Beyond the Hands-On Approach: Health Information Management

In honor of Health Information Management Week, we sat down with Linda McKone, manager of Health Information Management Operations at Connecticut Children’s to discuss what happens behind-the scenes to keep patient information safe and secure.

Young Boy Accountant Wearing Glasses at Office Desk

Patient care is typically thought of as the hands-on process of treating and healing. Linda McKone, Operations Manager of Health Information Management (HIM) here at Connecticut Children’s, would suggest that patient care goes beyond the hands-on approach.

HIM’s primary function is to collect patient information for Connecticut Children’s, and keep that information accurate, safe, and up to date when a patient and their family need it. McKone firmly holds that while “we are not hands-on patient care, everything we do impacts patient care.” Whether the task is scanning and indexing patient records, or confirming that releases are going to those entitled to patient information, the work of managing a patient’s health information contributes to the continuity of patient care.

The work of keeping health information safe and accurate, however, can be complicated. For instance, in this modern era, HIM must work with multiple record formats as well as with the information being stored in various locations. Previously, being timely with patient information was as simple as making a photocopy of the paper record and sending it out the door. Today, there is the time consuming process of scanning paper documents and uploading them to online databases, as well as maintaining microfiche files. To add to the process, HIM has to gather health information from Connecticut Children’s locations around the state.

Although HIM faces its challenges, new technology has helped create an overall positive impact on the patient’s care and experience. For example, this new technology allows us to offer tools like MyChart and CareEverywhere, which provide access to some parts of a patient’s medical record to families and outside providers, respectively.

McKone has full confidence in her team in HIM. Despite all the demands on their time and the varying workflow, Linda and her Assistant Manager Steven Ross proudly hold that “the staff members have stepped up and people are doing things that aren’t normally expected of them.” The staff’s “what can we do to help” attitude allows HIM to reach and successfully exceed goals; such as scanning over one million pages of patient information into our online database from January 2016 to November 2016.

Regardless of the challenge that may surface, the staff in Health Information Management has sustained outstanding patient care by keeping patients’ health information accurate and secure.

 

Daylight Savings Time: Ways to Prepare

Connecticut Children’s  “Bedtime Doctor” Lynelle Schneeberg, PsyD, joins our blog to share some valuable techniques that can help prepare you and your family for Daylight Savings on March 12.

cute little girl on morning

There are two ways to prepare for Daylight Savings Time. Adjust gradually during the week before the change: If your child goes to bed at 8pm, put him or her to bed at 7:45, 7:30, and so on until you have made up the hour. Adjust naps, too. OR you can…

Adjust on the actual weekend of the change: On Saturday night, adjust the clocks in your home after your children go to bed.  On Sunday morning, get your children up at the time they’ll need to rise on Monday morning.  On Sunday,  you will also want to expose them to sunlight at the “new” rise time for at least 30-60 minutes (play/walk outdoors) and have breakfast at the new time, too.

~ All day Sunday, do everything at the new time (meals, naps, bedtime routine) and put them to bed “on time” (an hour early but read longer perhaps).

~ Using your typical bedtime routine will help to cue sleep.

~ Try to help your children go into the change well rested.

~ Be patient if your children are short-tempered during the first week of the change.

~ It should take your children about a week to adjust.

In addition, it always helps to get up at about the same time each day, every day.  The weekend rise time should not be more than an hour or so later than the weekday arise time.  This helps to keep the “body clock” set properly.  Sleeping in later on the weekends makes it much harder to go to sleep on a Sunday night, for example, because there has not been enough “wake time” to let the body know that it’s time for sleep again at the desired bedtime.  Consistent wake times also help decrease irritability at rise time work and school days.

In the morning, try sunlight exposure to help with awakening at the desired time.  The bed can be situated near a window with open drapes.  If outdoor sunlight exposure can be obtained, this is even more ideal.  Perhaps breakfast can be eaten outdoors or while waiting for the bus for a school-age child or teen or perhaps some time can be spent outside after arriving at work or school during a break.  Sunlight exposure signals the brain to “wake up” fully and sets the clock for the same rise time the next day.

Some light physical activity (walking the dog or walking to the bus stop) and a breakfast with protein (a protein shake or an egg, for example) are also helpful.  On the weekends, schedule an enjoyable activity to take place at the desired wake up time so it is not so difficult to get up.

Some teens and adults may also benefit from a small dose of caffeine (perhaps a cup of strong tea or coffee) in the morning but generally, large amounts of caffeine should be avoided.  Use the word CALF to remember how to set the clock: Caffeine, Activity, Light (sunlight) exposure and Food.

Connecticut Children’s Sleep Center specializes in diagnosing disorders that disturb children’s sleep. To learn more about our center, please visit http://www.connecticutchildrens.org/our-care/sleep-center/

Steven’s Incredible Journey Begins with 140-Day NICU Stay

steven-lefevre-nicu-photoMegan Lefevre’s first pregnancy was a difficult one. She threw up about three times a day and lost 12 pounds in the process. But the difficulties she endured during her pregnancy did not prepare her or her husband, Paul, for the challenges that lay ahead when their son, Steven, was born prematurely at 27 weeks on Oct. 24, 2012 –three months early.

“I woke up with terrible back pain and my stomach was as hard as a rock,” the Woodbury resident recalled. Following a 12-hour stay in a local hospital, Megan was transferred to UConn Health at John Dempsey Hospital for the next four days. While there, she gave birth to Steven, who weighed 2 pounds, 15 ounces, and measured 15½ inches long. But after 28 hours in Connecticut Children’s Neonatal Intensive Care Unit (NICU) in Farmington, Steven was rushed to Connecticut Children’s Medical Center NICU in Hartford, where he underwent emergency surgery to fix a perforation in his small intestine.

It was the first of several surgeries, dozens of procedures and “countless scares” for Steven’s parents. Steven remained in Connecticut Children’s Level 4 NICU for the next 140 days and returned several times to the Medical Center for follow-up treatment and hospitalization.

Big Scares
“Our first big scare was driving from Farmington to Hartford,” said Megan, who teaches first grade in Oakville. “We worried whether our baby would live.” “At one week old, Steven had a grade 2 brain bleed and increased fluid,” Megan said. “The following week, he had a grade 3 brain bleed with increased fluid. The blood vessels in premature babies’ brains are very fragile and can burst easily,” she explained.

lefevremomchild4x6Their second big scare came when Steven needed surgery for hydrocephalus, a condition in which fluid accumulates in the brain after brain bleeds. Initially, a reservoir was placed from which the neurosurgeons could draw off the extra fluid as needed. After his brain bleeds, Steven had pauses in his breathing because of the increased pressure in his brain from his hydrocephalus.

“His heart rate would drop and his blood oxygen level would drop,” Paul said. “Sometimes he would turn gray, other times he would turn blue and need oxygen resuscitation.” After undergoing shunt surgery to permanently drain the extra fluid, Steven was remarkably better, his father said.

Overcoming the Obstacles
From pneumonia and chronic lung disease to an enlarged liver and urinary tract infections, Steven fought many battles in his first few days, weeks and years of life. From weekly eye exams for grade 3 retinopathy of prematurity that can lead to blindness – to surgery for a tethered spinal cord – he also underwent numerous procedures and has been followed by many specialists along the way, including Marilyn Sanders, MD, a Connecticut Children’s neonatologist, who cared for Steven during his NICU hospitalizations. “He had many problems typically seen in very preterm babies and some unusual ones, including surgical and growth concerns,” said Dr. Sanders, who continues to follow him in Connecticut’s Children’s Neurodevelopmental Follow-up Program. “Given how sick he was in the NICU, he has done amazingly well.”

“Steven came home from the hospital in March of 2013,” his mother said. “He began rolling around at 10 months, sitting at 12 months, crawling at 18 months and walking at 2 years of age.”

In October 2015, at age 3, he started preschool. “He can walk, he can talk. He’s an easygoing child, who is very likeable and very social,” Megan said.

steven-lefevre-family-photo-fall-2016Grateful for Care
Steven’s family – which includes half-brother Matthew, 17, and sister Shayla, who turned 1 in March – is happy about his progress.

“We are so grateful for how well he is doing because of the amazing help he received,” said Megan, who keeps in touch with many of Steven’s caregivers at Connecticut Children’s. “He had the best care possible.”

So much more than a toy…

By Rachel K., a grateful mom

15873173_709235219258211_5247297050631256053_nIf you have ever wondered what happens to all of the generous donations made to your local children’s hospital, this is a great example.

My daughter is 10 years old, born with multiple disabilities and autism. We spend a lot of time getting care from over 20 different medical specialists at Connecticut Children’s Medical Center. She usually gets to pick out a sticker (sometimes two if she worked hard) after all appointments at the hospital.

Some days the promise of a sticker is the only way she can hold her stuff together. On days like today, when an early morning, 20-minute routine hearing test turned into an additional 40 minutes, to include injecting molding putty into her ears after being told she now needed hearing aids – well, let me tell you just how much it means to a mom with a limited budget when the staff says, “You need to pick out a TOY for working so hard today!”

It is an incredible gift that goes way beyond just getting us out of Day Surgery or an appointment in one piece. It gives my daughter the opportunity to not focus on the many challenges she faces. She looked forward to putting this together all day.

So thanks to all those who think of our medically complex kiddos when giving. We really, truly love you.

How Dancing Makes A Difference: Crystal’s Story

By Eliza Kanner, HuskyTHON

crystal-1_huskythonOn February 18 more than 2,500 HuskyTHON participants will dance all through the night. They will spend 18 hours on their feet, dancing to raise funds for Connecticut Children’s Medical Center. When I spoke to Crystal Torraco on a Sunday afternoon, she was enjoying a day off after spending the previous night on her feet, but rather than spending it at the student recreation center at the University of Connecticut, she was making her rounds as a Registered Nurse in the Neonatal Intensive Care Unit at Connecticut Children’s.

Crystal spent her college days heavily involved with organizations at UConn that pride themselves in community service and philanthropic efforts. She was a counselor at Hole in the Wall Gang Camp in Ashford, Connecticut, and held numerous leadership positions within HuskyTHON. Dancers are asked to find their “why,” and Crystal’s “why” has changed since working at Connecticut Children’s. “I danced for my future patients and now, I donate to those who dance for the patients I take care of each and every day,” Crystal said.

Working at Connecticut Children’s was Crystal’s first choice when applying to jobs after graduating from Northeastern University’s Accelerated Bachelor of Science in Nursing (ABSN) program. “(Being involved with) HuskyTHON allowed me to go into the hospital and really see the impact it was making. So when it came down to applying for jobs, I knew I wanted to work in a children’s hospital…the first thing that came to mind was Connecticut Children’s.”

The Neonatal Intensive Care Unit strives to have continuity of care, so Crystal is with the same patient family for an extended period of time. “We take the extra time to explain things to parents and to get them involved. We value it so much” Crystal explained.

Crystal feels the impact of HuskyTHON every day at work. “Huge fundraisers like HuskyTHON that go toward the hospital allows us to go beyond the normal supplies we need, it allows us to get newer technology, newer products. It helps us continually advance.”

crystal-huskython_dancersBabies born premature (prior to 32 weeks) or weighing 1500 grams (around 2.2 lbs.), are immediately placed in a giraffe warmer. This lifesaving incubator and radiant warmer auto regulates the temperature to provide a healing environment for the baby. HuskyTHON’s goal is to utilize the money raised on “100K in One Day” to purchase four giraffe warmers for the Neonatal Intensive Care Unit.

“Even one giraffe makes all the difference in a baby’s life, and the care we can provide,” Crystal said. “That’s their safe place–it’s what is keeping them warm and happy and lets us do our job safely and effectively.”

“It makes a huge difference. If we didn’t have the resources and the technology that allows us to do our job every day, it would be really hard,” Crystal said when asked about the impact HuskyTHON has for Connecticut Children’s.

“It’s hard to really see the impact you’re making when dancing, but to see it day by day in my job–and be able to do my job because of the impact HuskyTHON has–it’s huge. It’s really awesome.”

Extraordinary Outcomes for an Extraordinary Little Girl: Isabella’s Story

isabella-1Isabella O’Connell was just 3 months old when her pediatrician noticed ‘cafe au lait’ spots suddenly appearing on her skin. “The spots were appearing at such a rapid pace” said Isabella’s mother, Melissa Kulak. “Thankfully, he referred us to a neurologist at Connecticut Children’s Medical Center.”

Shortly after being referred, Isabella had her first appointment at Connecticut Children’s Division of Neurology, where she met Dr. Francis DiMario. Dr. DiMario would finally provide the answers Melissa had been waiting for…a diagnosis no one could have expected.

Isabella had Neurofibromatosis, a rare neurological condition which occurs in approximately 1 in 4,000 births each year. The genetic disorder can cause tumors to grow on nerve tissues and even on or underneath the skin.

Following her diagnosis, Isabella experienced very little symptoms as a result of her treatments, but in early  2016 that would all change. The 3-year-old began feeling a pain on her side where she currently had a band of tiny spots.  At her 6 month checkup, Dr. DiMario suggested an MRI that would reveal 2 tumors growing on Isabella’s right and left optic nerve.

“From that moment on, we also began seeing Dr. Eileen Gillan of the Center for Cancer and Blood Disorders. Dr. Gillan has been keeping a close eye on Isabella’s condition ever since” said Melissa.

Three months after that first MRI, a follow up would discover a new tumor growing at the base of Isabella’s head – a tumor that was causing her severe hydrocephalus. It was more devastating news that Melissa did not want nor expect to hear.

isabella-2“That 3 month MRI came and our world got flipped upside down. Within a week we had seen Dr. Marcus Bookland of Neurosurgery, scheduled a surgery date, underwent a biopsy and had a shunt placed.”

The procedure was a successful one and Melissa is happy to report that Isabella’s tumors are in fact shrinking as a result of her treatments and medication. She is currently on her third round of targeted chemotherapy. “So far it is working amazingly. We had our 6 month MRI to make sure Isabella’s shunt is working properly and found that her tumors have shrunk quite a bit. She also no longer has any trace of hydrocephalus.”

“In one word I would describe our experience so far as extraordinary. Although, Connecticut Children’s definitely deserves more than one word.”

A Part of Our Family

The Howard family shares a message of thanks to Connecticut Children’s Center for Cancer and Blood Disorders following their son’s last chemo.  

gage-photo-for-blogOur son Gage recently finished his last chemo on September 18th. We would like to thank all of the wonderful staff at Connecticut Children’s Medical Center!

Our world was turned upside down in July of 2013 when we learned that our son Gage had Leukemia.  From the very beginning the nurses on the 8th floor were amazing!  Dr. Andrea Orsey is truly an amazing physician and we cannot thank her enough for what she has done for Gage and our family!

His nurse Barb is hands down the best nurse around!  Gage loves her (as do we)!  I am pretty sure Barb can read minds because no matter what she always knew what to do to make Gage feel better!

These last three years have had its ups and downs.  We are so very happy to say that Gage has finally finished his chemotherapy.  It makes our hearts happy to see him just get to be a kid.  We could not have done it without you Dr. Orsey and Barb!!  You will forever be a part of our family!

Lots of Love XOXO,
The Howard Family