaining in the hospital for patients during holidays and at various outreach programs. Now with approximately 25 talented members, the choir performs for the Hospital Center during the year for various functions. In 2002 and 2003, we performed for 1,199 SEIU Graduation ceremonies. The choir sings as a committed, loving, and spiritual experience.

The choir looks forward to the upcoming concert being held on December 21, 2004 at 5:00PM in the Auditorium 3rd floor North Pavilion. The choir will be singing throughout the community for the holidays. In addition, we hope to continue serving our hospital and the community for many years to come.

Anyone interested in joining, call for more information: (718) 250-8104 Carole Reames-Rhoden, Secretary.

The Brooklyn Hospital Center Unveils Cutting Edge Imaging Technology

BROOKLYN — The Brooklyn Hospital Center unveils a new, state-of-the-art Computed Tomography (CT) imaging system, the GE LightSpeed 64 Slice VCT system. This cutting edge technology allows The Brooklyn Hospital Center's physicians to more quickly obtain the information they need to diagnose disease and life threatening illnesses, including cardiovascular disease, stroke and chest pain.

"This new scanner is just the latest investment by our hospital as we continue to provide the highest quality of health care, right here in Brooklyn," said Dr. Richard Becker, President and CEO of The Brooklyn Hospital Center. "We are matching top-notch care with cutting edge technology to increase the speed and accuracy of patient exams and are now able to offer new and enhanced diagnostic procedures, as well."

The purchase of the $1.4 million dollar scanner was made possible in part through a grant secured by Congresswoman Yvette Clarke. Congresswoman Clarke serves New York's 11th District, which includes Brooklyn. The Congresswoman helped secure a large portion of the funding for the purchase of the CT scanner when she was serving on the New York City Council.

The new technology will allow physicians to capture images of a beating heart in five seconds, an organ in one second and perform whole body trauma scanning in ten seconds, which is more than twice as fast as conventional multi-slice CT scanners. The speed is particularly beneficial for older patients, patients who are on ventilators and children.

"Our new CT system allows us to perform new and enhanced procedures and get the information we need to diagnose patients," said Dr. Douglas Kiviat, Chairman of The Department of Radiology "In the case of chest pain or stroke we know that time is a critical factor and this new tool is a major step forward for our physicians and patients. The faster scans will reduce patient stress and anxiety and some case we can now do multiple scanning procedures in one exam."

In a single rotation, the scan will create a 64 slice high-resolution image, which will produce a three-dimensional view of the patient's anatomy to be analyzed. These images will provide insight for physicians to view such things as blockages in the coronary arteries, in addition to the motion and pumping of the heart.

Established in 1845 as the borough's first hospital, The Brooklyn Hospital Center provides a variety of inpatient and outpatient services and education programs to improve the well being of its community. A member of the New York-Presbyterian Healthcare System and affiliated with Weill Medical College of Cornell University, the hospital and its primary and ambulatory care centers serve more than 500,000 people annually. To learn more, please visit www.tbh.org [44].

The Brooklyn Hospital Center Welcomes Dr. Richard Bruce Becker as President and CEO.

Jonathan Weld, Chairman of the Hospital Center’s Board of Trustees, states, “We are very pleased to have a hospital executive of Richard Becker’s stature take over the helm of our hospital. With his distinguished record of accomplishments and demonstrated leadership ability, Dr. Becker is well-suited to lead TBHC as it reaches its goal of becoming a model urban healthcare provider.” Dr. Becker is noted for his ability to strengthen relationships and build consensus between different groups both internally and with the external community.

Prior to joining TBHC on June 30, 2008, Dr. Becker served as Chief Executive Officer of The George Washington University Hospital in Washington, D.C. and as Dean of Clinical Affairs at The George Washington University Medical Center.

Dr. Becker received his B.A. from the University of Virginia in 1981 and his M.D. degree from the University of Virginia School of Medicine in 1985. He is Board Certified in both Anesthesiology and Critical Care Medicine and was Associate Professor of Anesthesiology and Critical Care Medicine at The George Washington School of Medicine. He also received his M.B.A. from The George Washington University School of Business and Public Management in 1998. Dr. Becker and his wife Rachel, a psychiatrist and a native New Yorker, have three young children.

The Cancer Resource Center's New Home

TBHC 's American Cancer Society's Resource Center Rededicated
August 8, 2003 was a damp and rainy day but that did not dampen the spirit of the crowd gathered in the upper lobby of The Brooklyn Hospital Center for the rededication of the American Cancer Society's Resource Center . Collaboration was the word of the day. It was wonderful to see the community, the Hospital and the American Cancer Society's efforts coming together on a project well needed in the community.

The center was the first in the New York City area sponsored by the American Cancer Society (ACS). The center is a place for cancer patients, their families and the general public to visit and obtain reliable information on all aspects of cancer (latest treatments, resources, early detection and prevention etc). A volunteer who is a cancer survivor and trained by both the American Cancer Society and The Brooklyn Hospital Center will assist visitors not only in navigating the internet for reliable sources but will also be there to allow the visitor to see that there is life after a diagnosis of cancer.

The Resource Center was the end product of a three-year investigation funded through a grant from the national office of the American Cancer Society. Carol Cintron, the Principal Investigator of the grant, formed a multidisciplinary committee including nurses, social workers, cancer survivors, and members of the staff of ACS. After several months, it was decided to hold focus groups in two areas of New York City , the Brooklyn Downtown Area and The Bronx. The object of the focus groups was to obtain an understanding of how newly diagnosed cancer patients and their families gathered information on all aspects of the disease. Many in the focus groups spoke about the problems of having to travel a long distance to use a computer, and then not have someone to help them navigate the Internet for reliable information on cancer. Based on this investigation, three resource centers were planned in New York State - one in Brooklyn , one in The Bronx and one in Binghamton , New York .

The re-dedication was a wonderful event; it clearly showed the way in which collaboration lead to the development of a needed program. The ribbon cutting ceremony took place at 10:30 a.m. with representatives from the community, the hospital and the American Cancer Society. The applause echoed through the lobby as Mr. Samuel Lehrfeld, CEO and President of the Brooklyn Hospital Center, Jonathan Weld, President of the Board of Trustees TBHC , Congressman Ed Town, Borough President Marty Markowitz, Helen McCarthy, RN OCN, MPA (former Director of Cancer Communications TBHC ) and Carol Cintron, RN, MSN (Director of Education and Information Patient and Family Services the American Cancer Society) cut the ribbon.

A reception and tour of the Center followed. Approximately 100 guests attended. It was a great day and no one noticed the rain.

The Caring Heart Award

This year's annual Caring Heart Award is presented to Audrey Sealey, a twenty-year plus veteran staff member who is presently engaged as the Trauma Coordinator, Department of Surgery. She is known for her compassion for patients, taking into account their physical, emotional and spiritual needs. She sees patients holistically, and works diligently at ministering to them. She treats patients as if they are members of her own family.

Here is what the six staff members (Juanita Jones, Denise Harris, Maria Giganti, Pedro Vega, Bella Kronfeld, and Diane Shelton) who nominated her have to say of this spirited woman: "Audrey D. Sealey, FNP, PhD has always exemplified herself as a compassionate and loving person. She is always available to assist in patient care and long-term heath care plans. She is a team player, and is on call whenever needed. She mentors students in the Nurse Practitioner Program in the Emergency Department, as well as her colleagues at TBHC. We feel Dr. Sealey should receive The Caring Heart Award 2005 because of her dedication to patient care in all aspects of her career. She is a healthcare person who loves her profession, and a mother who devotes herself to both her work and her family. Dr. Sealey demonstrates kindness, concern and caring at all times - it defines her personality."

The Caring Heart Award is presented annually after nominations have been received from staff members. All staff members are eligible who: (1) demonstrate respect for human beings as a whole, in the treatment of patients, their loved ones, and staff colleagues; (2) practice healthcare with an appreciation for the interrelated functioning of body, mind and spirit; (3) realize and model the importance of promoting teamwork among various disciplines; and (4) embody a substantial degree of wholeness in their own personal and professional lives, striving for a balance of physical, mental and spiritual well-being.

This year's nominees are pictured here, and they are: Manuel Alcantara, Isaint Alexander, Jennifer Aquino, Bertha Artis, Nereida Borrero, Angel Cartagena, Daphne Gabbidon, Bertina Hutchinson, Robert Krakowski, Patrick LeBlanc, Doris McCoy, Kathleen McManus , Monica Morris, Oscar Molina, Annie Peralta, Linda Phinezee, Patricia Phan, Maribel Sanchez, Diana St. Croix, Pat Shelton, Sieuchand Sinanan, Kenneth Soobrian, Georgia Williams, Deborah Wright, and our winner, Audrey Sealey - but they are all winners, aren't they?

Nominations are requested in July of each year. A sub-committee of the Pastoral Care Advisory Committee reviews the nominees, interviewing them, the persons who nominated them, their supervisors and peers. The sub-committee recommends the winner, with the selection left in the hands of the Pastoral Care Advisory Committee, and a final blessing from the Senior Administration of the hospital. The Caring Heart Award is presented annually at a special ceremony during Pastoral Care Week, the last week in October.

Congratulations, Audrey Sealey - you have won our hearts through your caring heart!

The Great American Smoke-Out

Thursday, November 19, 2004 is the Great American Smoke-Out, and this year the Cancer Commission Department would like to assist all of the staff of The Brooklyn Hospital Center in their quest to be part of the Smoke-Out. How are we going to help? Please check the list below:

• If you are a non-smoker and would like to 'adopt' a smoker for the day, we have the adoption papers ready for you. To adopt a smoker you must pledge to be there for the smoker all day. If they want to smoke, you have to talk them out of it. How do you do this? You can do it with words of encouragement, offering a piece of sugarless gum or candy, give them a hug, or take away their cigarettes. This is a very serious obligation; you are on call for 24 hours starting Midnight November 19 until Midnight November 20.
• If you are a smoker and going to go "cold turkey" for the day, Cancer Communications will have a table set up in the upper lobby with candy and assorted treats. There will also be literature on smoking plus some behavior modification ideas for you to use. CANCER COMMUNICATIONS Department is challenging all of The Brooklyn Hospital Center Staff to make November 19, 2004 a smoke-free day.

The Health Partners Mobile Health Clinic in Brooklyn

The Brooklyn Hospital Center welcomed Liz Holleran, BSN, RN, Community Health Nurse to the Community and Public Affairs Committee Meeting on May 9th, 2005. Ms. Holleran gave a presentation on behalf of the Brooklyn Community Health Partners Mobile Clinic in regards to community-based care. The Brooklyn Community Health Partners is a program funded through a federal grant obtained through New York University , and run by the Division of Nursing at The Steinhardt School of Education. Ms. Holleran's presentation focused on the many methods of reducing health inconsistencies in the underserved Brooklyn communities. These methods include providing access to comprehensive primary health care services, such as mobile health clinics, offering programs for health education, and providing research that will reduce health disparities for the community. The Mobile Clinic will be obtaining funding and support from its partners at New York University College of Nursing, explained Ms. Holleran. In addition, they will be receiving $200,000 worth of funding from The Starr Foundation. They will also receive $2.3 million dollars over the next 5 years from the Health Administration of the Department of Health and Human Services.

According to Ms. Holleran, "The scope of our services will include primary care services at school and community sites, health education programs, vision and hearing screening, and Community Outreach programs. We would like to devise a community-based care program as a healthcare 'delivery system' by implementing the mobile clinics". The Clinic would also offer other primary care services, including physical exams, immunizations, pregnancy and prevention, counseling, referrals for insurance coverage and for dental services, psychosocial counseling and referral for drug and alcohol abuse assessments. Ms. Holleran explained that this system would attend to unmet needs in the community, such as reducing or eliminating barriers to healthcare, supporting low-income families and single mothers, and reducing long-term health care costs, making affordable healthcare available to all areas and demographics of the population. "This would be achieved by the coordination and integration with traditional and hospital-based clinics", explained Ms. Holleran. She also noted that there are many advantages to a community-based model: "Through its close proximity to patient's homes and children's schools, it serves patients that may otherwise not seek medical care and its presence will foster trust. It's like bringing the child to the doctor's office, only the office is parked outside your house!"

Since February 2004, the Clinic has seen over 650 patients and has received approximately 2,000 visits, with an average of seven to eight patients per service day each month. If this trend continues, notes Ms. Holleran, there will be fewer walk-ins and more patients by appointment. In addition, the benefits of community-based care include decreased ER visits, the prevention of unnecessary hospital admissions, and the elimination of barriers (which normally delay care) that will improve school attendance as a result. Ms. Holleran added, "The Brooklyn Community Health Partners visions for the future include a larger client base, increased utilization of the clinic, greater satisfaction of its clients, improved health status of its clients, and growth of health education and school screening programs. We hope that by providing accessible care to all nationalities and demographics of our community, we will improve the quality of life for our residents. Our hopes as a clinic are not only to provide primary medical and dental care to our community, but also to educate the public. We also strive for a positive impact in regards to training our nursing students through the cultural diversity that this program will provide."

The Ideal Weight

Why Is It So Important? How Do We Calculate?

Health is one of the most important factors that affect the quality of our life from childhood to old age. Our hospital can treat various illnesses and conditions to improve your health. But it is an even more important task to prevent disease through the effort of your doctors and YOURSELF.

In this series of articles we will talk about many sides of health and how to improve, preserve this precious asset of ours.

There has been a flood of information in the news about the importance of weight. Many of us probably started to look at ourselves to see if the latest curse of modern civilization - obesity affects us or not.

But how do we know if we need to lose weight?

The simple answer would be to look in the mirror. But we have different bodies and different cultural backgrounds. So we see ourselves differently.

The best method nowadays to estimate whether we are overweight or obese is to use the Body Mass Index (or BMI). This index has been shown to accurately estimate whether our weight is all right or we need to shed a few pounds.

The BMI is calculated from the person's weight and height. Since the calculation is somewhat complicated in pounds and inches, I recommend the use of a chart or a calculator.

If you have access to the internet simply calculate your BMI and visit the Centers for Disease Control web site at http://www.cdc.gov/nccdphp/dnpa/bmi/calc-bmi.htm [98] .

For children, it is more complicated to calculate BMI since it has to be counted with age in addition to the height and weight. If you understand medical language, read the link below or bring this address to the attention of your pediatrician who can help you with the calculation: http://www.cdc.gov/nccdphp/dnpa/bmi/bmi-for-age.htm [99] .

Now that you calculated your BMI let us see what these numbers tell us:

Your weight is normal if your BMI is between 18.5 and 24.9. If your BMI is less than 18.5, you are underweight. If it is 25 and over, you probably need to lose weight (you are overweight) and if it is 30 or more you are considered obese. Keep in mind that BMI is a good measurement tool but not without limitations. A very muscular person, for example, a body builder, may have a BMI of 28 and not have any excess fat. But these calculations will be correct for most people. Check with your physician about your BMI.

Questions on overweight and obesity?
Email andras@fenyves.net [100] or make an appointment with our specialists at 718-250-8000

The PCAP & WIC Programs

PCAP or Prenatal Care Assistance Program is a comprehensive model of care which covers prenatal care from conception to 8 weeks postpartum. It is a low income program that enrolls pregnant women at no cost regardless of their immigration status into comprehensive prenatal care. The services include Obstetric and Gynecological care, health education, nutrition assessment, social services, case management, HIV testing and counseling.

The PCAP Program is administered jointly by the office of Medicaid management and the Bureau of Women's Health at NYSDOH. The PCAP Program at The Brooklyn Hospital Center just received approval from New York State Department of Health for the Caledonian Health Center and the Williamsburg Family Health Center to be participants in the program as of March 1, 2003 . We now have a total of five PCAP approved sites - the Downtown Campus, Manhattan Avenue Family Health Center , La Providencia Family Health Center and the two previously mentioned sites.

The PCAP Program reaches a minimum of four thousand eligible women yearly at the hospital. With the PCAP approval, we receive enhanced reimbursement rates for prenatal care which changes from $88.66 per visit to $303.80 for the initial visit, $155.87 for follow up visits and $131.19 for postpartum visits. The annual PCAP reimbursement is approximately Three Million dollars.

WIC is a supplemental food and nutrition program for eligible women, infants and children by providing checks to purchase nutritious foods on a monthly basis. It is a low income program and covers pregnant women, infants and children up to five years of age. It also covers postpartum women for up to six months after delivery and breast feeding women for up to 12 months post delivery.

The WIC Program is funded by a grant from the Federal Government and the New York State Department of Health. The Brooklyn Hospital Center received additional funding in 2003 to provide WIC services to 5,500 participants every month. Our annual funding increased from $460,000 to $814,000 for the next year. In addition, the NYSDOH has funded expansion of the WIC Program to two new sites - the Williamsburg Family Health Center and La Providencia Family Health Center.

In the past, The Brooklyn Hospital WIC Program issues checks worth four million plus dollars annually but with the expansion, we plan to issue checks over six million dollars in the coming year.

PCAP

    * covers prenatal care from conception to 8 weeks postpartum.
    * a low income program that enrolls pregnant women at no cost regardless of their immigration status into comprehensive prenatal care.
    * includes Obstetric and Gynecological care, health education, nutrition assessment, social services, case management, HIV testing and counseling

WIC

    * a supplemental food and nutrition program for women, infants and children
    * provides checks to purchase nutritious foods on a monthly basis.
    * covers pregnant women, infants and children up to 5 years of age
    * covers postpartum women for up to 6 months after delivery
    * also covers breast feeding women for up to 12 months post delivery.

TransCare Donates Ambulance to Grenada

Recently, Brooklyn-based TransCare Ambulance Corporation donated an ambulance to the country of Grenada to help the victims of Hurricane Ivan during a ceremony with Brooklyn Borough President Marty Markowitz . On March 4, 2005, TransCare Chief Executive Officer Matt Harrison, along with President and Chief Executive Officer of The Brooklyn Hospital Center Sam Lehrfeld, presented the ambulance keys to the Honorable Allen McGuire, Consul General of Grenada.

When Hurricane Ivan hit Grenada in September 2004, it caused ninety percent of the island's structures to sustain damage and over 60,000 people became immediately homeless. There are over 50,000 Grenadians living in Brooklyn, and by donating this ambulance, TransCare - along with The Brooklyn Hospital Center - will be helping thousands of people on the island receive medical assistance.

"TransCare is pleased to help the thousands of people in Grenada who don't have access to hospitals and will now be able to be reached," said Harrison . "We are in the business of saving lives, and when The Brooklyn Hospital Center asked if we could help, we knew that donating this ambulance would make a difference . We already have plans to donate three more ambulances to the islands this year hit by the Hurricane."

Lehrfeld commented, "It is the true spirit of humanitarianism in outreach efforts like providing help wherever it is needed that sets The Brooklyn Hospital Center apart. We are proud to partner with TransCare in providing this ambulance and because of our close ties not only with Grenada , but the Caribbean , we will look for more opportunities to lend whatever assistance they may require."

"We are thankful to TransCare and The Brooklyn Hospital Center for donating this ambulance. It will be of great use to the people of Grenada ," said McGuire. " Brooklyn Hospital has been forging strong ties with the emerging nations of the Caribbean region, and when Grenada was devastated by Hurricane Ivan last September the hospital immediately asked how it could help. They have come through for us."

TransCare Corporation is the largest private ambulance company in New York City , operating over 500 vehicles in the greater New York metropolitan area and the Mid-Atlantic region. In addition to its dominance in the New York area, TransCare also controls the operations of the largest ambulance service in Pittsburgh , and is one of the main providers in the Baltimore-Washington D.C. market. In 2004, TransCare transported over 660,000 patients on emergency and non-emergency runs.

TransCare provides hospitals and a wide range of related healthcare facilities in its service territories, with a complete array of emergency medical transportation services including routine transports, specialized services such as neo-natal and other high-risk transfers, corporate response and standby services, and the provision of 911 emergency response services for several municipalities.

Tribute to Anne Goonan

Tribute to Arthur Blutstein

This past year marked the retirement of a long-time employee and friend of The Brooklyn Hospital Center (TBHC). On July 1, 1967 , Arthur Blutstein began a career that spanned 38 years. He started his career at the Caledonian Hospital and moved to The Brooklyn Hospital after the merger of the two institutions in 1983. Mr. Blutstein married his wife, Judy, 26 years ago, presently the Perinatal Nurse Coordinator for Dr. Cabbad. They are the proud parents of three daughters, Tamara, Jessica and Melissa, all of whom were born at Caledonian or The Brooklyn Hospital.

As Arthur continued his career at TBHC, he completed his Masters in Health Care Administration from C.W. Post, Long Island University (1974). Mr. Blutstein retired as the Senior Vice President of Clinical Operations and Corporate Compliance Officer. When asked what highlight in his career he cherished the most, Mr. Blutstein explained that it was the honorary doctorate he received from the Chairmen of the Departments of the Medical Staff. He was also proud of the merger between The Brooklyn Hospital Center & Caledonian, as he feels it was one of the most effective mergers in the city of New York .
Overall, Mr. Blutstein truly enjoyed his work within The Brooklyn Hospital Center and The NewYork-Presbyterian Healthcare System. He will always warmly remember when fellow employees organized an engagement party for him and Judy in 1978, describing the family-like nature of TBHC's staff as the "heart and soul of the hospital." We will truly miss Arthur Blutstein and wish him many enjoyable years ahead.

Urology Staff Utilizing Latest Technology at TBHC By Rajveer Purohit, MD, MPH

History
Urological diseases are as old as human history. In fact, bladder stones have been found in mummies dating back to over 5,000 years. Kidney and bladder stones were common, but the side effects of surgery were as painful and deadly as the stones themselves. The risks of surgery were so high that Hippocrates, whom some consider the father of medicine, prohibited any treatment for kidney stones over 2,400 years ago. His oath, still taken by student doctors today, urges surgeons to "not use the knife, not even on sufferers from stones" and shy away from "such men as are engaged in this work." Fortunately, technology has progressed, and most urologists are not detested as back-alley stonecutters. During the Renaissance in Europe , surgeons traveled from city to city throughout Europe offering surgeries to remove stones. Although ancient Chinese physicians advised placing onion leaves in the urethra to help open the urinary channel for urination, by the 1700's, Benjamin Franklin had designed an early metal version of the urinary catheter in America to allow his brother and, possibly, himself to urinate. Technological advancement has been critical to the development of modern urology and increasing the comfort of patients.

Modern Times
The critical step into modern medicine in urology began with the creation of special instruments that allowed urologists to visualize the urinary tract. These instruments included lighting and sophisticated lenses to allow urologists to see inside the bladder, and later, the inside of the kidney. One of the next modern breakthroughs was the development of sound shock waves to break apart kidney stones. The technology developed after World War II, when scientists investigated why lung tissue in castaways were damaged from the explosion of water bombs. Over the ensuing decades, researchers were able to harness the power of these sound waves and use them to improve health. In the first machines, patients with kidney stones were submerged in a bathtub while shock waves were targeted at them. Sound waves travel harmlessly through the water and body tissues and focus their destructive energies on the stones. Newer machines are an important part of the urologist arsenal against kidney stones.

Recent developments
In the last few years, lasers have been increasingly used by urologists. Lasers harness energy from light and permit that energy to be directed towards a particular point. There are different types of lasers, and each has unique properties best suited for certain problems. One of the most commonly performed procedures using lasers is laser lithotripsy. In this technique, kidney stones are to be broken up using fine instruments that allow the urologist to get into the kidney and bladder, and pulverize the stones with the laser. Benign prostatic hyperplasia - a condition in which the prostate becomes very large and causes urinary problems in men - is often treated with lasers which allow surgeons to open a wider urinary channel through the prostate by vaporizing tissue. Lasers allow surgeons to decrease blood loss and permit patients to go home the same day as surgery with minimal discomfort. Lasers have also been used to treat skin lesions, strictures of the urethra, and certain types of cancers with minimal side effects and less pain for patients.

Laparoscopy and Robots
Over the last decade, the use of laparoscopy has exploded. Laparoscopy is a technique where a few small incisions are made in the abdomen (rather than one very large one) to allow small instruments, including a camera, to perform complex surgeries. The first purely laparoscopic nephrectomy (kidney removal), nephroureterectomy, and pyeloplasty (using complex laparoscopic suturing techniques) were performed at The Brooklyn Hospital Center during the past year. These techniques have allowed patients to recover much more quickly from their surgeries with less pain and fewer complications.

Recently, robots have increasingly begun to be used to perform urological surgeries. These robots are not quite the same as a human-like machine you may have seen in space movies. The robotic machine uses arms attached to laparoscopic instruments, and sits next to the patients during the operation. The surgeon still controls the robot's arms and instruments, but he can sit in another room and manipulate the robot to perform very detailed surgeries that would be difficult to do by standard laparoscopy alone. Because the lead surgeon does not need to be in the room at the time of surgery, it is not too difficult to imagine a future in which military surgeons in the United States may be able to operate on injured soldiers in distant countries. Another possibility being investigated by NASA is the use of robotic surgery on sick astronauts. Specialized surgeons on earth may be able to direct the movements of the robot to treat sick spacemen. Within the next ten years, the use of robotic surgery is likely to become much more widespread - in the future, you may not think twice about being operated on by a machine!

Prevention
Perhaps some of the most significant gains that will occur in the future will be in prevention and treatment. Researchers are working on vaccines against prostate cancer that would contain benign viruses, which stimulate our bodies' own immune systems against prostate cancer. A lot of recent research has focused on genetically analyzing prostate cancer. With new laboratory techniques using tools such as DNA microarrays, it is possible to analyze over 50,000 genes being expressed at a particular time in one patient. Unlocking the mystery of all these genes may help predict, for example, which patients will form deadly prostate cancers and which will not.

Technological developments have continued to characterize the field of urology and are extensively utilized by The Brooklyn Hospital Center Urology Staff. The future of urology will clearly be one driven by large technological advances, and ultimately, patients will increasingly benefit from these advances.

WIC Current Events and Programs for 2005

Click here to schedule an appointment with the WIC department

From February 2 - April 6, WIC conducted its Breastfeeding Peer Counselor Class. On August 12, the Pump Technology Class was attended by all WIC staff. Breastfeeding Peer Counselor Graduation was held on August 19, 2005 with 18 mothers who completed the class. In addition, WIC received two additional grants; the first was the Breastfeeding Peer Counseling Pilot Program. Through this grant, Peer Counselors are trained and then employed to help mothers with their breastfeeding issues. The Peer Counselors assist mothers from their prenatal stages through labor & delivery, as well as home visits, to ensure breastfeeding is successful. The second grant is the Breast Pump Program, which allows breastfeeding mothers in WIC to receive free breast pumps after delivery to help them with the initiation and duration of breastfeeding. Electric, hospital grade and manual pumps are all available through this grant.

In other recent events, the Allocations of Farmers Market Nutrition Program, which took place from June through September 2005, distributed coupons for fresh fruits & vegetables to WIC recipients. WIC recipients also completed a Customer Service Survey to further improve customer services. In addition, WIC staffs have participated in various health fairs as part of community outreach. Another notable program that has begun, called Fit WIC - Eat Well, Play Hard, was initiated to incorporate physical activity and nutritional counseling into the overall program.

In the past decade, Federal human service legislation has tended to rely less on dispersing general (Welfare) grants to individuals and families. In place of this, it has emphasized the need for programs that target specific population groups and their needs. Food Stamps, Medical, Medicaid, the School Lunch Program and WIC are all examples of this new trend.

The WIC Program is designed to meet the nutritional needs of low-income, pregnant, postpartum, and breastfeeding women, as well as children (one year to five years) and infants who are at nutritional risk or who suffer from medical conditions that predispose them to inadequate dietary intake.

WIC Sites at The Brooklyn Hospital Center:

    * Caledonian Health Center - (718) 940-5244
    * Downtown Campus - (718) 250-8126

What is a Trustee?

According to Webster's New Universal Unabridged Dictionary, a trustee is "any of a group or board of persons appointed to manage the affairs of a college, hospital, etc." Simple enough to understand, right? Well, perhaps the question should have been, "What is a Trustee of The Brooklyn Hospital Center?" There is no concise way to describe what our Trustees do for us and our Hospital. Our Trustees do meet the definition outlined above in the sense that they are appointed to manage the affairs of our Hospital, but what exactly does that mean?

To begin with, our Trustees are volunteers, meaning they are not compensated for the work they perform on our behalf. And work they do: Each of our Trustees spends many hours each month either here at the Hospital, on telephone conferences, or at other venues representing the interests of the Hospital. This is time away from their personal life or professional responsibilities. The Board of Trustees of TBHC is comprised of a minimum of 18, to a maximum of 30 Trustees at any given time, as defined in the Corporate Bylaws. Presently, we have 23 Trustees.

The Board of Trustees of our Hospital is as culturally and professionally diverse as the communities we serve. They bring expertise in the areas of healthcare, business and finance, law, and community outreach. By and large, they live in the communities served by the Hospital. They come to the Board by way of a recommendation made to the Chairman of the Board, who meets with them to explain the responsibilities of being a Trustee. The Governance Committee of the Board then makes its recommendation to the Board.

Trustees are expected to attend meetings of the Board, as well as subcommittee meetings, be political advocates, represent the Hospital in the community, and even offer their personal financial support to the Hospital. They also participate in the planning and attendance of special events run by the Hospital. Knowing up-front what is expected of them, the 23 men and women currently serving on our Board of Trustees, those who came before them, and those who will serve in the future, dedicate themselves to accepting responsibility for the operation, safety, security, and preservation of The Brooklyn Hospital Center, its patients and its staff. They truly are our unsung heroes, and we owe them a deep sense of gratitude for all that they do for each of us.