Cape Regional First in USA for Dual Certification

COURT HOUSE — Both Diabetes Care Center and Wound Care programs at Cape Regional Medical Center received Joint Commission certification Nov. 23, a first in the nation, and especially rewarding for a small facility at the Jersey Shore.
The Wound Care program here was one of just 14 hospitals in the nation to be certified to date, according to Judith Horn, certified wound specialist, who oversees the program here.
For the Diabetes Center, Joint Commission certification makes it one of only 39 in the nation to receive such status, according to Cindy Kraemer, program manager.
Achieving such status may be the equivalent of passing the Scholastic Aptitude Test with 1600, and then final exams with flying colors all wrapped together.
There were smiles aplenty among the staff members of each program last week as the remarkable feat was told to the Herald.
Not only did the certifications go to those members who work closely with the program and patients, but with virtually everyone at Cape Regional who might come into contact with patients being served for wound care or with diabetes.
Wound care treats both inpatients and outpatients, according to Horn.
Inpatients are done on referral orders from physicians, and follow a similar process for the plan of care, Horn said.
For the Diabetes Care program, “everyone is involved,” according to Kraemer. That means front line staff, nurses, ancillary staff and physicians.
With the arrival of endocrinologist Dr. Christopher Zitnay, the program at Cape Regional got even stronger.
“There is no one that this doesn’t touch to improve our processes,” Kraemer added.
“The organization has to support and embrace this. It take tremendous organizational commitment to make it happen,” she said.
As an indication how far along the commission checked, Kraemer said that food-service tray servers were asked what symptoms they would look for when giving food to the patient. If diabetic, was the patient sweaty or confused?
Kraemer said it was under Dr. Arthur Childs, board certified in critical care and internal medicine, that the diabetes program was begun.
“Diabetes is a disease that touches all of our lives,” stated Childs. “The diabetic team, QI, nursing and medical staff of Cape Regional Medical Center through their hard work, commitment and dedication to this quality initiative has taken an important step in raising the bar to a new level of excellence in the treatment of this pervasive epidemic,” he continued.
“All those involved with this disease specific Diabetic Joint Certification should be proud that they have through their actions improved and saved the quality of those living with this disease in the county for many years to come,” Childs stated.
“We are very proud of the hospital and staff for the dedication and commitment and achieving certification from the Joint Commission, and look forward to the long-term benefit for patients,” said Thomas J. Piratzky, executive director, Cape Regional Medical Center Foundation.
Horn said one part of the Wound Care services program was S.T.A.R.S. (Skin Team and Resource Staff). That means there are staff members who have received additional training. They are the “champions” of each unit, Horn said. Those members provide outreach for the team when more information is needed, she said.
That aids in keeping the quality of care high, Horn added.
Kraemer said Cape May County is second in New Jersey with persons having diabetes. That has much to do with the county’s elderly population, some in nursing homes or in assisted living facilities, Kraemer said.
There is a lot of obesity in the county, due in part to the seasonal employment of many.
“Lifestyle has a lot to do with it,” Kraemer said. “Half have it (diabetes) and do not realize it. They don’t get tested, that may because a lot of people do not have insurance and don’t get a physical every year,” she said.
Kraemer said the American Diabetes Association is “putting a big push to test earlier.”
She said the center is seeing more children with Type 2 diabetes. She cited a 3-year-old outpatient who recently had an insulin pump activated. She has an appointment to do the same with a 4-year-old.
The link between obesity in children may be linked to “super sizing” of fast-food portions and inactivity, with increased use of computer games that require no physical activity to burn calories.
From a pharmacist’s point of view, the certification means a standardization of treating those with diabetes. Insulin doses are specifically tailored to the patient based on weight, diseases and tests the patient may be undergoing, if they are inpatients, according to Richard J. Artymowicz, Cape Regional’s director of Pharmacy Services.
Kraemer also noted that counting of carbohydrates was an important factor, as was whether a patient may be undergoing surgery or having procedures done that would affect insulin levels.
“Once you come into the hospital, everything changes. When you are sick, your metabolism goes up. You handle it differently when you are not sick,” Artymowicz added.
Horn said one of the greatest advances at Cape Regional is the electronic medical record system that allows staff members to look at a patent’s information in real time.
That means everyone involved in patient care can see what is being done up to the minute from each discipline.
“What makes us unique is our ability to share this information and make adjustments very quickly,” Horn said.
Kraemer said Cape Regional is “The only hospital in the country that has wound care and diabetes programs together.” she added it was “very significant to care for wounds and diabetes at the same time.
“Sometimes diabetics will have wound issues,” she added.
Both Horn and Kraemer stressed that the certification could only be possible with full support of the administration of the center and everyone associated with the programs.
When applications are reviewed, Kraemer said many hospitals are not considered, because they are not ready for the process.”
The certification process found no deficiencies in both programs.
“I think we are in a better position to help them (patients) achieve wellness with their diseases,” added Artymowicz. “We are in a better position to maximize the outcome and improve their quality of life,” he said.
Patients being treated for wounds come in three times per week, said Horn. Caregivers may be told how best to aid the patient between hospital visits.
“They may come for months of treatment. Some patients with severe issues come for up to a year,” said Horn.
Both Horn and Kraemer said their programs have impacts on their patients. It is rare either go to a store that one of their patients will not see them and, in Horn’s case, might even roll up pant legs to show her their improving wounds.
“That shows they have relationships with the patients,” Piratzky said. “That is the beauty of a community hospital and a community like ours.”