Update October 2011

 Residency Directors

Canned Goods Drive at ADM

Bring canned goods to the 2011 ADM to support Safe Horizon, the largest victims’ services agency in America 

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ACOG District II
152 Washington Ave.
Albany, NY 12210
518.436.3461 (phone)518.426.4728 (fax)info@ny.acog.org (email)www.acogny.org (website)

From the Chair
Scott D. Hayworth, MD, FACOG

A Farewell - and Thank You

As I prepare to finish my term as District II Chair, I want you to know what an honor it has been to serve you - our membership. This experience has been enormously fulfilling on many levels – and I thank you for the opportunity.

District II will be in fine hands under the leadership of Eva Chalas, MD, FACOG, FACS. Eva is always looking out for our patients as well as for physicians’ interests – and has done a wonderful job for us through the years. She will make an outstanding District II Chair. I would also like to take a moment to recognize Ron Uva, MD, FACOG. Ron has been very active in legislative affairs and is an enormous asset to District II. I wish him well as Vice Chair. We have all been fortunate to have Richard Waldman, MD, FACOG as Immediate Past President of National ACOG and Immediate Past Chair of District II. Rich continues in his national role until May. I thank him for his guidance and friendship as well as for all of his service to ACOG.

Finally, I would like to extend my gratitude to District II Executive Director Donna Montalto and her team for their exceptional work in Albany. If you have ever come in contact with them, you know how great they are to work with. If you haven't - I hope you soon have the pleasure of doing so.

It has been a tremendous privilege to serve as District II Chair. I hope our paths will continue to cross - such as at the Annual District II Meeting - (Oct. 28-30) - at the Grand Hyatt in Manhattan. If you plan on attending - I'd love to see you!

From the Executive Director
Donna Montalto, MPP

When It Rains It Pours

…and I don’t mean Hurricane Irene! There are so many things happening in and around the District II office in Albany this month that I honestly don’t know where to begin.

First, I am delighted to report that when registration closed for our Annual District Meeting last Monday, our registration totals were 420 physicians. With the annual anticipated 100 walk-in registrants – the 2011 Annual District II Meeting will be largest District II meeting on record. Kudos to our scientific co-chairs and the district leadership for always improving on what is considered an outstanding clinical program – there is truly something for everyone.

Second, Governor Cuomo has gathered teams of workgroups to once again overhaul the Medicaid program. Earlier this year, the state secured over $600 million in savings from 78 cost-cutting proposals adopted in the budget – well on its way to the $2.2 billion is savings that was projected. Latest figures show that Medicaid covers 4.96 million people, almost a quarter of the total state population. So what’s on the horizon for ob-gyns regarding new savings measures (a.k.a. cuts)? We are going to revisit 2 proposals: 1) Medicaid will not cover any C-section prior to 39 weeks without a documented medical indication; and 2) Medicaid will not cover elective inductions prior to 39 weeks unless there is a documented medical indication. The battle of government interfering in medical decision making is occurring in states throughout the country. As Elliott Main lamented to me last week, Who would have thought that the zeal for the California/March of Dimes 39 week tool kit initiative would turn into payment rules?

Third, Governor Cuomo has instituted a Medical Malpractice Reform Work Group which is seeking "scorable" proposals to reform our medical liability system with outcomes that result in Medicaid savings. We all witnessed the political dismissal of the $250,000 CAP proposal and the implementation of the medical indemnity fund to help hospitals offset Medicaid cuts. Three meetings in 3 weeks will take place with 10 members (including 5 trial lawyers) negotiating the virtues of tort reform. ACOG will be present and we plan to address the workgroup at its first meeting on October 17th.Our specialty is challenged most by the need for true tort reform. ACOG will be ready to once again, fight for reform!

Lastly, I bid farewell to a wonderful District II Chair, Scott Hayworth. Throughout the past 3 years, I have learned a great deal about the business of medicine and business in general. While an impressive physician, Scott is a most impressive businessman and ACOG has greatly benefited from his wisdom. The meaning of compromise cannot be understood until one witnesses a "negotiation" beside the master, Scott Hayworth. As a truly giving person – I know I can call on Scott in the future and I thank him for his gift of time to District II.

I hope to see you all at the Annual Meeting in a few weeks – let’s hope that the rain stops!!

Albany Connection

The Legislative and Regulatory Affairs Department

The NYS Legislature is in session from January to July. However, throughout the whole year, our legislative department stays abreast of ground breaking news and events from the Capitol in Albany as well as the State Legislature and State Agencies on issues affecting your practice and your patients. We constantly have our "ear to the ground" to get the inside scoop on proposals and ultimately votes. This department encourages all ACOG members to have a say in government and affect outcomes that impact you and your livelihood. We encourage members to read our e-newsletter materials and in-depth analysis located on our website and get active in health policy decisions.

The Committee will be hosting its annual in-person meeting at the District II Annual Meeting. Current activities of the Committee include:

1. Lobbying for meaningful tort reform has been the essence of our legislative agenda for the past 25 years. During the 2011 budget negotiations, District II lobbied intensely for medical liability reform as a way to achieve savings in Medicaid. Despite losing the $250,000 CAP on pain and suffering, we did see a 3% reduction in medical liability premiums for all ob-gyns across New York State. The Governor’s Medical Liability Reform Workgroup consisting of 5 health advocates and 5 trial lawyers will be meeting 3 times during the next month – these meetings will surely be fiery and hopefully meaningful.

2. Passing the state budget in New York State is always a protracted, lengthy debate – often extending past the April 1st deadline. ACOG actively participates in budget discussions with the legislature and state agencies. Budget items expected in 2012 negotiations include:

protecting coverage and promoting availability of maternity care services for all women in all plans;

There will be 2 particularly important budget proposals coming forward in 2012. The state is going to suggest: 1) eliminating Medicaid payment for all C-sections prior to 39 weeks, and 2) eliminating Medicaid payment for inductions prior to 39 weeks – both proposals will require medical indication for payment.

3. Over 10,000 individual pieces of legislation are introduced in the legislature every year. ACOG continually reads the ledgers to watch for bills that impact ob-gyn’s and/or women’s health care. ACOG categorizes bills as "priorities" or "watch for movement". Priority bills are written about in the form of memorandums and letters and are sent to the sponsoring members of the legislature or state agencies. Priority bills often require many in-person meetings with legislative staff. In some cases, ACOG members are called upon to act as lobbyists – writing or calling legislators on priority bills. Some likely high profile/priority bills that will require ACOG action in 2012 include:

Authorizing physicians to collectively negotiate in managed care;

With all of the state legislative activity proposed for 2012, plan now to join your colleagues in lobbying the state legislature in Albany, NY. Dates will be forthcoming.

Medical Education

District II seeks funding for pre-term birth prevention and education
District II submitted a grant application that would offer physicians clinical education on cervical length screening and measurement and the subsequent administration of vaginal progesterone as a pre-term birth prevention strategy. This education would be delivered in the form of a second, complementary chapter to District II’s Preventing Pre-Term Birth physician resource guide and will also offer a webinar on the subject. Approval is currently pending.

District II seeks funding for office-based surgery (OBS) education
District II revised and resubmitted a grant application to improve patient safety in the office setting. The purpose of the grant will be to offer comprehensive, medical education to ob-gyns regarding compliance with state laws and regulations on office-based surgery and to enhance patient safety practices. Approval is currently pending.

Immunization smartphone app development in the works
District II recently received funding for the development of an immunization smartphone “app” and other valuable web-based, interactive decision-making tools related to vaccines. A Health Technology Workgroup has been formed and is currently working to create the necessary infrastructure. The smartphone “app” is expected to be released to District II members in spring 2012. If you would like to be part of the Workgroup, please contact Kristin Zielinski, Medical Education Director, at kzielinski@ny.acog.org.

District II smoking cessation activities heat up
District II has completed the first round of introductory visits to each of the five pilot sites selected for its smoking cessation initiative. In addition, each site has received a District II-developed provider resource guide, smoking surveys, and patient education posters. All five sites have positively reported that activities are underway and well received by all patients. While materials developed for this initiative will be available to the full District II membership in 2012, you can take a sneak peak at the patient posters by Clicking Here.

Finding Solutions for Female Sexual Dysfunction now available
District II’s Finding Solutions for Female Sexual Dysfunction is now available via the District II website. The guide contains helpful information on patient screening and assessment, treatment strategies, and important resources for both providers and patients, including the latest ACOG Practice Bulletin on this issue.

 Patient Safety
The Patient Safety and Quality Improvement Committee will conduct its annual in-person meeting in conjunction with the 2011 ADM. Current activities of the Committee include:

• Optimizing Protocols in Obstetrics: Series 1 - 4

• The DII PSQI Committee has embarked on a new quality improvement initiative focusing on enhancing existing hospital protocols within the following areas: use of oxytocin for labor augmentation, managing hypertensive crisis, managing massive obstetric hemorrhage and preventing shoulder dystocia. The Committee, divided into four subgroups, has conducted an in-depth review of individual hospital protocols in order to create a set of core elements that should be included in each of the 4 clinical areas. The outcome of this project will be a 4 chapter volume that offers educational tools and resources including model hospital protocols, assessment tools, suggested checklists, posters, and relevant national specialty guidelines and practice bulletins. Use of oxytocin for labor augmentation will be the first series of materials distributed under the resource entitled: Optimizing Protocols in Obstetrics: Series 1 Oxytocin and Inductions. The resource will be distributed to District II members and hospital obstetric department chairs this winter.

• Eliminating Non-Medically Indicated Elective Inductions Prior to 39 Weeks Gestation ACOG District II has embarked upon a yearlong clinical quality improvement initiative.The ultimate goal of this initiative is to focus on changing the attitudes and behaviors of ACOG members, including hospital leadership and administration, with training and education to help avoid these elective deliveries. This education will be rolled out to 10 pilot hospital sites across the state. In addition to provider education, ACOG District II, in collaboration with the March of Dimes will disseminate patient education materials such as posters, palm cards, patient education videos and conduct on-site patient education classes.

• MOREOB (Managing Obstetrical Risk Efficiently): A Patient Safety Model in Obstetrical Care Units
  ACOG District II sets out to prove that preventable adverse events that occur in labor and delivery and have identifiable causes can be addressed through the implementation of a long-term, comprehensive patient safety program. The MORE^OB project is a universal model of obstetric patient safety and quality improvement, a deficiency witnessed in the current health care system. There are 5 participating hospitals currently in the program. Expected outcomes include statewide dissemination of evidence-based data demonstrating that implementation of an obstetric safety model will result in improved patient health, continued access to obstetric services, prevention of a substantial number of adverse events, more efficient care delivery, and needed changes within hospital culture. Strong improvements in the delivery of obstetric care are expected, leading to improved quality of patient care.
  
  Following completion of the three-year program, clinicians will be able to demonstrate improved communication and competence in high-risk and near miss situations; improve their core knowledge base; increase performance through completion of simulation training drills; and improve maternal and neonatal outcomes. Evaluation is pivotal and will consist of annual review mechanisms to assess change in culture and personal performance.
  
  After three years, participating hospitals can remain in the MORE OB post-initiative safety modules.

• Electronic Fetal Monitoring (EFM) Initiative
  This fall, New York State's Obstetric Safety Initiative: Providing Excellence in Fetal Monitoring is offering a two-part webconference series on electronic fetal monitoring (EFM) presented by expert clinical faculty David Miller, MD, FACOG and Lisa Miller, CNM, JD. These webconferences are designed to educate obstetric teams on how to interpret, communicate, and manage fetal heart rate tracings using a standardized nomenclature and an EFM management model. The next webconference in this series is scheduled for November 8: EFM Case Study Review and Ask the Expert.

   

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Communications & Outreach

Here for YOU

The Department of Communications and Outreach oversees membership, marketing and electronic resources. Primary areas of focus include media, government and public relations. The department is dedicated to showcasing the tremendous work of District II members while raising awareness about women’s health care matters across New York State.

Current projects associated with the Department of Communications and Outreach include:

• Development of the soon to be unleashed Well-Woman website – where women will have the opportunity to receive health education on numerous topics. This site will ultimately drive patients to a section dedicated to women’s health care policies – including how medical liability reform affects access to care.
• Ongoing membership outreach efforts include the bulletin board project, where a wide range of information is showcased via bulletin boards in hospitals throughout New York State.
• Production of patient materials such as public service announcements and patient education videos. Two such videos – (addressing Fetal Alcohol Spectrum Disorders and Cervical Cancer) – are currently airing on the Newborn Channel in more than 1,000 hospitals across the United States.
• Monthly newsletter, website, and other membership communication venues.
• Development and maintenance of the ACOG District II website, Facebook and YouTube pages.

District II’s Department of Communications & Outreach is here for YOU! If you have any questions on how we can better serve District II, please contact department director Sue Nigra at snigra@ny.acog.org.

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