January 15, 2016
MEDICAL UNIVERSITY of SOUTH CAROLINA
Vol. 34, No. 18
Second Science cafe a SucceSS MUSC held its second Science Cafe at Southend Brewery Jan. 12. The Science Cafe lecture series allows scientists to present cutting-edge research to the public over a beer or glass of wine. “It’s supposed to be a relaxed atmosphere,” said Dr. Joe Helpern, an internationally recognized expert on magnetic resonance imaging. “Science is fun,” he added. Helpern presented the latest findings on ADHD and Alzheimer’s disease, both of which affect millions of people worldwide and for which MRI might hold the key to a cure. “We can use MRI to measure these things,” he said. “But, now we have to find out what those measurements mean.” Read more about Helpern’s research in next week’s Jan. 22 Catalyst. photo by J. Ryne Danielson, Public Relations
MUSC’s online nursing graduate program ranked No. 2 Staff Report U.S. News & World Report has ranked the MUSC College of Nursing No. 2 among online graduate nursing programs in the United States. The college surpassed more than 500 nursing schools surveyed to earn the No. 2 position on the publication’s 2016 Best Online Graduate Nursing Programs list. This is the third year the College of Nursing’s online graduate nursing program has held one of U.S. News & World Report’s top two spots: In 2015, it was ranked No. 1, and in 2014, it was ranked No. 2. “The College of Nursing’s frequent top ranking among the nation’s nursing schools is a testament
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Idea Campaign MUSC employees prove they’re innovators. LIKE US
to the excellence and ingenuity of MUSC,” said Gail Stuart, Ph.D., dean of the College of Nursing. “Twelve years ago, we were one of the first nursing schools to make a commitment to innovative nursing education through online instruction. Today, the College of Nursing remains engaged in what has become a standard practice while continuing to focus on innovations that will enable us to further distinguish MUSC from other institutions,” The college offers online graduate programs that award a Master of Science in Nursing (MSN), Doctor of Nursing Practice (DNP) and Doctor of Philosophy in Nursing Science (Ph.D.). The school also provides an
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on-campus accelerated Bachelor of Science in Nursing (BSN) with classroom, clinical and lab components, as well as an online R.N. to BSN program. In the fall of 2015, more than 575 students were enrolled in the College of Nursing. The upcoming application deadline for the college’s online DNP and R.N. to BSN programs is March 15. To learn more about MUSC’s nursing programs visit http://www.musc.edu/nursing. To view the U.S. News & World Report rankings, and related information, visit http://www.usnews.com/ education/online-education/nursing.
Golden year
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DAISY Award
College of Health Professions turns 50.
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Meet Cody
11
Reflections
Medical University of South Carolina — FOLLOW US
@ Catalyst_MUSC
2 The CaTalysT, Jan. 15, 2016
DAISY presented to dedicated 5East ART nurse The December DAISY (Disease Attacking the Immune System) Award winner is Justyn Lamb, R.N., who works on 5East ART. Lamb was nominated by the 5East ART Leadership Council. Below is Lamb’s nomination: “It is with great enthusiasm that I write this DAISY nomination for Justyn Lamb. We currently have a patient on our unit that has been here for several Lamb months and is projected to be here for an even longer extended period of time. The patient, M.R., has many complex emotional and physical needs and he is considered our highest acuity patient. Many of the staff have expressed compassion fatigue when assigned to care for this patient. As a unit, we decided to create a rotation log to give staff a little respite and yet still remain engaged in his care. It is important for this background information because even in light of having to care for one of our most challenging patients, Justyn has found a way to be amazing with him each and every shift. Justyn is meticulous with his orders. Frequently she can be heard
Editorial of fice MUSC Office of Public Relations 135 Cannon Street, Suite 403C, Charleston, SC 29425. 843-792-4107 Fax: 843-792-6723 Editor: Cindy Abole catalyst@musc.edu Catalyst staff: Mikie Hayes, hayesmi@musc.edu Dawn Brazell, brazell@musc.edu J. Ryne Danielson, daniejer@musc.edu Helen Adams, adamshel@musc.edu Sarah Pack, packsa@musc.edu Jeff Watkins, watkinsj@musc.edu
thinking out loud and collaborating with the physicians, clarifying his orders. She has gone as far as to pad a urinal with an Allevyn dressing to enhance comfort when he voids. M.R. is receiving HD daily and accurate urine output documentation is crucial to his care. She was observed weighing him for a second time in one shift just to be sure we had the most accurate measurement. To some, weighing a patient may not seem like a big deal. Those that know M.R. know that it is a tedious and timely process to get him out of bed. These are just a few acts that happen all the time when she is caring for M.R. These small acts seem trivial yet are vital to his care and outcome. The compassion Justyn gives is not limited to just the patient. Justyn has been overheard asking the patient’s family to take care of themselves as well. Compassion fatigue isn’t limited to just hospital staff. The patient’s wife has been at his bedside since he arrived. Justyn frequently reminded M.R.’s wife to take breaks and go eat. Last, I would be remiss to leave out that Justyn has oriented two nurses since M.R.’s admission. The thoughtful and meticulous care she provides can be seen in her orientees. It’s heartwarming to know that she cares so much about her patients but also that she teaches the same compassion to new nurses. There is no doubt in my mind that her patients are receiving the most comprehensive and compassionate care ever. We are The Catalyst is published once a week. Paid adver tisements, which do not represent an endorsement by MUSC or the State of South Carolina, are handled by Island Publications Inc., Moultrie News, 134 Columbus St., Charleston, S.C., 843-849-1778 or 843-958-7490. E-mail: sales@moultrienews.com.
photo provided
December DAISY winner Justyn Lamb is joined by her 5East team. lucky to have her and even luckier that she is sharing this compassion with each new nurse she orients.” Each month, MUSC nurses are honored with the DAISY Award for Extraordinary Nurses. It is part of the DAISY Foundation’s program, recognizing the efforts that nurses contribute daily in their jobs. The award is given to outstanding
nurses in more than 1,800 health care provider hospitals in the U.S. and 14 other countries. Nominations can be submitted by anyone — patients, visitors, physicians, fellow nurses and all MUSC staff and volunteers. For information or to nominate a nurse, visit http://www.musc.edu/ medcenter/formsToolbox/DaisyAward/ form.htm.
MUSC Waring Historical Library Presents Building a Medical Center: The Construction of the 1955 Medical College Hospital 60th Anniversary Web exhibit Visit http://waring.library.musc.edu/exhibits/1955Hospital/index.php
Founded in 1824 under the auspices of the Medical Society of South Carolina, MUSC has grown from an initial faculty of seven and student population of five into one of the nation’s top academic health centers.
Nominations for Teaching Excellence Awards due Jan. 22 A call for nominations is underway for all MUSC faculty and students to recognize faculty members who have made outstanding contributions to the university through teaching. Awards may be given from the following categories: q Clinical/Professional (Educator– Mentor) q Scholarship/Academic (Educator– Mentor) q Educator–Lecturer q Developing Teacher
Any regular, full–time faculty member who holds an academic rank of instructor or higher in a college or department at MUSC, who has not been the recipient of this award within the previous three years is eligible for nomination. The deadline for nominations is Friday, Jan. 22. Nominees must submit supporting materials. Forms may be found at http://www.carc.musc.edu/ nomination/ or call 792-2228.
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Cutting-edge PET-CT scanner first of its kind in the U.S. By helen adams
Hilda Rabon hopes MUSC’s new PET-CT scanner will show that her melanoma has not returned. Tech assistant Bill Mitchell prepares her for the procedure.
Public Relations
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t’s Hilda Rabon’s birthday, and the only present she really wants is a scan that shows she’s cancer free. “I’m a little nervous,” she says in a waiting room at MUSC. Rabon has already been treated twice for melanoma, the disease that killed her mother and aunt. She has routine scans to see if it has returned to her body. Melanoma is the most serious type of skin cancer. But at this visit, something is different. A new “128-slice” PET–CT scanner awaits Rabon, the first of its kind with such a powerful CT scan in the United States. It will reduce the amount of time she has to spend in the device, and more importantly to Rabon, it may increase the accuracy of the scan. “That sounds great,” she says. PET stands for positron emission tomography, a scan that that can pick up on cellular changes early. CT is computed tomography, an X-ray exam that captures cross-sectional images of blood vessels, bone and soft tissue. Combining PET with CT in one device allows doctors to overlay images as they explore possible problems. While this hybrid imaging is not new, the increased capability of the MUSC scanner is. Its 128-slice CT technology is many times more powerful than that of MUSC’s old scanner and the PET–CT scanners still in use in other U.S. hospitals. Leonie Gordon, M.D., a professor of radiology at MUSC and director of Nuclear Medicine, says the more slices, or images, that doctors have to work with, the more precise they can be. “It’s anatomically clearer. You can see all sorts of things now. We can do very thin slices. Functional and anatomical images are
photo by Sarah Pack, Public Relations
Nuclear medicine technologist Melissa Dutton prepares Hilda Rabon for a PET-CT scan while Dutton’s husband, Joe Rabon, waits.
photo by Helen Adams, Public Relations
acquired simultaneously and superimposed. We can look at them individually or together.” The machine’s speed is worth noting too, she says. “Instead of taking about 45 minutes a scan, it will take about 15–20 minutes a scan.” That’s important because some patients who need scans are very sick. Every minute that can be shaved off their time Gordon in the scanner is a minute they can be somewhere more comfortable. The faster speed will also help children who need scans but have a hard time staying still. The 128–slice PET–CT scanner is already used in some hospitals in Europe, where Siemens, the company that makes the device, is based. MUSC became the first U.S. hospital to get one, Gordon said, because it has the expertise to do research using the new device and recognizes the importance of using the latest technology available for its patients. It cost MUSC about $3 million. That may sound like a lot, but Gordon says it’s not for a cutting-edge piece of medical equipment such as this. In fact, she says, “We got a deal.” Back in the waiting room, technologist Melissa Dutton tells Rabon it’s time for her scan. She takes Rabon to a private room and injects her with
radioactive glucose that will show where any cancer cells may be once Rabon is in the equipment. “We’ll scan you all the way from the top of your head to the tip of the toe in about 25 minutes,” Dutton tells her. “You will not have to get up and turn around for another scan of your legs.” That’s a nice change, Rabon says. Gordon compares the new PET–CT scan to one-stop shopping. “You see the primary tumor, and because we’re scanning the top of the head down to your feet, we see all the metastases. We can see them in the bone, in the liver, lymph nodes or skin or wherever they happen to be. It’s a bad thing, but the more aggressive the cancer, the more likely we are to see it.” Rabon hopes there’s nothing to see in her case. After the scan, she goes home to Georgetown to wait for the results. A few days later, she gets the call she was hoping for: There’s no sign of cancer. “It was absolutely marvelous. God is so good. I am so blessed, I cannot tell you,” Rabon says. She’ll return to MUSC in six months for another check. It’s a never-ending process, but one she says she’s grateful for, and one that has gotten a little easier with the new PET/CT scanner. “It was great – I was in it for a shorter time, and it was quieter,” Rabon says. “I can’t even put into words the feeling I have for MUSC. I know early detection is the reason I’m here today.”
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Idea Campaign yields innovative projects
By mikie hayes Public Relations It’s long been said that it’s difficult to be recognized as an expert in your own backyard, but that couldn’t be further from the case at MUSC. Innovative ideas submitted by MUSC Health employees were selected and the winners announced at the Dec. 17 Leadership Development Institute, with plans for the projects to be implemented enterprisewide this month. Barton Sachs, M.D., chief of staff for CEO Pat Cawley, M.D., is serious about innovation. During his presentation at the LDI, he said, “Innovation is a core value at MUSC. You’ve seen it; it is part of something that we live by. It was recently adopted as the organizational sixth pillar for performance and goal evaluation. Innovation allows us to encourage a culture of new ideas, new developments and new thoughts.” He believes this commitment to innovation and excellence will lead to the continuous improvement of experiences and outcomes. MUSC Health, he said, has been tasked with creating strategic and operational plans for promoting a culture of innovation throughout all parts of MUSC and offering the MUSC community a process for advancing innovative ideas. This includes the Innovation Program, Foundation for Research Development, MUSC Center for Innovation and Entrepreneurship and Center for Translational Research. To ensure a coordinated effort to bridge institutional silos and promote a transformational work effort, the MUSC Health Innovation Center (MUHIC) was created. Sachs serves as co- administrator along with Tom Finnegan, administrator of the Center for Innovation and Entrepreneurship. In describing the role of the center, Sachs said, “We act as a conduit, or as an entry point for all those new ideas, and we help to advance the value of the ideas and develop the value over time.” The three major initiatives of the Innovation Program to date are
developing the Idea Campaigns, teaching leaders about innovation and building bridges with corporate industry. The first of the Idea Campaigns was launched last fall and focused on the subject of employee wellness. Through the inaugural project, “It is all about you,” employees were encouraged to submit ideas related to improving the health and well-being of their colleagues. The submission process opened Nov. 1 and closed Nov. 15. Sachs said they had hoped to receive somewhere in the neighborhood of 100 employee-generated ideas and were amazed when the final count tallied 217 submissions. Those involved in voting for the projects went through a REDCap survey process, and subsequently, the ideas were awarded points based on how innovative, feasible, impactful and fundable they were, as well as how valuable and measurable the judges rated the projects. The Population Heath Implementation Team (PHIT) initially analyzed the submissions and reduced the pool from 217 to 135 and then again down to 60 of the best ideas. Next, MUHIC leadership reviewed the ideas and narrowed it down once again, this time to the best 21 ideas. Finally the MUHIC board of advisors, along with the MUHA senior leadership council, performed the final review and selected the top five candidates, ranking them in order. Employees proposed many creative and implementable ideas that various committees will continue to consider. The winners will see their programs begin to come to fruition this month. Phil Smeltzer, director of population health and a member of PHIT, said, “In my 25 years of doing population health, some of these ideas are as clever as any I’ve ever seen. There were ideas that made the short list that are easy to do, and we’re already doing them, but there is another group of ideas that are so powerful that we will figure out a way to make them happen because, honestly, they are awesome ideas.” The next two campaigns will roll out later in 2016. The second project involves app development and will begin in February, with the winning apps
photos by Mikie Hayes, Public Relations
Dr. Barton Sachs, MUHA chief of staff, far right, and Tom Finnegan, third from left, Center for Innovation and Entrepreneurship, join MUSC Idea Campaign winners at the MUHA December Leadership Development Institute. Wayfinding will present ways for people to get around the institution more easily and efficiently. Sachs could not have been more pleased with the results of the first campaign. He reminded the audience that good ideas can come from anyone in the institution. “Innovation comes from everybody - every employee that is involved in the MUSC enterprise. It’s not for just a few people, everyone is involved.”
Top five winning ideas Dr. Barton Sachs and Tom Finnegan discuss the Idea Campaign. beginning to roll out in April. At the LDI, Sachs invited the audience to participate in the voting process and determine the focus of the third Idea Campaign, encouraging participants to vote via their cell phones. The audience chose between five areas including teamwork, hospital appearance, wayfinding, hand–offs, and an undetermined choice whereby participants could submit other unique ideas. Ultimately, and by a large margin, wayfinding took the most votes and will be the Idea Campaign launched in May.
1. Measure steps walked daily — Katrina Reynolds, Tracy Yohe, Kayla Brown, and Ebony Forbes (a team from Revenue Cycle) 2. Update stairwell appearance — David Thomas 3. Chronic disease care management education classes — Joan Herbert 4. MUSC fitness groups for local running, biking, and swimming races — Kay Burke 5. Fifteen–minute yoga and breathing classes — Sundar Balasubramanian, Ph.D.
The CaTalysT, Jan. 15, 2016 5
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6 The CaTalysT, Jan. 15, 2016
Looking ahead:
College of Health Professions celebrates 50
By J. Ryne danielson Public Relations This year marks the 50th anniversary of the College of Health Professions. The youngest of the six colleges at MUSC, CHP was established in 1966 with a budget of just $300,000, but has grown to become the largest, with almost 800 enrolled students. “It’s been a pretty amazing trajectory,” said Lisa Saladin, Ph.D., PT, dean of the College of Health Professions. “When we started, we didn’t even offer a bachelor’s degree. We now have 10 academic degree programs in the college: bachelor’s, master’s, and doctoral.” Saladin said one of the biggest changes for the college during her tenure as dean has been the shift to research. “When I arrived, we were primarily known for our outstanding educational programs, but very little research was being conducted.” Research is important, she said, because it drives professionalism. “Technicians do what they’re told. Professionals act independently to develop their own science, knowledge base and best practices through research.” Much of the growth in research Saladin attributes to Steven Kautz, Ph.D., chairman of the Department of Health Sciences Research and co-director of the Center for Rehabilitation Research in Neurological Conditions. In 2014, Kautz received a five–year $10 million Center of Biomedical Research Excellence grant from the National Institutes of Health to establish a groundbreaking stroke rehabilitation and recovery research center at MUSC. Funding for stroke recovery research has nearly quadrupled as a result, from around $2 million to more than $8 million annually, making MUSC a leader nationwide. “Too little research has been devoted to stroke recovery,” Saladin said. “While there is extensive research in treating stroke medically, there is not much doctors can do once an individual has experienced a stroke. Dr. Kautz is leading a great group looking at how we can improve quality of life and function for those individuals. It’s pretty cutting–edge research.” Stroke is one of the leading causes of long-term disability in the United States, according to Kautz. One in 6 Americans will suffer a stroke at some point in their lives; the odds are even higher in the American South. Doctors have known for some time that the southeastern United States has an unusually high prevalence – so high, in fact, it has become known to public health officials as the “stroke belt.” “South Carolina is the buckle of the stroke belt,” Saladin said. “Stroke is a huge problem in the state, so having the center located here is a great benefit. Subjects can get treatment here they can’t get anywhere else as part of experimental research.” Kautz has worked closely with professionals across MUSC, including neurologist Robert Adams, M.D.,
photos by Anne Thompson, Digital Imaging
College of Health Professions Dean Dr. Lisa Saladin, center, joins other MUSC deans and faculty members during a previous MUSC Commencement ceremony. Saladin was named dean in 2011. and Mark George, M.D., director of MUSC’s brain stimulation laboratory, to develop neuromodulation brain stimulation techniques to facilitate healing within the brain and make the brain more receptive to traditional rehab techniques. “The College of Health Professions made a large investment in resources to build the research program, and their good vision and proper resources have allowed us to be very successful,” Kautz said. Because of that vision and investment, CHP now ranks third nationally in NIH funding among colleges of health professions. This past September, MUSC was awarded another grant from the NIH to establish the National Center of Neuromodulation for Rehabilitation, which will serve as a research and training resource for the entire country. Kautz will serve as program director; George, as science director; and Rick Segal, Ph.D, PT, chair of the Department of Health Professions, as education director. The three will lead this multidisciplinary center. “The NIH recognizes that we have a unique resource that we can teach to the rest of the country,” Kautz said. “We are now one of six such centers in
See Anniversary on page 7
CHP students, circa 1970.
photo provided
The CaTalysT, Jan. 15, 2016 7
anniveRsaRy
Continued from Page Six
College of Health Professions Timeline 1966 – Medical College of South Carolina established the School of Allied Health Sciences (SAHS) and approved a budget of $300,000 on December 9, 1966 1968 – SAHS awards first Bachelor of Science degrees 1969 – Medical College of South Carolina granted university status. School of Allied Health Sciences renamed College of Allied Health Sciences. 1973 – Physical therapy program launched 1977 – Master in Health Sciences awards first degrees 1980 – Master of Health Sciences program offers first distance education courses 1986 – Master in Health Services Administration (later renamed Master in Health Administration) program awards first degrees 1992 – College of Allied Health Sciences renamed College of Health Professions 1994 – Physician Assistant Bachelor of Science program awards first degrees photo provided
MUSC leadership and leaders of the community break ground on the College of Health Professions Complex in the former High School of Charleston location in 2003. the United States, each with its own teachable expertise.” Kautz said the interdisciplinary nature of the new center is unique and indispensable. “It’s a real partnership between the College of Health Professions and the College of Medicine,” he said. “It couldn’t exist without both.” Saladin agreed wholeheartedly. “Such interprofessionalism should feel natural. This is what health care should be.”
Michelle Woodbury, Ph.D., OT, is another researcher pursuing novel research in the College of Health Professions. Working with graduate students from Clemson University’s School of Computing, Woodbury has developed a virtual reality system to aid in stroke rehabilitation and recovery. Using Microsoft’s Kinect, a motionsensing peripheral for the Xbox 360 and Xbox One game consoles, Woodbury created a “game” to help individuals with
photo provided
1996 – Doctorate in Health Administration (DHA) degree approved by South Carolina Commission on Higher Education 2000 – Office of Research established; College of Health Professions becomes largest college at MUSC, comprising 1/3 of student body 2002 – Center for Health Economics and Policy approved by MUSC – the first center designation outside the College of Medicine 2003 –Groundbreaking for new CHP building complex on the former site of the High School of Charleston 2005 – Doctorate of Physical Therapy approved by SCCHE 2007 – Mark Sothmann appointed Dean of CHP 2008 – First doctorates in physical therapy awarded 2009 – CHP restructured into two departments: Department of Health Professions and Department of Health Sciences and Research 2011 – Lisa Saladin appointed dean; Center for Rehabilitation Research in Neurological Conditions opens 2014 – Stroke Recovery Research Center opens
Physical Therapy faculty and Dean Lisa Saladin join PT students during the group’s commemorative white coat ceremony.
stroke recover arm function. “It’s more than a game,” Saladin said. “It’s a treatment program.” The program’s clever design encourages repetitive motions that patients might otherwise find monotonous, but which aid in the recovery process. “This isn’t going to cure everything,” Woodbury said. “But, it is one small piece of the puzzle.” Woodbury’s application recently took second place
in the Kinect Fun Labs Challenge, a competition intended to solve difficult problems with innovative technology, held in Sydney, Australia. Woodbury is now working with MUSC’s Foundation for Research and Development to launch a start–up company to develop more virtual reality tools to aid in stroke recovery. “The college is hitting on all cylinders
See Anniversary on page 11
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Students gain collaboration, teamwork at Interprofessional Day By J. Ryne danielson Public Relations
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ore than 1,500 students, faculty and staff members participated in MUSC’s 11th annual Interprofessional Day January 8. First launched in 2006 by David Garr, M.D., executive director of the South Carolina Area Health Education Consortium and associate dean for community medicine, the event was created to establish a culture of collaborative teamwork and improve patient care and safety. According to Jeff Borckhardt, Ph.D., one of the event’s keynote speakers, between 210,000 and 440,000 patients die in hospitals every year as a result of preventable harm, and medical error is the third leading cause of death in the United States after heart disease and stroke. “Your chance of death in an airline accident is 1 in 4.7 million,” Borckhardt said. “You have about a 1-in-600 chance of an accident-related death in the hospital. That’s a lot more dangerous than aviation.” It’s also more dangerous than bungee jumping, sky diving or working in a nuclear power plant. “One of the most dangerous things a physician can do is order medication,” said Danielle Scheurer, M.D., chief quality officer for MUSC. “Five out of every hundred medications ordered are
wrong. So, we build layers of protection around the ordering process to make sure those mistakes don’t get through.” Yet, each layer of protection has holes, she explained, like a slice of Swiss cheese. The trick is making sure the holes never line up. “When bad things happen to patients and their families, it’s almost never the fault of a single person or the result of a single failure,” Scheurer said. “It’s usually a series of failures, and there is almost always a miscommunication involved.” Borckhardt agreed. “The most common root cause of medical errors is communication problems, both verbal and written,” he said. “Miscommunication between health care team members, miscommunication between shift changes, miscommunication between providers and patients, poorly documented or lost information, sound-alike medications, unapproved abbreviations, failure to communicate timely and accurate information, poor communication of medical orders — the list goes on.” Scheurer explained that to improve patient safety, a team-based approach is necessary, and that begins with transparency and accountability when something goes wrong. “Not only does forthrightness help develop processes to prevent similar errors in the future, it is necessary to rebuild the faith of the patient, and his or her family, in
Dr. Danielle Scheurer, MUSC’s chief quality officer, presents the “Swiss Cheese” model of medical errors. Every layer of protection has holes, she says, the trick is making sure they never align.
photos by Anne Thompson, Digital Imaging
Tom Hamm, a staff member in Instructional Technology & Faculty Resources, plays the role of an angry son as students from the six colleges disclose and apologize for a serious medical error involving his mother. Students review a fictional case study of a woman who suffered a stroke during a dental procedure and work in small groups to prepare for a difficult role-playing experience.
MUSC,” she said. “Disclosure is the first step to restoring the patient’s dignity, self-respect, and trust.” David Schenck, Ph.D., director of ethics at MUSC, was the final keynote speaker. Schenck counseled students on how to discuss errors with families and begin the healing process after something has gone wrong. “We have an obligation to establish trust with our patients, to tell the truth and to tell the truth well,” he said. “There can be no healing without trust.” After the morning speakers concluded, students broke into small-group sessions for a chance to apply the lessons they’d learned and role–play, disclosing a serious medical error to an actor portraying the family member of a patient who suffered a preventable
stroke. Each group contained at least one student from each of the six colleges. Participants gained vital experience in both communicating interprofessionally with each other and with an anxious, worried, even angry family member. “I thought the experience went really well,” said pharmacy student Tyler Genaway. “It’s hard being put on the spot. You start talking faster, and you want to duck down. She was a very good actor.” Cathy Duram, DNP, director of the MSN-DNP program in the College of Nursing facilitated one of the roleplay groups. “Interprofessional teams are integral to having good patient outcomes,” she said. “This is a really important day.”
The CaTalysT, Jan. 15, 2016 9
NIH $1.68 M grant funds pancreatitis, diabetes research Staff Report MUSC researchers received a $1.68 million National Institutes of Health grant to explore a better treatment for chronic pancreatitis, with the hopes that it also may shed light on a future cure for patients with Type 1 diabetes. Hongjun Wang, Ph.D., of the Department of Surgery, is leading a collaborative team to study ways to increase the survival of the islet graft following islet cell transplantation for chronic pancreatitis patients. Islets are tiny clusters of cells in the pancreas that produce insulin. Researchers in Wang’s lab earlier piloted a smaller study looking at the protective effects of Alpha 1 anti–trypsin (AAT) in mice islet transplantation, using human islets from cadaveric donors. The results showed that infusion with AAT prevented the mice from getting diabetes and improved liver implantation. AAT is a protein made in the liver. Normally, the protein travels through the bloodstream, helping to protect the body's organs from the harmful effects of other proteins. The five–year NIH grant involves infusing AAT into patients who have had their pancreas removed by a weekly IV infusion for one month. The study will examine whether humans will replicate the success seen in the mouse model. “The goal is to lessen the number of patients who are diabetic at the end of one year,” Wang said. How the anti–inflammatory properties of AAT work remains unknown. “Through studies like this, the investigators seek to understand how AAT works in the body to lessen cellular stress,” she said. “AAT, most commonly used for the treatment of emphysema for more than 25 years, has an excellent safety record,” Wang said. “The islet autotransplantation model offers a unique opportunity to assess the direct effect of AAT on human islets in the absence of an immune response. “While much of the work associated with AAT has been directed at lung and liver disease, it may help in the treatment of other diseases, including chronic pancreatitis, which can be incredibly
painful,” Wang said. Chronic pancreatitis is caused by inflammation of the pancreas gland, an organ that has a duct connecting it to the intestine. The pancreas gland is responsible for excreting many of the enzymes that allow for the digestion of food. These enzymes are inflammatory if they get into the body's tissues. The gland also secretes hormones into the blood. The most important of these is insulin. Inflammation and destruction of the pancreas gland is caused by a variety of conditions including some common drugs, high levels of triglycerides and too much alcohol. The duct that leaves the gland can become scarred and blocked, and the pancreas enzymes can further destroy the gland. The result is a painful condition that has few cures. One of the treatments is a pancreatectomy or surgical removal of the pancreas. “But the surgery creates problems, too,” Wang said. “It means all of the patient’s islet cells also are removed, taking away the patient's insulin and making the patient diabetic, which creates other lifelong complications.” Wang is putting to good use her research expertise in islet cell transplantation gained at the Beth Israel Deaconess Medical Center at Harvard Medical School. That’s where she worked as instructor and assistant professor for almost 10 years before coming to MUSC, where she serves as the co– scientific director of the Center for Cellular Therapy. The clean cell facility is the second largest autologous islet transplantation center in country Islet cell transplantation is a technique in which the pancreas gland is taken to a laboratory after removal while the cells are still alive. The gland is then gently digested to break it into different cell types. The islet cells are separated and injected back into the patient to go to the liver in the hope they will stay there and continue to secrete insulin. “In the best outcomes, the patient would not be diabetic at all,” Wang said. The number of cells that survive determines the severity of a patient’s diabetes after removal of the pancreas. This surgery is done at only a small number of specialty centers because of
photo by Lauren Hooker, Surgery
Dr. Jingjing Wang, from left, Dr. Hongjun Wang and Dr. Wnyu Gou test a gene expression profile in islets treated with AAT. Colleen Cloud, processing manager, works at the islet isolation box, a computeroperated system used to manipulate the extraction of the islets from pancreatic tissue. photo by Sarah Pack, Public Relations
the detail and expertise involved. According to Wang, the value of working in islet cell transplantation research at MUSC is the expertise of the clinicians. MUSC is a designated National Pancreas Foundation center, focusing on the multidisciplinary approach to the treatment of pancreatitis, including access to expert surgeons in the field of chronic pancreatitis. “This study is half basic science and half clinical. At MUSC, we have some of the best pancreatic surgeons in the country, and if we have questions in the research environment, we can work directly with the surgeons to find solutions,” said Wang.
“We are excited to be at the cutting edge of translating basic science research into clinical outcomes that will change the way we treat not only patients who suffer from chronic pancreatitis but eventually patients with Type 1 diabetes,” Wang said. “Just imagine a day when people with Type 1 diabetes no longer need to take their insulin. That’s the future and direction we are going.” Co–investigators for this study from the Department of Surgery include Katherine Morgan, M.D., chief of the Division of Gastrointestinal and Laparoscopic Surgery and David B. Adams, M.D., professor of Surgery in the Division of Gastrointestinal and Laparoscopic Surgery.
10 The CaTalysT, Jan. 15, 2016
Sharing my health tips for 2016 At home: As director of health q Take a few 10–minute promotion at MUSC, I am walks or bike rides during responsible for creating a healthy the day. work environment that provides q Use an exercise DVD opportunities for employees for a little while in the and students to make good morning and a little while choices that contribute to overall in the evening. wellness. I know that I should be q Take a 10-minute dance a role model for making personal break with your young health a priority but like many children. of you, I struggle to find time q Play Frisbee, hopscotch, for myself. As I consider my own or jump rope with challenges as a single working Susan Johnson children. mom, I decided to share some q Walk or bike to the tips on how to work healthy store. habits into the small pockets of time we q Walk the dog. can find throughout the day. q Read the newspaper on a stationary The most common reason people bike or treadmill. give for not exercising or eating healthy At work: is that they don’t have enough time. A q Park further from the office or get off lot of people have an “all or nothing” the bus a few stops early. mentality and feel that if they aren’t q Take the stairs instead of the elevator. able to get a full 30 minutes of cardio q Conduct walking meetings. in or a trip to the gym then it’s not q If you need to speak to a coworker, worth it to do anything. Nothing walk to that person’s office or station could be further from the truth. rather than using e-mail or the phone. Although sustaining target heart rate q Use your morning and afternoon for extended periods of time is good breaks to take quick 15–minute walks. for cardio-respiratory fitness, small For more ideas on how to work healthy bouts of intense exercise are also habits into your daily life, check out extremely beneficial. Additionally, these resources: 10 minutes of moderate intensity http://www.choosemyplate.gov/ activity such as walking three times physical-activity.html per day can significantly reduce your http://www.heart.org/HEARTORG/ risk for developing chronic disease. GettingHealthy/PhysicalActivity/ So simply parking a little further from GettingActive/Get-Moving-Easy-Tips-toyour destination or walking instead of Get-Active_UCM_307978_Article.jsp driving to lunch or errands can make a big difference in overall health, and burns extra calories. Every little bit Employee Wellness counts. q MUSC Employee Fitness Series Class Another barrier to exercise for — Piloxing from 12:15 to 12:45 p.m., working parents is that they are just too Wednesday, Jan. 20, MUSC Welllness exhausted after a long day of work, and Center. Piloxing is a blend of Pilates, I can certainly relate to that. Try the “10 boxing and dance. Free day pass to the minute ticker” – you can do anything Wellness Center for event participants. for 10 minutes and sometimes that’s all Register at musc.edu/ohp/musc-moves/ it takes to mentally convince yourself employee-fitness-signup.html to do it. Once you’ve started, usually q Chair massages — Free massages you’ll continue longer. Try doing simple are offered to employees midday exercises like planks, push-ups and Wednesdays. Check broadcast messages lunges during commercials or while for new locations and times doing household chores and make it a q Farmers Markets — Fresh fruits and habit to take at least a 10–minute walk vegetables are available from local every night after dinner or before bed. farmers on Friday from 7 a.m. to 4:30 Here are some additional ideas for fitting bursts of activity into your day: p.m. at the Horseshoe.
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The CaTalysT, Jan. 15, 2016 11
MUSC’s own reflects on demo of Charleston Memorial Hospital
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Continued from Page Seven
Jan. 2, 2016 Letter to the Editor, During the next few months, people who travel along Calhoun Street and the James Island Connector will have the opportunity to witness the demolition of a building that served the Lowcountry as Pinehaven — The Charleston County Tuberculosis Hospital, Charleston County Hospital and Charleston Memorial Hospital (CMH). The hospital can best be described by an inscription found on one of its building plaques: “Pinehaven the Charleston County Tuberculosis Hospital erected 1951-1953 by the County Council of Charleston County with assistance from federal funds and the Charleston County Tuberculosis Tolley Association to replace Pinehaven Sanatorium erected 1925 dedicated to the care and cure of the tuberculosis sick.” The Pinehaven Sanatorium was located in the area of what is now the old Naval Hospital on Rivers Avenue. At the time it was built in 1925, it was about six miles outside of Charleston, where it was thought that patients suffering from tuberculosis would benefit from fresh air, good food and rest. The sanatorium was constructed in part from World War I surplus materials. With advances in treatment and technology along with deterioration of the 1925 buildings, there became a need for a new facility. In 1953, Pinehaven — The Charleston County Tuberculosis Hospital was opened at 326 Calhoun Street. It was built on filled in marsh land in the hospital district of Charleston. In 1963, the Charleston County Council changed its name to Charleston County Hospital. The decision was made to make it a general hospital providing care to indigent patients. In July of 1965, the new County Emergency Room opened and replaced the ER at Roper Hospital, the same month I became one its patients. Within the following year, medicine, surgery and psychiatric wards were established at the hospital. Inpatient obstetric and nursery service was provided from 1992 until 1994. In 1981 the hospital name was renamed Charleston Memorial Hospital (CMH).
Throughout its existence, the hospital, under its various names, was always closely associated with the Medical University of South Carolina. CMH served not only the patients of the area, but provided many of the residents and students of the Medical College, now the Medical University of South Carolina, with valuable educational training and experience. In 2001 CMH was sold to the Medical University of South Carolina. The staff at CMH worked as a multiracial family, serving all with great dignity and compassion. Those who worked at the hospital took pride in giving their best to all who entered its doorways. At one time, it was common knowledge that on a particular day of the week, some of the best fried chicken in town was available in the CMH cafeteria. The site of Charleston Memorial Hospital along with the McClennan- Banks Ambulatory Care Facility will now be the location of the new MUSC Shawn Jenkins Children’s Hospital. This state–of–the art facility will be an exciting addition to our existing medical district. Future medical professionals will continue to be trained there, and care, compassion and dignity will be provided for patients, their families and our community, as is the heritage of this site. As a child, I remember the large symbol of the American Lung Association that was embedded on the west wall of the CMH building, prior to it being remodeled and covered with the present-day stucco façade. As the building is being demolished, I will be watching in hopes of seeing that symbol one more time. I will reflect upon all of the medical caregivers, hospital staff, patients and compassionate services that were provided within its walls. James H. Tolley, M.D., MAT, FAAFP Assistant professor, MUSC Department of Emergency Medicine, Emergency Department director, Charleston Memorial Hospital (1996 to 2008) Source: Waring Historical Library Archives Editor’s Note: This letter is a reprint of an original letter to the editor submitted by Dr. Tolley that ran in The Post and Courier on Jan. 2. It is reprinted with his permission.
photo provided
CHP construction began in 2003. For information about CHP events and the ongoing celebration, visit: http://academicdepartments. musc.edu/chp50. now,” Kautz said. “We’re reaping the benefits of our increased reputation in research to recruit some extraordinary faculty. The College of Health Professions has, in many ways, put MUSC on the map nationally in terms of rehabilitation research.” Where does Saladin see CHP going in the next 50 years? Students will drive future changes, she said. “Students want more accessibility and freedom in the way they learn.” One way to provide that is through online education. CHP was one of the first colleges at MUSC to invest in distance and online education and Saladin anticipates expanding that investment going forward. “We’re looking for ways to be innovative in how we educate our students, and we’re looking for ways to reduce student costs,” she said. “The cost of tuition is becoming exorbitant across the country for all health professions, so it’s important for us to look for ways to reduce the cost of health care. How can we use technology to facilitate that? That’s a question we’re always asking ourselves.” CHP currently has three distance education programs: master of science in health informatics, master in health administration and doctor of health administration, and it currently has proposals pending to add several more. These programs serve students from across the state and country. Together with the college’s innovative research initiatives, these programs are helping to build the reputation of MUSC on a national level. “I’m really excited about where we are as a college,” Saladin said. “I’m even more excited about where we’re going.” To celebrate its 50th Anniversary, the College will hold a gala March 19 at Founders Hall at Charles Towne Landing. Tickets will be $75 per person and space is limited. CHP is also sponsoring a lecture series to highlight collaboration, creativity, diversity and excellence within the college. The lectures will run throughout 2016, with the first scheduled for January 27 at noon in the Storm Eye Auditorium.
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