WellSpan Surgery And Rehabilitation Hospital - PowerPoint Presentation

1. WellSpan Surgery And Rehabilitation HospitalPrint copies are not controlledUpdated 11 Sep 2019

2. WellSpan Health MissionWorking as one to improve health through exceptional care for all, lifelong wellness, and healthy communities.

3.

4. Wildly Important Goals (WIGs)Chosen by WellSpan HealthA means of having all entities work on common goalsCurrent areasSafetyKnow Me (Patient-related)Employee EngagementAccess/Growth

5. Priority 1: Improve Health WIG: SafetyWith the intent to eliminate avoidable harm, leverage the Leapfrog frameworks and pursue CMS 5-stars performance. With a two-year goal of achieving an A rating or better for all rated hospitals, achieve a minimal Leapfrog B (predicted) rating at the end of FY20. All rated hospitals will achieve or maintain CMS 4 Star performance (per the WSH 12-month calculator) at the end of FY20.

6. Priority 2: Know Me & Make Healthcare Easier to UseWIG: KNOW ME – knowing the patient’s storyContinue to learn and apply what our patients tell us about themselves to create perfect patient experiences for every patient. Focus on: Meeting individual preferences Reducing points of friction and anxiety

7. Priority 3: Inspire and Engage PeopleWIG: Employee EngagementWith the belief that providing an outstanding employee experience fuels an outstanding experience for those we serve, our focus will improve employee engagement in times of organization change throughout the lifecycle of our team members. Communication: Create and execute a comprehensive communication strategy that inspires and connects staff members to the key aspects of change including the organization’s vision, mission, values, transformation and diversity/inclusion. Change Management: Identify and utilize a consistent change management approach that provides resources for leaders and support to staff members in our changing environment. Recognition: Enhance a culture of recognition through re-vitalization of system-wide recognition opportunities that provide a framework from entity-based and local recognition efforts.

8. Priority 4: Grow WellSpan as a Value-Based NetworkWIG: Access/Growth: Expand patient access to comprehensive local care

9. WellSpan Surgery and Rehabilitation Hospital MissionSupporting the journey to optimal health and independence by providing exceptional orthopedic, spine and acute rehabilitative care in a healing environment and coordinated through a comprehensive system of care.

10. WellSpan Surgery & Rehabilitation Hospital Director of PatientCare Services & Chief Nursing OfficerRosa Hickey, RNDirector ofInpatient RehabilitationElizabeth Trumble, PTDirector ofBusiness OperationsVal DanielsDirector of Quality/Regulatory ComplianceRuth Eckert, RNVice President Operations - WSRH Carol Smith, MSN, RNInfection ControlPamela Goodling· Nursing Practice· Rehab Nursing· Magnet Coordinator· Patient Experience· Post Surgery NursingLiaison· Clinical Informatics· Laboratory· Pharmacy· Respiratory Care· Clinical Educator· Pastoral Care· Wound Care· Dialysis · Occupational Therapy· Physical Therapy· Speech Therapy· Therapeutic Recreation· Outpatient Rehabilitation· Rehab Program Development -FIM -Outcomes -Specialty DesignationsLiaison· Psychology· Admissions· Business Development· Liaison Services· Prospective Payment System· Rehab CodingLiaison· Case Management· Guest Services· Volunteer Services· HIMS· Employee Health· Patient Safety· Peer Review· Quality· Regulatory Compliance· Risk Management· ISO Coordinator & Safety OfficerLiaison· Emergency PreparednessControllerDavid MartinChief Medical OfficerAlyssa Moyer, MDDepartment Chairs· Medicine Dan Motter, DO· Physical Medicine Rehabilitation Hugh Gregory, MD· Surgery Craig Ruder, MDPACUPHASPreOpORSchedulingStage IISterile ProcessingExternal ContractsBiomedical EngineeringSupply ChainFacility Management-EngineeringFacilities SpecialistsHousekeepingLaundryLDMS RolloutFood Services LiaisonImagingVictoria DiamondPresident, WSRH

11. Our Cultural Pillars(Our Values)Print copies are not controlled

12. Engaged EmployeesRespect for AllWorking as OneAssume Positive IntentDo the Right ThingFind a Better WaySupportive Leadership StructurePeak Performance&Patient Centeredness

13. Emergency Management CoordinatorSteve Gibson

14. Fire Alarm ProcedureRemember, the Fire Alarm voice notification is to inform visitors of procedure, not staffReport to your Charge Person/Home DepartmentCharge Person should account for Staff.Clinicians should account for patients. Await further instructions.Don’t forget R.A.C.E. and P.A.S.S.Smoke/Fire Door Closure

15. WellSpan Surgery and Rehabilitation HospitalOR 1OR 3OR 4OR 2PACUStage IIPre-OpImagingAdministrationFood ServicesFIRST FLOORPharmacyTraining RoomMain EntranceOutpatient Surgery ExitMeditation RoomEngineeringEnvironmental ServicesReceivingLabEntrance/ExitExit OnlyStairsElevatorSecurity 812-6555911 Response 1st floor123910111215161706/201255 Monument RdYork, PA 17403AEDBBAASmoke Compartment OutlineRally PointsAB

16. SECOND FLOOREntrance/ExitExit OnlyStairsElevatorRooms2201 - 2207Rooms2101 - 2118Therapy Gym25 BedPost Surgical UnitADL ApartmentPatient DiningActivity RoomRooms2401 - 242140 BedInpatient Rehab Unit8 BedBrain Injury UnitRooms2501 - 2508Rooms2301 - 2318Rehab Patient Entrance911 Response2nd FloorSecurity 812-655545Therapy Garden67806/2012WellSpan Surgery and Rehabilitation Hospital55 Monument RdYork, PA 17403Observation RoomsAEDSmoke Compartment OutlineRally PointsCDCCDD

17. Emergency CommunicationsAvaya IP Phone (Desk Phone)Network OutagePower OutageASCOM Phone (Portable)Component FailureOn Emergency PowerSend and Receive outside callsPersonal DistressEmergency Overhead PageOn Emergency Power6 Placed throughout WSRHTo be used only if everyone needs to know immediatelyKey to be kept in area of micEmergency Phones Radios When All else fails, RUNNERS

18. DISASTER CODE MATRIX  *The External Disasters emergency code will only be initiated by WSRH Facilities and/or WSRH Administration.  

19. HAZARDOUS MATERIALS & WASTEHazardous MaterialsTypes of Hazardous MaterialsOxygenNatural GasCleanersFormulinHazardous WasteTypes of Hazardous WasteRegulated Medical WasteChemo Therapy WastePharmaceutical WasteSolid Waste (Batteries and Light Bulbs)SDS SystemAccessible via the INETWaste Collected by Staff and Contractors.Hazardous Materials Room is the collection point.SDS SHEETS

20. The bins are not meant for:Regular trashNeedles or other sharpsControlled substances (Rx Destroyer)The lids to the black hazardous waste bins should remain closed. The bins are located in secure areas by the automated dispensing machines (PYXIS)Pharmaceutical WasteMedications (MEDS)Disposed of in black hazardous waste bins

21. Medical Gas Zone ValvesMedgas ON, cover fits.Medgas OFF, cover will not fit.The Charge Nurse or Designee is responsible for Medical Gases in an emergency.Know where the panels are in your work areaIf you have any questions, contact Maintenance.

22. AEDsThere are three AEDs in the buildingBy the vending machinesBy the receiving dock in back of houseOn the second floor next to the Activity Room door (near the public elevators)

23. General EvacuationAwait instructions to evacuate the building.Horizontal Relocation then Vertical.Move at least one set of Smoke and Fire doors away if your area is evacuatedKnow who is to “clear” your area.Charge Nurse/Area Supervisor will designate who will “clear” the area (Room by room).Use the Cleared signs (All areas but Surgical Services)Surgical Service uses orange cones at foot of the room.Know your rally point (Door Number and Letter).Bring your ASCOM phone and a WOW.Remember a fire alarm does not mean you have to evacuate. Know your smoke compartments. EVAC DevicesRally Point

24. Ruth Eckert, RN Director of Quality & Regulatory CompliancePatient Safety OfficerChair of Patient Safety CommitteeRisk ManagerManagement Representative (ISO) Print copies are not controlled

25. AccreditationDet Norske Veritas – Germanischer Lloyd (DNV-GL)Through Feb 2020Entire hospitalAnnual and unannounced surveyCommission on Accreditation of Rehabilitation Facilities (CARF) Through Nov 21 Rehab side only; specialty accreditationComprehensive Adult Inpatient RehabilitationBrain InjuryStrokeAmputeeSpinal Cord

26. DNV GL AccreditationStandards are called National Integrated Accreditation for Healthcare Organizations (NIAHO ®)First integrated accreditation program in USCMS Conditions of Participation for Hospitals ISO 9001 Quality Management System requirements

27. What is ISO?ISO = the organization (International Organization for Standardization)A network of 163 member countriesFocused on International standardsISO = the standards (9001:2015)A minimum set of quality standardsNot Healthcare specific: Applicable to all types of organizationsNot very prescriptive

28. Seven Quality Management Principles of ISO 9001:2015Customer Focus LeadershipEngagement of people Process approachImprovementEvidence-based decision makingRelationship management

29. Your Role in ISO 9001:2015Customer FocusKnow your direct and indirect customers: patients, families, visitors, co-workers, supervisors, other departmentsUnderstand their needs and expectationsBe aware of your patient satisfaction scores from Press GaneyEnsure new processes are designed with the patient in the centerLeadershipKnow the organization’s mission, vision, strategies, policies and processes throughout the organizationFollow the WSRH Cultural PillarsBe committed to quality – SPEAK UP if you see any issue

30. Your role continuedEngagement of PeoplePromote collaboration throughout the organizationIdentify opportunities for improvement in your department and WSRHWork with your supervisor/manager to create goals to facilitate your personal and professional developmentFill out the Employee Engagement Survey from WellSpanProcess approachKnow if workflows or standard work have been created for the work you doFollow the workflows or standard workIf you identify an issue/difference between your practice/work and the workflow – SPEAK UPLet your supervisor/manager know if there is a process that needs to have standard work created

31. Your role continuedImprovementSPEAK UP when you see an opportunity for improvementParticipate in department huddlesBe a problem solverEvidence-based decision makingAsk to see the data/metrics from your departmentUse the data to drive process improvementRelationship managementShare concerns or satisfaction with vendors, suppliers

32. Your role continuedControl of DocumentsPut expiration dates on any created materialsToss posted materials that are expiredDo not keep copies of printed policiesPrint  Use  Discard DO NOT HOARD PRINTED DOCUMENTSEnsure you are using the most current version of the document, form etcNotify supervisors/managers of any identified defects (any where)Complete SRS report when you identify an unexpected occurrence or eventBring the issue up at your department huddles (Heads Up, Speak Up)

33. Patient Safety – Act 13Print copies are not controlled

34. Definitions in Act 13Health Care Worker - An employee, independent contractor, licensee or other individual authorized to provide services in a medical facility Incident - An event, occurrence or situation involving the clinical care of a patient in a medical facility which could have injured the patient but did not either cause an unanticipated injury or require the delivery of additional health care services to the patient. The term does not include a serious event. Infrastructure failure - An undesirable or unintended event, occurrence or situation involving the infrastructure of a medical facility or the discontinuation or significant disruption of a service which could seriously compromise patient safety. Serious Event - An event, occurrence or situation involving the clinical care of a patient in a medical facility that results in death or compromises patient safety and results in an unanticipated injury requiring the delivery of additional health care services to the patient. The term does not include an incident.Sentinel Event - A sentinel event is an unexpected occurrence involving death or serious physical or psychological injury, or the risk thereof. (Joint Commission)Print copies are not controlled

35. Requirements of Act 13Patient Safety Officer – Ruth EckertPatient Safety Committee 2nd Thursday of every monthOpen to anyone who wants to comeSystem to report serious events and incidents that is accessible 24/7 – Safety Reporting System (SRS)No retaliatory action against a health care worker for reporting a serious event of incidentWritten notification to the patients/familyPrint copies are not controlled

36. ReportingEvent Reports are to be made immediately or as soon as reasonably practicableMUST be NO later than 24 hours after the occurrence or discovery of a serious event of incidentIf you are not sure what to do, call RuthDesk phone 812-6153ASCOM phone 812-6453Print copies are not controlled

37. Patient SafetyEvents are to be reported in the Safety Reporting SystemLink is on the INET home pageConnects to PAPSRS (PA Reporting System)

38. Patient SafetyJust CultureA safety-supportive system of shared accountabilityManagement is accountable for good system design and responding to the behaviors of their staff in a fair and just manner Staff members are accountable for the quality of their choices and for reporting errors, adverse events, and system vulnerabilitiesCrew Resource ManagementStop the line concept: any team member can/should ask for clarification or interruption of a process when s/he perceives an Immediate Risk to Patient SafetyStaff must feel empowered to use it!Print copies are not controlled

39. Regulatory IssuesTobacco – freeNo use of tobacco in any form on campus, including in your carsInclude vaping, e-cigarettesBadgesMust be worn above your waistQuick release lanyardsNo defacing eg stickersIf you forget yours, get a temporary one

40. Safe Haven (PA Act 201)Law allows new parents to surrender their newborn within 28 days of birth, ANONYMOUSLY, that is not a victim of abuse or criminal activity.Any employee can accept; volunteers cannotConfirm that the parent is surrendering their infant to you.Contact 911 to have the baby taken to YH Emergency Department via Ambulance for further care.If there is an indication of abuse, also notify Police

41. Adult Protective Services Act of 2010Provides protection of adults who are abused, neglected, exploited or abandoned18-59Physical/mental impairment limiting 1 or more major life activitiesActions to takeAssure the individual’s health & safetyREPORT See WSRH Policy, Abuse of Vulnerable Populations, for detailsPlease notify Ruth if you are concerned any of these situations exist

42. WSRH Risk ManagementProactive rather than reactiveNeed to identify and report “Good Catches”Notify Employee Health if you are injuredRisk Manager is Ruth Eckert

43. Top Physical Environment/Safety ItemsKeep your area clean and clutter-free.Keep overhead storage at least 18 inches below the sprinkler heads .DO NOT prop open doors.DO NOT block fire doors, pull stations or extinguishers.Keep corridors and hallways free from obstructions.Medical devices must be checked by Biomedical.Personal plug-in devices must have a safety check123456

44. Security ManagementWSRH Security DepartmentCall 812-6555Security ConsiderationsPark in designated areas.Please ensure your vehicle(s) are registered with WellSpan HealthPlease use your WellSpan hangtag in your vehicleSecurity can escort you to your car Don’t allow individuals to “tailgate” through access controlled doors.If someone is lost, give them directions to appropriately enter the facility or area

45. Workplace Violence (WPV) Zero Tolerance: patient  staff, staff  patient, staff  staff, visitors  staff, visitors  patients, etcCategories: ThreatNear MissActual Event with or without injuryReportingAll categories are to be reportedSRS report must be filed for an actual event with injuryAll others may be reported using the worksheet on the forms section of the WSRH portal

46. WPVYou will get an email with information related to documents for you to readBrochureA statement to sign and returnTask Force Multidisciplinary volunteer groupLooking for more volunteers

47. Process ImprovementYou are encouraged to identify opportunities for improvementWhat is not working?What frustrates you?What do could be done better?Everyone is encouraged to speak upPrint copies are not controlled

48. https://portals.wellspan.org/sites/wsnursing/System%20Policies/ System%20Policies/Practice%20and%20Quality/SYS‐ PQ%20Restraint%20Policy.pdf48 | P a g e

49. 49 | P a g e

50. 50 | P a g e

51. 51 | P a g e

52. 52 | P a g e

53. 53 | P a g e

54. Pam GoodlingManager Infection Control and PreventionPrint copies are not controlled

55. Infection Control BasicsPrint copies are not controlled

56. Why Is Hand Hygiene So Important?Thousands of people die every day around the world from infections acquired while receiving health care.Hands are the main pathways of germ transmission during health care.Hand hygiene is therefore the most important measure to avoid the transmission of harmful germs and prevent health care-associated infections.Print copies are not controlled

57. Why should you clean your hands?Any health-care worker, caregiver or person involved in patient care needs to be concerned about hand hygieneTherefore hand hygiene concerns you!You must perform hand hygiene to:protect the patient against harmful germs carried on your hands or present on his/her own skinprotect yourself and the health-care environment from harmful germsPrint copies are not controlled

58. Hand Hygiene – ObservationsAll staff must perform hand hygiene upon entering the patient’s room.All staff must perform hand hygiene upon exiting the patients room.If patient is not in their room, hand hygiene must be performed before contact with the patient.Print copies are not controlled

59. Hand Hygiene and Glove UseThe use of gloves does not replace the need to clean your hands! You should remove gloves to perform hand hygiene, when an indication occurs while wearing glovesYou should wear gloves only when indicated otherwise they become a major risk for germ transmissionPrint copies are not controlled

60. Fingernails and Artificial NailsNatural nail tips should be kept to ¼ inch in lengthArtificial nails should not be worn when having direct contact with patients and patient care items.Nail length is important because even after careful handwashing, HCWs often harbor substantial numbers of potential pathogens in the subungual spaces. Guideline for Hand Hygiene in Health-care Settings. MMWR 2002; vol. 51, no. RR-16.60

61. Standard PrecautionsUse for the care of all patientsYou never now what is lurking in the next roomUse standard precautions whenever there is a chance you you’ll be exposed to:BloodAny other body fluids, secretions, or excretions Nonintact skin (broken skin)Mucous membranesRespiratory etiquettePrint copies are not controlled

62. Why is Adherence to Standard Precautions So Important?Because colonization with multidrug resistant organisms (MDROs) is often unrecognized (e.g., MRSA, VRE, CRE, ESBL, etc.).We can’t screen for every possible MDRO.Because other infectious organisms may spread (e.g. coagulase-negative Staph., MSSA, Serratia species, Pseudomonas species, Klebsiella species etc.)Print copies are not controlled

63. Respiratory EtiquetteObserve Droplet Precautions (i.e., wearing a surgical or procedure mask for close contact), in addition to Standard Precautions, when close contact with a patient with symptoms of a respiratory infection, particularly if fever is present. These precautions should be maintained until it is determined that the cause of symptoms is not an infectious agent that requires Droplet Precautions Print copies are not controlled

64. Dirty Patient Care Equipment/Itemsis a Source of Indirect Transmission of MicroorganismsEquipment that is contacting the patient and/or the patient environment should be properly cleaned between patients with a WellSpan approved disinfectant wipe between patients.Print copies are not controlled

65. Other MDROFluroquinolone-resistant P. aeruginosaErythromycin-resistant S. pneumoniaCarbapenem-resistant S. marscensExtended spectrum ß-lactamase, E.coli, K. pneumoniae (ESBL)CRE (Carbapenemase-producing EnterobacteriaceaePrint copies are not controlled

66. The Iceberg EffectInfectedColonizedThis iceberg graphically represents colonization versus infection. Those patients that are infected with an organism represent just the “tip of the iceberg” of patients that are colonized or infected. Just because a patient is not infected, or showing signs of infection, does not mean that they do not carry organisms that could be transferred to another patient if proper hand hygiene and other infection control precautions are not taken.Print copies are not controlled

67. Standard PrecautionsPatients with MDROs can be cared for using Standard Precautions if they have contained secretions/excretions.Secretions/excretions (including wound drainage, stool and urine) are contained when they are unable to leak out of containment products (e.g., wound dressings, incontinence product, urine bags, ostomy bags, etc).Print copies are not controlled

68. 68Print copies are not controlled

69. Patients suspected with or confirmed with C. diff will require contact precautions.Once positive, the patient must remain in precautions until cleared by a member of the Infection Prevention TeamTest of cure should NOT be performed for the purposes of treatment or to justify discontinuing isolationC. diffPrint copies are not controlled

70. C. difficile ProtocolContact Precautions as soon as testing is ordered (purple octagon for C. diff).If assay negative - consider other pathogens before removing from precautions.The disease is from ingestion of the organism not in the air or general contact Print copies are not controlled

71. C. difficile ProtocolIf assay is positive, keep on precautions until pt has “normal” stools x 48 hrsDo not test for cure!Room must be terminally cleaned prior to removing patient from Contact PrecautionsLeave the sign in place until housekeeping has designated the room clean and ready for use.Print copies are not controlled

72. Multi-drug resistant organisms may cause a significant risk to patients. MDROs are ever changing and emerging.Current examplesAny Vanco Resistant or Intermediate Staph aureus (VISA/VRSA)Resistant Acintobacter in the respiratory tract (especially in our ventilated patient population)Carbapenem-resistant Enterobacteriaceae (CRE)Overly resistantPrint copies are not controlled

73. This can be a little tricky, what is uncontained?When wounds are open and draining and are not contained within a dressing (particularly when infected i.e. bed sores, ulcerations, etc), there is a risk of spread REGARDLESS of the organism.This is a clinical decision that needs to be made with nursing and providers.Please consult with the Infection Prevention Team as needed.uncontained wound Print copies are not controlled

74. Those patients with open trachs and/or open suctioning that are showing increased secretions require isolation. The offending organism is not the driving factor.This is a clinical decision that needs to be made with nursing and providers. Please consult with the Infection Prevention Team as needed.Trach w/ increasedPrint copies are not controlled

75. C. diff is not the only cause of acute diarrhea.Norovirus (as well as other viruses) may cause acute onset diarrhea and is highly contagious to both patients and staff.It is important to separate the normal “loose” stools that some patients may be prone to from uncontained acute onset diarrhea.When seeing an unexplained acute onset diarrhea, place those patients on contact precautions.Acute onsetPrint copies are not controlled

76. For patients with a MDRO in their urine who:Do NOT have a Foley catheterAre incontinent and urine cannot be contained by a briefPrint copies are not controlled

77. No lab finding or algorithm can replace the critical thinking and judgment of a health care professional. There will be times that will seem appropriate to place enhanced precautions on a patient. The patient’s team needs to be open and discuss concerns to ensure that our patients are safe.When in doubt, do it!thinkPrint copies are not controlled

78. Discontinuing Contact PrecautionsWhen the condition of the patient with an MDRO changes (e.g., drainage contained) and they therefore no longer meet the criteria for requiring Contact Precautions, they may be cared for using Standard Precautions.Before removing any patient from Precautions the Infection Preventionist must be consulted (ASCOM ext.26489).Print copies are not controlled

79. Automatic Isolation OrdersAn automatic order for precautions is triggered for the following laboratory testing:C. difficile – Contact PrecautionsInfluenza AB RSV PCR – Droplet & Contact PrecautionsRespiratory Viral Detection Panel – Droplet & Contact PrecautionsIf RSV positive maintain the patient on Contact and discontinue the Droplet.If RSV negative but positive to any other respiratory virus, maintain Droplet and discontinue Contact.Print copies are not controlled

80. Stop Sign The Stop Sign is used for any patient placed on Contact, Droplet, Airborne or Neutropenic.It is an alert for staff to check Room Link for the specific type of Precautions the patient is on.It is also an alert for visitors to stop at the nurses station for instruction on any type of precautions they must take before entering the patient’s room.Print copies are not controlled

81. Contact Precautions Signage for C. difficileWhen the order is triggered the Room Link will display Contact Precautions.In addition to the STOP Sign a purple octagon indicating Contact Precautions for C.difficile

82. Transmission-Based Precaution Signage 82

83. Contact PrecautionsPerform hand hygieneGown and gloves MUST be worn when entering patient room for any reason.Change gloves after having contact with material that may contain high concentrations of microorganisms.Remove PPE before leaving patient room.Perform hand hygiene immediately after glove removalPrint copies are not controlled

84. Droplet PrecautionsPerform hand hygieneUse Standard Precautions in addition Droplet Precautions.Mask and Eye ProtectionMust be worn to enter the roomEye glasses do not provide adequate protectionWear a procedure mask with attached eye shield.Patients must don a surgical mask and perform hand hygiene prior to leaving their roomRemove your PPE before leaving patient room.Perform hand hygiene immediately after PPE removalPrint copies are not controlled

85. Airborne Precaution ProtocolMask the patient with a isolation mask.Contact Infection Control ASCOM# 26489.Call Facilities at ext. 26555 to have the negative air room turned on.Ensure that the room is functioning.Transfer patient to negative air room.Print copies are not controlled

86. BIOHAZARDOUS WASTE Laboratory waste Human surgery specimens or tissues Items saturated or dripping with blood or OPIM or caked with dried blood or OPIM. Waste containing discarded material contaminated with excretion, exudates or secretions from humans who are isolated for Biosafety Level 4 pathogens such as Ebola, Lassa or Marburg viruses.Print copies are not controlled

87. Non-Medical WasteMedical waste does not include: Urine, feces, saliva, sputum, nasal secretions, sweat, tears, or vomitus, unless it contains fluid blood Waste which is not biohazardous, such as articles containing nonfluid blood and other medical solid waste products commonly found in hospitalsPrint copies are not controlled

88. How to reach me...I can be reached by at ASCOM phone # 26489 Monday thru Friday, 7 am – 3:30 pmAfter hours I can be contacted by leaving a message on my voice mail. This will initiate an email to my PDA that someone has left a message.If it is an emergency after hours contact the operator and have her contact the Infection Preventionist on callWhen I am out of the office there will a voice message directing you to call the IC main extension # 12251 .Print copies are not controlled