Women’s and Children’s

For more than 30 years, we have been a leading provider of outsourced women's and children's services, specializing in acute inpatient care and treatment of infants and children. We continue to expand our services into pediatric intensive care, pediatric hospitalist programs and pediatric emergency medicine.

Through our demonstrated commitment to clinical excellence, we are also motivated to be an integral part of your community. We develop collaborative working relationships with community obstetricians, pediatricians, hospital nursing staffs and administration.

PremiEHR™, our proprietary EMR, captures medical information relevant to care provided in the NICU, nursery and delivery room. We also offer a turnkey, universal newborn hearing screening program called Healthy Hearing™.

Led by our dedicated on-site medical director, our locally based teams are comprised of full-time, board-certified or board-eligible physicians and ARNPs. Learn more about our women's and children's services management.

Read our posts related to women's and children's:

24 January2017

Strategies to Provide Neuroprotection for Preterm Infants

Neuroprotection for preterm infants can be one of the most important aspects of care provided to preterm neonates, yet it is sometimes overlooked because the providers are focused on other health issues. It is also essential that neuroprotection for preterm infants be done correctly to avoid causing lifelong struggles for both the babies and their families. A recent article in Neonatal Network, “Neuroprotection of the Preterm Infant,” co-authored by Sheridan Doctor of Nursing Practice (DNP) and Neonatal Nurse Practitioner (NNP) Abby Kaspar, offers simple strategies that providers and nurses can use to provide effective neuroprotection for premature infants.

The article defines neuroprotection as “strategies or interventions…used to prevent cell death and promote normal development.” This is done by supporting the developing brain or by facilitating the development of new connections and pathways for functionality and by decreasing neuronal death. These strategies are necessary to prevent intraventricular hemorrhage (IVH) and other brain injuries in very small, immature infants who are born preterm. Preterm infants who develop a severe IVH have an increased chance of mental retardation, cerebral palsy, seizures and/or hydrocephalus, and even preterm infants with milder IVH can have developmental difficulties. Since most IVHs occur within the first 24-48 hours of life, neuroprotection should be provided as soon after birth as possible. 

Fetal and Neonatal Neuroprotection Strategies

Neuroprotection strategies, which can be implemented during the prenatal or postnatal period and include organizational, therapeutic and environment-modifying measures, may protect fetuses and newborns from developing IVHs and cerebral ischemia.

One fetal neuroprotection strategy the authors recommend is administration of betamethasone to the mother at least 24 hours before preterm delivery. Betamethasone is a corticosteroid that protects the development of blood vessels in the germinal matrix of the infant’s brain or inhibits prostaglandin synthesis. It also helps an infant’s lungs mature, which can reduce the incidence of respiratory distress syndrome (RDS). If the mother tolerates it, continuous magnesium sulfate infusion during the same can decrease the likelihood that the infant will have an IVH.

Routine caregiving activities (e.g., diaper changes, endotracheal tube repositioning, other minor manipulations) performed on critically ill preterm infants has been shown to be associated with major circulatory fluctuations that can lead to IVH. The authors recommend supine positioning of preterm neonates and midline positioning of their heads, a position that favors cerebral venous drainage, prevents an elevation of cerebral blood pressure and increased flow, and may increase cerebral oxygenation. Another recommendation is keeping the head of the bed either flat or slightly elevated and keeping the infant’s head midline, which has been shown to decrease intracranial pressure.

Other recommendations for neuroprotection of preterm infants:

  • Keep the baby’s hips and legs lower than his or her head during diaper changes to avoid increasing intracranial pressure and maintaining a neutral thermal environment, since hypothermia has been associated with IVH.
  • Keep lighting and noise levels low and handle the infant as little as possible to minimize stress and overstimulation, which can increase blood pressure and, consequently, cerebral blood flow, which can lead to IVH.
  • Provide swaddling and pain medication to minimize crying, which can impede blood return from the brain, increase cerebral blood flow and decrease cerebral oxygenation.
  • Infuse fluid boluses or hyperosmolar solutions slowly or dilute the solution to avoid potential swelling, thinning and/or fluid reduction in the vessels in the fragile germinal matrix that can cause them to rupture, eventually leading to IVH.
  • Limit endotracheal tube suctioning, which can increase cerebral blood flow and intracranial pressure and has been associated with increased incidence of IVH.
  • Maintain a partial pressure of carbon dioxide (PC02) greater than 30 mmHg, keep peak inspiratory pressures (PIP) less than 30 cm H20 and keep the mean airway pressure (MAP) less than 12.5 cm H20.

19 January2017

Integrating Telemedicine Responsibly

Providers and patients alike view telemedicine as an increasingly important healthcare delivery modality. Per a recent article in Medical Economics, “How to balance telemedicine advances with ethics,” the American Telemedicine Association (ATA) reports that more than half of all U.S. hospitals use some form of telemedicine; and IHS Technology predicts the number of patients using telehealth services will jump from fewer than 350,000 in 2013 to 7 million in 2018.

But this modality can also be challenging to implement responsibly.

Telehealth Benefits

The dramatic growth of telemedicine is driven by its ability to further the goals of the “quadruple aim” framework for value-based care.

More Efficient Care

The recent American Hospital Association (AHA) issue brief on telehealth cited several examples of significant telehealth-driven savings, including the Veterans Health Administration’s “nearly $1 billion in system-wide savings associated with the use of telehealth in 2012.” A major contributor was the dramatic decrease in hospitalizations.

In addition, doctors who offer telehealth services can spend more time caring for additional patients – time that otherwise would have been spent traveling between offices or facilities.

Better Outcomes

The AHA brief also describes the efficiencies and improved outcomes resulting from the innovative Hospital at Home (HaH) care model developed by Johns Hopkins researchers. HaH is being used effectively to provide hospital-level care at home in place of acute hospital care for older adults. Per the brief, “When a patient is treated at home, clinical staff travel to the home as needed to provide treatment, while telehealth is used to monitor the patient’s condition and enable daily meetings with the physician.” According to the program’s website, HaH patients experience better clinical outcomes, higher patient and family satisfaction, reduced caregiver stress and better functional outcomes compared to similar hospitalized patients.

Expanded Access to Care

Traveling to medical facilities can be a hardship for people who are physically challenged/housebound, live far from the nearest medical center or cannot afford to take time off from work. The ability to meet with a clinician remotely via a secure audiovisual device or application can mean the difference between those patients seeking – and getting – the care they need versus going without.

More Convenient Care

While it’s early days yet, “virtual visits” are beginning to be offered for more and more types of medical care. For example, St. Vincent Heart Center in Indianapolis is piloting a telecardiology program, per a recent article in Cardiovascular Business.

There is also increasing demand by health care consumers for “at home” virtual visits. A recent ATA-WEGO Health survey of active health care users found that consumers are very interested in using telehealth to complement (or even replace) their in-person care, primarily because of convenience. Other commonly cited reasons included scheduling conflicts and issues with transportation. 

Expanded Access to Specialized Clinical Expertise

Many small or rural hospitals often don’t have the budget or volume to support staffing a range of staff specialists or subspecialists. Even hospitals that have the budget may be in areas that make it difficult to recruit those types of physicians.

Dr. Lynn Palmeri, National Medical Director of Telehealth for Sheridan’s Women’s and Children’s Division, explains that telehealth carts can allow doctors at these facilities to consult remotely with specialists or subspecialists as needed. For example, an obstetrician may see an expectant mother with high-risk findings that require her to be referred out to see a perinatologist. Rather than having the mother drive three or four hours to the nearest perinatologist – potentially putting her and her baby at even greater risk – the obstetrician could have a remote telehealth consult with the subspecialist to determine whether the mother can be given appropriate care locally with the help of follow-up telehealth consults with the perinatologist.

Telemedicine is equally valuable in emergency medicine. Physicians in the adult emergency department (ED) at Jupiter Medical Center consult remotely with neurologists at the Cleveland Clinic using a telehealth cart approximately 10–30 times per month, most often to expedite implementation of tissue plasminogen activator (tPA) therapy for stroke patients.

Sophisticated telemedicine robots can allow remote specialists and subspecialists to perform much more in-depth examinations. Dr. Palmeri says “there are robots with sensors that can, for example, allow a neonatologist to remotely inspect a patient, auscultate bowel, breath and heart sounds, examine a neonate’s eyes for retinal findings, and even palpate to see if there is abdominal pathology or edema. These patient care modalities augment the in-person physical examinations by the nurse and neonatal nurse practitioner at the bedside.”

Radiology’s many subspecialties make it a prime candidate for expanding access to highly specialized clinical expertise remotely while also increasing efficiency. For example, Sheridan’s distributed teleradiology network includes hundreds of the country’s best radiology subspecialists who can provide hospitals of any size with affordable, 24/7/365 coverage and faster turnaround times for final reads. 

Challenges to Responsible Implementation

The promise of telemedicine is exciting, and pertinent logistical and quality matters will be ensured prior to its implementation and expansion.

Protecting Patient Privacy

Maintaining patient confidentiality is a cornerstone of ethical medical practice. Telemedicine systems will be HIPAA-compliant and hospitals must make data security a top criterion when selecting robot cart and software options.

Maintaining Care Quality

The same standards of care must be maintained regardless of the delivery modality, and that’s a key challenge of telemedicine. The American Medical Association (AMA) released its Guidance for Ethical Practice in Telemedicine in June. In the policy announcement, AMA Board Member Jack Resneck, M.D. said, "Telehealth and telemedicine are another stage in the ongoing evolution of new models for the delivery of care and patient-physician interactions. The new AMA ethical guidance notes that while new technologies and new models of care will continue to emerge, physicians' fundamental ethical responsibilities do not change.” The AMA also released its Principles to Promote Safe, Effective mHealth Applications in November. 

Telemedicine can make continuity of care challenging, especially when patients seek care from doctors who are not affiliated with their primary care physicians or who use different EHRs. But in some situations telehealth can improve care continuity. “In a pediatric unit, for example, an attending physician might see the baby during morning rounds, but by the time the parents can come to the hospital that evening after work that physician’s shift may have ended and the parents may not speak directly to that same doctor,” explains Dr. Palmeri. “Telemedicine has the potential to overcome those types of scheduling conflicts so that parents can speak with the doctor ‘face-to-face’ through the telemedicine robot screen whenever needed.”

Telehealth will play an increasingly important role in care delivery and physicians will carefully adopt remote care technology in a manner that ensures patient safety and privacy.

17 January2017

Study Identifies Risk Factors for Congenital Heart Disease in Infants

A study in the Canadian Medical Association Journal identified the chronic conditions that may predispose women to give birth to infants with congenital heart disease, also known as congenital heart defects or CHD.

The study reviewed the Taiwan Maternal and Child Health Database’s records of 1,387,650 live births from 2004 to 2010. The researchers investigated three data sets including:

  • Birth Registrations data on the sociodemographic characteristics of live births
  • Birth Notifications data on prenatal care and the lifestyles of pregnant women
  • Medical claims data from Taiwan’s National Health Insurance program

The researchers found that several maternal chronic diseases were associated with higher rates of CHD in babies. These conditions include type 1 and type 2 diabetes, hypertension, CHD, anemia, connective tissue disorders, epilepsy and mood disorders. Pregnant women who are identified as at risk can receive preconception counselling and developing fetuses can be more closely screened for CHD via fetal echocardiography. Early recognition of CHD can additionally help clinicians optimize the care of both women and infants.

That said, there are some limitations to the study. The detection period for the study was restricted to the first year of life. Potential cases of CHD may have developed in later years; however, under-identification should be minimal, given the high frequency of prenatal care and health checkups for infants under National Health Insurance coverage. Additionally, researchers noted that maternal lifestyle factors, including smoking and alcohol consumption, were likely to be underreported in the Birth Notifications data set.

About CHD

CHD affects nearly 1 percent of births per year in the United States and is a leading cause of birth defect-associated infant illness and death, according to the CDC. About 25 percent of babies with CHD have a critical CHD and generally require surgery or other procedures in their first year of life.

Although a few states track CHD among newborns and young children, no tracking system exists for older children and adults with heart defects. A study published last July estimates that approximately 2.4 million people – including 1.4 million adults and one million children – were living with CHD in the U.S. in 2010. Nearly 300,000 of those individuals had severe CHD.

Research projects like the review published in the CMAJ continue to improve care for people affected by CHD. Improved counseling and screening procedures for CHD have the potential to both reduce the prevalence of CHD and its resulting fatalities.

5 January2017

Our 10 Most Popular Blog Posts of 2016

The most-read posts on the Sheridan blog in 2016 focused on key topics – ranging from the challenges involved in the transition to value-based care and this country’s physician burnout epidemic to exciting technology innovations and trends in clinical practice.

The 10 most popular posts from the past year are:

  1. How to Manage the Burdens of Change on Physicians and Health Care Practitioners, a summary of Chief Quality Officer Dr. Gerald Maccioli’s presentation at the 2016 Health:Further Summit about the overwhelming burdens on providers created by current and planned changes to the U.S. health care landscape and strategies for managing them.

  2. Sheridan’s 2016 Leadership Conference Recognizes Eight Outstanding Clinical Leaders: Dr. Mike Adkins, Anesthesia Services Chief of the Year; Dr. Joseph Toscano, Emergency Medicine Chief of the Year; Dr. Frank Seidelmann, Radiology Chief of the Year; Dr. Mitchell Stern, Women’s and Children’s Chief of the Year; Dr. Adam Blomberg, Diamond Award Winner; Cindy Houck, CRNA, Platinum Award Winner; Dr. Gary Gomez, Innovation Award Winner; and Dr. Jonathan Katz, Innovation Award Winner.

  3. Six Physician Communication Strategies to Increase Patient Engagement and Improve Outcomes, including encouraging patients to talk about psychosocial factors that might be related to their conditions, tailoring communications to each patient based on his/her culture, values and beliefs to avoid inadvertent offense or mistrust, educating patients on care best practices and about responsible antibiotic stewardship, providing compassionate, personalized care and reassurance, and providing online information resources to educate patients and set appropriate expectations.

  4. Technology Innovations That Will Transform the Future of Radiology, including the groundbreaking work of the IBM Watson Health medical imaging collaborative, in which Sheridan and its chief of teleradiology, Dr. Glenn Kaplan, are playing a key role.

  5. Five Medical Practices That Soon May Be Outdated, including hospitals advising doctors not to apologize, prescription labels that don’t include what condition the drug is treating, monitoring handwashing by hospital staff, doctors spending more time on paperwork than on patient care, and making it difficult for patients to get their medical records quickly.

  6. The AMA’s New Tools to Ease MACRA Transition for Physicians, including the MACRA Assessment (aka Payment Model Evaluator), new MACRA-focused modules in the AMA STEPS Forward interactive, online practice transformation series, and the Inside Medicare’s New Payment System ReachMD podcast series.

  7. The Physician Burnout Epidemic, Part 1: Root Causes of This Alarming Trend, which looked at the factors fueling the increase in U.S. physician burnout. Part 2 offered strategies physician leaders can use to help combat burnout.

  8. Career Advice from Sheridan’s Chief Medical Officer for Radiology Services, Dr. Frank Seidelmann, including being proactive in managing your career, embracing technology and investing in your professional development and of the physicians you lead. 

  9. How Video Laryngoscopy Is Shaping the Future of Anesthesiology, which highlighted a discussion by Regional Medical Director Dr. Joseph Loskove, Chief Quality Officer Dr. Gerald Maccioli and National Education Director, Anesthesiology Division, Dr. Adam Blomberg in their Anesthesia News article, The Shift Toward Video Laryngoscopy: The Good, the Bad, and the Future.

  10. Pain Management Boosts Patient Satisfaction, which addressed the significant impact of addressing patients’ and caregivers’ concerns and setting their expectations appropriately – as well as treating patients’ physical pain – on their satisfaction with their pain management and overall care. 

3 November2016

Sheridan CRNA Jobina Ruiz Featured on AANA Journal’s October Cover

Sheridan is proud that the cover of the AANA Journal’s October issue features a photo of Sheridan Certified Registered Nurse Anesthetist (CRNA) Jobina Ruiz setting up for an obstetric fistula repair surgery in Rwanda. Ruiz participated in a global anesthesia immersion experience in Rwanda with the International Organization for Women and Development (IOWD) at the beginning of this year, when she was a student registered nurse anesthetist at Northeastern University. The IOWD is a non-profit organization that, among other things, provides free treatment and care to Rwandan patients suffering from obstetric fistulae, gynecologic and pelvic floor disorders. Ruiz, who was invited to participate in the mission at the invitation of her instructor, made the trip at her own expense.

Her 16 days in Rwanda with the IOWD was a valuable and eye-opening experience. For the first few days, she worked with the gynecological surgical team on general anesthesia cases and had the opportunity to watch those patients over an extended period of time. For the rest of her stay, she worked primarily on less invasive fistula repair cases and cystoscopies under epidural and spinal anesthesia. 

Working with the IOWD volunteers and local clinicians in Rwanda was both challenging and exciting. It provided Ruiz with many new learning opportunities, for example, administering anesthesia drugs such as halothane and sodium thiopental that are no longer used in the United States. Language barriers sometimes made communication challenging, and learning about the cultural differences between Africa and the U.S. was fascinating but also could be frustrating, such as the local cultural bias against using extreme measures to save the lives of critically ill neonates. But Ruiz fell in love with Africa and the people she met there – especially the women whose pain she helped manage during obstetric fistula repair surgeries. 

 

Jobina Ruiz draws blood from a Rwandan woman’s anti cubical vein as an anesthesiologist places an epidural to administer a blood patch

Fistula, a hole in the wall between a woman’s bladder and vagina, is a terrible condition found in women who have experienced a prolonged and obstructed labor without medical assistance, or sometimes as a result of injury to the bladder during a difficult surgery. This hole causes constant urine leakage. If the rectal wall is also affected, the woman also has no control over her feces. Ruiz learned that Rwandan women with untreated obstetric fistula are ostracized by their husbands and shamed by society, becoming social outcasts.

These women were incredibly grateful for the help of the surgical team volunteers, looking at them with eyes filled with hope and saying in their native language, “You’re going to fix me!” Ruiz said she’s equally thankful for having had the opportunity to meet and help them. “I helped these women,” she explained, “but in return they taught and helped me so much more! I am a better person because of them and this experience, and I am extremely grateful I was able to go.” She also appreciates the experience of having to make do with very limited supplies, equipment and drugs: “It taught me what I’m capable of.” Ruiz, who is well traveled, said she is anxious to return to Rwanda, next time with her husband.

She joined Sheridan in early September, immediately after passing her CRNA exam, and works at Memorial Regional Hospital in Hollywood, Florida. Prior to returning to school to earn her graduate degree and CRNA certification, she worked as a critical care registered nurse at the Mayo Clinic in Scottsdale, Arizona and NYU Langone Medical Center, Beth Israel Medical Center, New York-Presbyterian Hospital and Midtown Surgery Center in Manhattan, New York.

She hit the ground running at Memorial Regional, becoming a preceptor for nursing students after just two weeks. Her favorite thing about being a Sheridan CRNA is the strong sense of community. “It’s like being welcomed into a family.”

1 November2016

What Can Be Done About the Rising U.S. Maternal Mortality Rate?

As featured in The New York Times, several recent studies have revealed that the maternal mortality rate in the United States increased by nearly 22 percent between 2000 and 2015. This is a surprising finding, given that this increase defies current global trends. For most countries, maternal mortality has declined by a third over the last 15 years. Meanwhile, the U.S. is one of just 24 countries, including South Sudan and Democratic Republic of Congo, where the maternal mortality rate has increased.

Not only does America now have a higher rate than poorer countries such as Iran, Vietnam, Russia and Romania, but the U.S also stands as a notable outlier among wealthy countries. Data show that increased maternal mortality rates are incredibly unusual for rich countries, and this disturbing upward trend is particularly surprising in a country known for its robust health care system and dedication to improved care. Nevertheless, American maternal deaths have increased from 23 to 28 deaths per 100,000 births, and per the Institute of Health Metrics and Evaluation, the maternal death rate has increased by roughly half since 1990.

What’s Behind the Rise in U.S. Maternal Deaths

The rise in maternal mortality in the U.S. may be attributed in part to an increase in heart problems and some chronic medical conditions. One possible explanation is cardiovascular disease, which despite a declining mortality rate is still the leading cause of death overall and particularly for women. Diabetes, a diagnosis that has increased sharply and now affects 21.9 million Americans as of 2014, is considered another chronic cause. Obesity is also believed to have influenced maternal mortality rates, with more than one-third of Americans categorized as obese. It makes sense that the continuous physical strain of heart disease, diabetes and obesity, added to that of a pregnancy and subsequent childbirth, have contributed to the increase in maternal mortality in the U.S.

The health care community has yet to determine the definitive origin of America’s increase in maternal mortality. Previous research focused on isolating certain factors that might affect the data – such as poor public health in the African-American community and the rise in pregnancy among older women – but the results have been inconclusive. While maternal mortality rates varied among socioeconomic groups, every group experienced a rise in maternal death. 

Reversing the Trend Will Require More Accurate Tracking, Actionable Analysis

Further research has proven difficult as tracking maternal deaths accurately is a challenge. Maternal death is defined as complications from pregnancy or childbirth that may affect a woman up to a year after giving birth. However, in some cases the immediate cause of death may not be attributed back to the recent pregnancy and, instead, might be considered isolated and unrelated ailments. The longer the interval between the child’s birth and the mother’s death, the harder it can be to accurately attribute the death to the pregnancy or childbirth.

More accurate tracking and analysis of maternal mortality in this country is needed to better understand the causes and, potentially, reverse the upward trend. The World Health Organization (WHO) has encouraged global adoption of the Maternal Death Surveillance and Response (MDSR) approach, tracking maternal deaths, conducting expert investigations and using the findings to recommend policy changes that could reduce preventable deaths. Australia, Britain and a number of other European countries have implemented national maternal review boards. But although the MDSR working group includes representatives from the United States Centers for Disease Control and Prevention, a national maternal review board does not yet exist in this country. Half of U.S. states have set up state-level review boards, but more progress is needed. Implementing a national MDSR system could be an important step toward driving down U.S. maternal mortality. 

20 October2016

Postmastectomy Radiotherapy’s Value for Patients with Early-Stage, Node-Positive Breast Cancer

The American Society of Clinical Oncology (ASCO), the American Society for Radiation Oncology (ASTRO) and the Society of Surgical Oncology (SSO) recently issued a joint clinical practice guideline update for physicians who are treating breast cancer patients who have undergone a mastectomy. The update provides additional considerations to help physicians to determine which patients might benefit from postmastectomy radiotherapy (PMRT) and focuses on the role of PMRT for contemporary patients with early-stage, node-positive breast cancer.

While PMRT is clearly indicated for patients with very high risk of local regional failure, its use is controversial for patients with earlier-stage breast cancer, especially when there are three or fewer positive nodes. The new update focuses on this key area of controversy, stating that there is strong evidence showing that PMRT reduces the risk of breast cancer recurrence, but also providing evidence-based recommendations for the use of PMRT in patients with tumors smaller than 5 cm (T1-2 tumors) and 1 to 3 positive lymph nodes, as well as in patients undergoing neoadjuvant systemic therapy (NAST) and patients with T1-2 tumors and a positive sentinel node biopsy.

The expert panel that developed the updated guideline included representatives from ASCO, ASTRO and SSO. They reviewed relevant literature published between January 2001 and July 2015, including a meta-analysis of 22 clinical trials published in 2014 that provided evidence that PMRT is highly effective at preventing local breast cancer recurrence.

The focused guideline update emphasized that both the absolute benefit of PMRT and the benefit-to-risk ratio can vary substantially from one patient to another, and that doctors should obtain multidisciplinary clinical input and carefully consider factors that could reduce the potential benefit and increase the likelihood of complications before recommending postmastectomy radiation therapy. The panel also concluded that patients must participate fully in the decision-making process, and that their values as to what constitutes sufficient benefit and how to weigh the risk of complications against that benefit in the context of the treating physicians’ best information regarding PMRT must be respected and incorporated into the final choice of treatment.

Stephen B. Edge, MD, co-chair of the expert panel, said “We still don’t have a single, validated formula that can determine who needs PMRT, but we hope that the research evidence summarized in this guideline update will help doctors and patients make more informed decisions.” 

For more detailed information, read “Postmastectomy Radiotherapy: An American Society of Clinical Oncology, American Society for Radiation Oncology, and Society of Surgical Oncology Focused Guideline Update” published in the ASCO’s, ASTRO’s and SSO’s journals, Journal of Clinical Oncology, Practical Radiation Oncology and Annals of Surgical Oncology

This approach reinforces current practices at Sheridan partner Memorial Cancer Institute (MCI) which, like most cancer facilities, faces the complex considerations in deciding whether to recommend PMRT for this subset of patients. Sheridan collaborates with MCI oncologists and surgeons as part of a multi-disciplinary discussion addressing the relative risks and benefits of PMRT for each patient. This team looks at the patient’s entire clinical picture before making a recommendation, and patients are always included in the decision-making process.

19 October2016

Sheridan’s 2016 Leadership Conference Recognizes Eight Outstanding Clinical Leaders

The annual three-day Sheridan Leadership Conference is Sheridan Leadership Academy’s flagship event. This year’s conference took place Sept. 30-Oct. 2 in Orlando, Florida and was attended by nearly 600 physician and allied health leaders. 

 

Strengthening the Core

President of Physician Services Robert Coward and CEO Chris Holden provided opening remarks and introduced this year’s conference theme, “Strengthening the Core,” which focused on the key attributes required to succeed as a Sheridan clinical leader. Throughout the conference, each service line held multiple breakout sessions to promote discussion and knowledge sharing of topics related to the conference theme.

New Leadership Academy Programs

This year’s conference also marked the expansion of the Leadership Academy’s programs, whose participants are nominated by their leaders. In addition to the Emerging Leaders Program that began in 2014, the Academy added two new programs this year, the Physician Chiefs Program and the Allied Health Chiefs Program. Each of the three leadership programs kicked off its first course at the conference.

The 2016 Sheridan Leadership Award Winners

One of the highlights of the conference was the awards dinner, which took place on Oct. 1. Eight outstanding Sheridan physicians were honored with 2016 Leadership Awards:

Dr. Mike Adkins, Anesthesia Services Chief of the Year

Michael Adkins has been with Valley Anesthesiology since 1994 – providing cardiac anesthesia services for 13 years, serving as medical director at an outpatient plastic surgery center, and currently is chairman of anesthesia at Banner University Medical Center-Phoenix.

He also has filled important administrative roles during his tenure, including scheduling coordinator, division manager, board member, and principal in the formation and launch of Valley’s Mobile Services Division.

He is a former board member of the Arizona Medical Association and is president-elect of the Arizona Society of Anesthesiologists. He earned his medical degree from the University of Minnesota-Minneapolis, did a surgical internship at the University of Illinois in Chicago and received training in cardiothoracic and neuroanesthesia at Stanford University.

 

Dr. Joseph Toscano, Emergency Medicine Chief of the Year

Dr. Toscano has been an attending emergency physician at San Ramon Regional Medical Center since 1999 and chief of the department since 2013.

He has extensive experience and expertise in the field. In the early 2000s, he was a partner and corporate medical director for Pinnacle Medical Group, which operated five urgent care clinics in California and Arizona. He lectures frequently at urgent care conferences and is on the board of directors of the Urgent Care Association of America. He has been medical director of San Ramon Regional’s occupational medicine clinic since 1999.

He graduated from Dartmouth College and earned his medical degree from the Duke University School of Medicine. He trained in internal medicine at the naval hospital in San Diego and began practicing emergency medicine during an operational tour of duty with the U.S. Navy in the early 1990s. He moved to California in 1994 and has been an EM physician there ever since.

Dr. Frank Seidelmann, Radiology Chief of the Year

Dr. Frank Seidelmann is co-founder, chairman, and visionary force driving the success of Radisphere. Dr. Seidelmann brings a wealth of experience in radiology with subspecialty expertise in MRI and neuroradiology. He has more than 25 years’ experience in interpreting MRI cases and functions as a consultant on difficult cases for radiologists and clinicians around the country. He has lectured on MRI, both nationally and internationally.

Before venturing into subspecialty teleradiology in 1996, Dr. Seidelmann co-founded a highly successful hospital and outpatient imaging center based radiology group with 20 contracts in the Midwest and central states, at one time employing more than 50 physicians, which was acquired by Med Partners and later became Team Health. He also has owned several diagnostic imaging centers in Ohio and co-founded RIS Logic, a leading radiology software company that targeted diagnostic imaging centers. RIS Logic was later acquired by Merge Healthcare in 2003. Additionally, he has held staff positions at the Cleveland Clinic Foundation and Case Western Reserve University, and has expertise in small joint imaging.

Dr. Mitchell Stern, Women’s and Children’s Chief of the Year

Mitchell Stern, MD joined what was then known as Neonatology Certified in 1987, immediately after completing his Neonatal Fellowship at Babies Hospital (Columbia Presbyterian Medical Center) in New York City. He did his residency, including a chief residency, at Brookdale Hospital Medical Center in Brooklyn, New York. He attended medical school at St. George’s University School of Medicine in Grenada, WI and attended college at Cornell University in Ithaca, New York. 

Dr. Stern joined the staff of Plantation General Hospital in 1987 and became a Director of the unit shortly after Neonatology Certified became a part of Sheridan Healthcare in 1996. Besides being the clinical and administrative leader of the PGH Level III NICU, Dr. Stern has also been the Principal Investigator in several multicentered research projects and has been involved with several committees at both the hospital and HCA Corporate Levels.

Dr. Adam Blomberg, Diamond Award Winner

Adam L. Blomberg, M.D. is the Chief of Anesthesiology for Memorial Regional Hospital in Hollywood, Florida., as well as the National Education Director for Sheridan Healthcare’s Anesthesia Division. He serves on the Anesthesia Quality Committee at Sheridan as the co-chair of the Clinical Education & Best Practice Subcommittee. He has held positions at Memorial on the Physician's Satisfaction Committee and the Multidisciplinary Peer Review Committee as well as the Co-Chair of the Surgical Services Executive Committee.

Dr. Blomberg has had numerous articles published on anesthesia trends and best practices in leading industry publications, such as the Wall Street Journal, CNN Health, ASA Newsletter, Anesthesia Patient Safety Foundation Newsletter, HealthLeaders, Managed Care Outlook and Becker’s Hospital Review. In addition, he has spent more than 15 years as the national speaker for the “Driving Responsibly” campaign.

Dr. Blomberg completed his training at Brigham & Women's Hospital, a teaching affiliate of Harvard Medical School in Boston in the Department of Anesthesiology, Perioperative and Pain Medicine. During his final year of residency, he served as Chief Resident. He is a graduate of the University of Miami School of Medicine in Miami, Florida.

Cindy Houck, CRNA, Platinum Award Winner

Cynthia Houck, CRNA joined Sheridan Healthcare in 1984 after graduating from George Washington University’s Nurse Anesthesiology Program. She has witnessed the growth of Sheridan from a small private anesthesia group to the nation’s largest anesthesia outsourcing provider.

Cynthia has served as the Chief of Allied Health at Memorial Regional Hospital, a 700-bed tertiary care level-one trauma center, since 1993. She has also been the Regional Director of Allied Health, South Florida Region since 2009. Her responsibilities include oversight of all Allied Health in Dade and Broward Counties, 14 hospitals and 6 ambulatory facilities. She was the Clinical Coordinator for SRNAs from FIU from 2006 until 2012.

In addition to her clinical duties, Ms. Houck is also co-chair of the Policy & Procedure Subcommittee for Quality Improvement

 

Dr. Gary Gomez, Innovation Award Winner

Dr. Gary Gomez has served as chief of anesthesiology at Memorial Hospital Miramar since 2013 and has led several clinical improvement projects. These include enhanced recovery after surgery protocols, PONV prophylaxis tools and intrathecal catheter management protocols. He also was one of three lead physicians to develop the ClearPATh anesthesia patient readiness program and is currently collaborating to develop further clinical pathways as part of Sheridan/AMSURG’s nationwide initiatives.

Dr. Gomez received his medical degree from the University of Florida and is currently enrolled at UF’s executive MBA program. He lives in South Florida with his wife and three children.

 

Dr. Jonathan Katz, Innovation Award Winner

Dr. Jonathan Katz started with Sheridan eight years ago as a member of the cardiac team at a 227-bed hospital. He was promoted to vice chief a year later and has been a regional medical director for 1.5 years.

Dr. Katz graduated from the University of Pennsylvania School of Dental Medicine and got his medical degree from the University of Connecticut in oral and maxillofacial surgery. He completed his anesthesia residency at the University of Miami, where he served as chief resident and did his cardiothoracic anesthesia fellowship. He also worked as an attending in UM’s cardiac anesthesia subdivision and was assistant program director for the anesthesia residency.

 

 

Please join us in congratulating this year’s Sheridan Leadership Award winners.

17 October2016

Joe DiMaggio Children’s Hospital NICU Joins National Severe Bronchopulmonary Dysplasia Collaborative

The Wasie Neonatal Intensive Care Unit (NICU) at Joe DiMaggio Children's Hospital in Hollywood, Florida, was recently accepted into the national Severe Bronchopulmonary Dysplasia (BPD) Collaborative under the guidance of its medical director, Sheridan physician Bruce Schulman M.D. BPD, a chronic lung disorder of infants and children, is more common in infants with low birth weight and those who require prolonged mechanical ventilation to treat Respiratory Distress Syndrome (RDS). 

The Joe DiMaggio Children’s Hospital NICU, which provides level II and level III neonatal intensive care services, is one of only nine prestigious U.S. medical centers in the BPD Collaborative that have multidisciplinary teams dedicated to optimizing outcomes of infants and children with severe BPD. The other members of the collaborative – all academic medical centers – are:

  • Nationwide Children's Hospital – Ohio State University College of Medicine
  • The Children's Hospital of Philadelphia – Perelman School of Medicine at the University of Pennsylvania
  • The Johns Hopkins Hospital – Johns Hopkins University School of Medicine
  • Women & Infants Hospital of Rhode Island – Warren Alpert Medical School of Brown University
  • Monroe Carell Jr. Children's Hospital at Vanderbilt – Vanderbilt University Medical Center
  • Texas Children's Hospital - Baylor College of Medicine
  • Children's Mercy Kansas City – University of Missouri-Kansas City School of Medicine
  • Children's Hospital Colorado – University of Colorado School of Medicine

The mission of the collaborative is to improve the lifelong outcomes of babies who develop severe BPD by fostering collaboration and innovation in the identification and treatment through the sharing of data, the development and implementation of quality improvement initiatives, as well as fostering research protocols to address the most pressing gaps in our knowledge. 

Sheridan congratulates Dr. Schulman and his Sheridan team along with Joe DiMaggio’s Pediatric Pulmonary Medicine program and Respiratory Therapy services on being accepted into the collaborative and contributing to its important mission.  

19 July2016

Sheridan Helps NICU Boost Average Daily Census 600%

Sheridan Healthcare’s decade-long partnership with Penrose-St. Francis Health Services has helped St. Francis Medical Center upgrade to a level III NICU, increase its ADC to six times the original volume, decrease the minimum gestational age of the babies it cares for by five weeks, build its market reputation and improve the quality of care.

Penrose-St. Francis Health Services is a full-service, 522-bed acute care facility in Colorado Springs that includes Penrose Hospital and St. Francis Medical Center. Healthgrades has named Penrose-St. Francis one of “America’s 50 Best Hospitals” for nine years in a row (2008 - 2016).

About 10 years ago, Penrose-St. Francis wanted to upgrade the level II NICU at the 522-bed, not-for-profit St. Francis Medical Center facility to a higher-level unit that would provide expanded neonatal services to the Colorado Springs community. They also wanted to build their reputation among sister hospitals in the Centura Health system and also in the local market, which included two other highly respected and established hospitals. Mark Hartman, St. Francis Medical Center’s chief administrative officer, explained, “We were in a much smaller facility at the time and wanting to improve what we were doing from a NICU point of care perspective. We didn’t like seeing transfers out of our system and thought we could do more.”

Sheridan helped Penrose-St. Francis establish a successful NICU strategy based on providing high-quality, high-level neonatology services and a commitment to the local community, including relationship-building initiatives with other prominent area hospitals and local non-profits including Colorado-based Project Newborn Hope, which raises money for funding NICU projects to support at-risk mother and infant programs. Sheridan recruited two dedicated neonatologists, collaborated on program development and helped Penrose-St. Francis upgrade its St. Francis Medical Center NICU to Level IIIA care.

St. Francis adopted our proprietary PremiEHR™ web-based neonatal EHR system that gives physicians real-time information on neonatal patients and allows doctors to record consistent, searchable notes. Sheridan also helped St. Francis add a Maternal-Fetal Medicine (MFM) program for high-risk maternity care as well as 25 private neonatal bays.

By improving the hospital’s level of care, Sheridan expanded Penrose-St. Francis Health Services’ reputation in the community and with neighboring Centura Health facilities, and cultivated strong relationships with other area hospitals. The quality of NICU services attracted sister facilities and retained patients within the Centura Health system of hospitals.

As of mid-July this year, the NICU hadn’t had a central line infection in 486 days. The gestational age of the babies they care for has been pushed from 28 weeks and older to around 23 weeks. And the original average daily census of five babies, which more than doubled in the first four years, is now nearly 30 – six times the original ADC.

Mr. Hartman and Sheridan doctors talk more about how Sheridan Women’s and Children’s Services has worked with Penrose-St. Francis to achieve its goals. 

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