South Florida Hospital News
Friday February 23, 2018

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February 2018 - Volume 14 - Issue 8




K. Alex Daneshmand, D.O., MBA, has been promoted to Lee Health’s Vice President for Quality and Safety.

Prior to this promotion, Dr. Daneshmand served as the Acute Care Medical Officer for Golisano Children’s Hospital. Dr. Daneshmand joined Golisano Children’s Hospital in 2007 as a physician in the pediatric intensive care unit. During his tenure with the hospital, he also served as founder and medical director of the pediatric procedural sedation center, on the oversight system medical staff quality services committee and as chairman of the pediatric medical staff quality committee. Dr. Daneshmand assumed the role of medical director of quality and safety at Golisano Children’s Hospital in August 2015.
Prior to joining Golisano Children’s Hospital, Dr. Daneshmand served as director of pediatric intensive care quality utilization, co-medical director of the pediatric intensive care unit and pediatric intensive care assistant professor at UF Health at Shands Children’s Hospital in Gainesville.

Larry Antonucci, M.D., MBA, Lee Health’s President and CEO, was elected and installed to the Safety Net Hospital Alliance of Florida’s (SNHAF) Board of Directors.  The SNHAF advocates on behalf of Florida’s 14 safety net hospital systems.

Dr. Antonucci has nearly 35 years of leadership experience - both as a practicing obstetrician/ gynecologist (OB/GYN) and as a health care executive.
In 2007, Dr. Antonucci joined Lee Health as Chief Administrative Officer for Cape Coral Hospital. By 2009, he was appointed Chief Operating Officer of Hospital Services for the health system and assumed the responsibility for Physician Services in early 2010. In October 2011, Dr. Antonucci was named Chief Operating Officer for the health system, and assumed the role of President and Chief Executive Officer in June 2017.

Hospital for Special Surgery (HSS), Tenet Healthcare Corporation (“Tenet”) (NYSE:THC) and United Surgical Partners International (USPI), a Tenet subsidiary, announced that they have entered into a definitive agreement for a joint partnership to create an orthopedic care center in West Palm Beach, FL.

Located in a new building to be constructed in West Palm Beach adjacent to Tenet’s Good Samaritan Hospital, the new center will offer outpatient orthopedic care including diagnostics services, ambulatory surgery, rehabilitation, and sports performance programs. The facility will be staffed by HSS physicians, some of whom also will continue to serve at the HSS main campus in New York City.
“Many Florida residents travel to HSS in New York for the highest quality musculoskeletal care,” said Louis A. Shapiro, president and CEO of HSS. “We are delighted to be making that same top quality care more convenient to communities in South Florida where quality of life is so highly prized."

Palmetto General Hospital proudly honors Dr. Janet Kowalsky, pediatric hospitalist, as the hospital’s Physician of the Month for January 2018. Dr. Kowalsky was nominated because her colleagues describe her as highly engaged and is beloved by both staff and patients. Dr. Kowalsky was presented with a plaque in recognition of her outstanding service, commitment and dedication to caring for others.




Holy Cross Hospital in Fort Lauderdale is the first facility in South Florida to have partnered with the medical technology company HeartFlow in Redwood City, CA to offer patients fractional flow reserve computed tomography (FFR-CT) of the heart.

Cardiac CT is a non-invasive test acquired with very little radiation in less than ten seconds in this state-of-the-art 256 slice CT scanner that generates thousands of 3-D images of the heart. FFR-CT is an FDA- approved technology allowing doctors to determine whether blockage areas in the coronary arteries are depriving the heart of blood flow that can lead to a heart attack and/or sudden death. FFR-CT analysis is performed by utilizing the patient’s cardiac CT scan when artery blockage is identified in a cardiac CT scan. Additional testing on the patient is not required.

"Cardiac CT is a great study for seeing the anatomy of the heart including the coronary arteries," said Claudio Smuclovisky, M.D., director of Holy Cross Hospital’s Radiology Cardiovascular Imaging. "The study is 99 percent accurate in excluding significant coronary artery disease. In patients who do have potentially significant coronary artery disease, the piece of the puzzle that was missing was not knowing whether there was functionally decreased blood flow to the heart muscle that could lead to a heart attack. FFR-CT is an exciting new capability that is able to, in most cases, demonstrate whether the blockage in the arteries is seriously affecting blood flow to the heart muscle.”
The results of FFR-CT also help direct the cardiologist to the area of blockage during invasive coronary angiography. There are more than 125 published scientific papers supporting FFR-CT. Recent publications demonstrate that the combination of cardiac CT plus FFR-CT was better than other non-invasive tests and avoided unnecessary invasive coronary angiography in 61 percent of the patients. The Centers for Medicare and Medicaid Services (CMS) has recently approved payment for FFR-CT.

With a focus on innovation and research to provide the best evidence-based medicine available, cardiologists at the Jim Moran Heart & Vascular Center at Holy Cross Hospital in Fort Lauderdale are now performing the WATCHMAN procedure, which provides an alternative to oral blood-thinners for the treatment of atrial fibrillation.

The first WATCHMAN procedures were performed at Holy Cross by Rishi Anand, M.D, FACC, FHRS, and Daniel Weitz, M.D, FHRS. “Both cases were successful, and both of the patients were discharged the following day,” said Dr. Anand. “This procedure aligns with our mission of providing the most leading-edge technology to give patients the options they deserve.”
The WATCHMAN procedure involves a one-time implant which provides protection from stroke that is comparable to warfarin (the most common blood thinner) without the risk of bleeding.
“WATCHMAN is the only device of its kind approved by the U.S. Food and Drug Administration for reducing the risk of stroke in people with atrial fibrillation not caused by a heart valve problem,” said Dr. Weitz. “At the Jim Moran Heart & Vascular Center we are at the forefront of cardiac care, advanced treatments and clinical trials.”

Mount Sinai Health System in New York announces the opening of a new state-of-the-art medical practice in Palm Beach bringing world-class, innovative care to patients and businesses in the region. Mount Sinai Doctors Palm Beach, centrally located on North Flagler Drive in West Palm Beach, will offer primary care, cardiology, gastroenterology, and ophthalmology services.

Mount Sinai Doctors Palm Beach represents Mount Sinai’s longtime commitment to the region and its residents, and is the newest addition to a growing network outside New York State, which also includes Mount Sinai Heart New York Palm Beach. A dynamic partnership with Jupiter Medical Center, launched in 2015, has resulted in greater access to high-quality care for patients, including research and education initiatives in cardiology, oncology, and digestive health, and access to groundbreaking research and protocols developed by the faculty of the Icahn School of Medicine at Mount Sinai.
The compassionate and highly trained physician staff will be led by prominent cardiovascular specialist Gonzalo Loveday, MD, FACC, who will be the practice’s medical director. The practice will also include primary care provided by Ruben Reider, MD, and Yael Vidal, MD; highly specialized cardiovascular care provided by Gabriel Breuer, MD, FACC, Chauncey W. Crandall IV, MD, FACC, Steven A. Malosky, MD, Utpal N. Sagar, MD, FACC, and Dr. Loveday; nationally recognized gastroenterology care by Chester Maxson, MD, FACG, Louis Rosainz, MD, FACG, and Bernard Stein, MD, FACG; and innovative ophthalmology care by David A. Goldman, MD.
Mount Sinai Doctors Palm Beach will provide seamless coordination of care, including same-day and next-day appointments, as well as 24-hour on-call access to specialists. The practice prides itself on individualized patient care.

Cleveland Clinic and Martin Health System announced an affiliation agreement to share best practices in cardiology and heart surgery, optimize superior patient-centered care, and develop programs to improve quality, safety and outcomes.

The cardiac programs at Cleveland Clinic's Sydell and Arnold Miller Family Heart & Vascular Institute and the Frances Langford Heart Center at Martin Health will form this affiliation. Through these relationships, Cleveland Clinic provides management services, including clinical direction, quality assurance, and access to the latest in cutting-edge technologies and techniques.
For more than a decade, the Miller Family Heart & Vascular Institute has formed affiliations with cardiothoracic surgery and cardiovascular medicine programs in Ohio and across the country, providing access to world-class care and the unparalleled expertise of Cleveland Clinic’s heart program. The affiliate network now extends to more than 20 hospitals and health systems across the U.S.

For families faced with the difficult decision of placing a loved one in a nursing home, a government rating system is often the only source of information to determine which facilities are the best. However, a new study of nursing homes in California, the nation’s largest system, by faculty at Florida Atlantic University and the University of Connecticut, found that some nursing homes inflate their self-assessment reporting to improve their score in the Five-Star Quality Rating System employed by Medicare to help consumers.

“We were able to empirically demonstrate that inflation does exist in the current system,” said Xu Han, assistant professor in the Department of Information Technology & Operations Management within FAU’s College of Business, who co-authored the study with Niam Yaraghi and Ram Gopal from UConn’s School of Business. “So many nursing homes have a five-star rating; they look like they’re luxury hotels, but it’s difficult to see through that and determine what kind of service they’re actually providing. In reality, many of them are not really providing five-star services.”
The five-star rating system that Medicare uses to compare nursing homes is made up of three components: employing a base score from an objective, on-site inspection, along with two scores from information on staffing and quality reported by the facility. Patients, physicians and payers rely heavily on these overall ratings, which have climbed higher as self-reported scores have trended upward.
The study, recently published in the journal, Production and Operations Management, investigates whether these rating improvements reflect actual quality gains or unjustified ratings inflation. Among the study’s findings:
- Nursing homes that have more to gain financially from higher ratings are more likely to improve their overall rating through self-reporting.
- Little direct correlation exists between self-reported measures and on-site inspection results, either contemporaneously or over time.
- The number of resident complaints is similar for nursing homes with the same inspection rating but varies noticeably between facilities with the same overall rating, which suggests inflation in self-reported measures.
- At least 6 percent of the nursing homes inflate their self-reported measures, which include quality measures on patient health, as well as staffing numbers.
The study provides systematic evidence that some nursing homes are inflating the self-reported measures in Medicare’s star rating system. By showing that there is a manageable number of facilities that are likely inflators and identifying key predictors of being an inflator, the researchers said the findings can help Medicare focus its future audits more strategically and improve its inspection process and ratings system.    

 There is new hope for South Florida residents who suffer from atrial fibrillation (AFib), the most common type of heart arrhythmia. Cardiac electrophysiologist, Dr. David Weisman will offer a new, FDA-approved, laser balloon treatment option known as the HeartLight® Endoscopic Ablation System by Cardiofocus®. Dr. Weisman is the first and only cardiac electrophysiologist in the state of Florida using the HeartLight® Endoscopic Ablation System to treat heart arrhythmias associated with AFib. This minimally invasive treatment option is used for AFib patients whose heart arrhythmias cannot be controlled with medication. The outpatient procedure typically takes less than three hours and in most cases patients can go home from the hospital the very next day.

Dr. Weisman maneuvers the HeartLight System electrophysiology equipment into the heart via a minimally invasive groin incision, to deliver precise and controlled laser energy to diseased areas of the heart. He said that the HeartLight System is the latest technology on the market for the treatment of AFib. The unique benefit of this ablation system, versus other options on the market, is the availability of the visually guided laser balloon technology to control laser treatment consistently during pulmonary vein isolation (PVI) for AFib treatment.
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