MUSC Catalyst 3-27-2015

March 27, 2015

MEDICAL UNIVERSITY of SOUTH CAROLINA

Vol. 33, No. 30

Ebola drill was no March Madness

Inside TelehealTh

7

Technology aids in emergency preparedness.

Above: C.J. Kopeck and Brandy Pockrus inspect all aspects of Sethe Wetter’s Personal Protective Equipment (PPE). Right: As paramedics Susan Stockdale opens the Isopod, Seth Weller and C.J. Kopeck stand ready to transfer the mock Ebola patient Dr. Mary Favaro.

WOmen’s hisTOry photos by J. Ryne Danielson, Public Relations

By Mikie Hayes Public Relations

S

ome might say March 20 was a rather dreary Friday morning. Still, even a chilly, overcast Friday is better than most days when it signifies the end of the work week — especially during March Madness.

And on that day, members of MUSC’s specialized medical team would be guarding their own zones, confident in the knowledge that the best offense to fighting an infectious disease is a strong and steady defense.

This is a drill, Only a drill An hour away from MUSC, at Georgetown Memorial Hospital, a 62-year-old woman entered the Emergency Department early that morning feeling sick. Two weeks prior, she had spent time in a country that had, in late 2014, been at the epicenter of the Ebola epidemic with the third highest incidence in the world — the West African country of

Guinea.

After returning stateside, she drove to Andrews to visit family. She started running a fever and twice had to quickly pull her car over at roadside gas stations, suffering extreme bouts of diarrhea.

Her dates of travel and symptoms fit within the 21-day incubation period for Ebola, and being that her symptoms seemed consistent with those of Ebola, she was further screened.

Any patient in South Carolina who recently traveled to West Africa and exhibits a fever is to be isolated and the Department of Health and Environmental Control notified immediately. Having met the Centers for Disease Control and Prevention criteria for possible Ebola infection, the staff placed her in isolation and informed DHEC, which in turn instructed MUSC to send Meducare to safely transport her in the Isopod from Georgetown to MUSC for further treatment.

That morning, the MUSC notification cascade had alerted appropriate medical leadership to the possibility of an Ebola patient being brought to MUSC. The Ebola protocol was initiated.

Kathy Lehman-Huskamp, M.D., director of Emergency Preparedness and medical director of the Specialized Medical Unit, and Brian Fletcher, R.N., disaster preparedness program manager, assumed oversight and coordinated processes from MUSC’s control room. Janet Byrne, nurse manager of the Specialized Medical Unit (SMU), mobilized the Specialized Medical Team (SMT), which would arrive around noon to begin the very specific regimen.

Via a large, wall-mounted computer screen, Lehman-Huskamp and Fletcher were able to see and consult with Georgetown staff in both the isolation room with the patient as well as outside the room, thanks to MUSC’s telehealth communications system created

See Drill on page 6

8

New career path changes nurse’s life.

3 Safe Kids 4 Research Impact 5 Meet Abid T h e C aTa ly s T O n l i n e

http:// www.musc. edu/ catalyst

2 THe CaTalysT, March 27, 2015

PeoPle

Around Campus

evenTs

Kathleen Brady

Cooper River Bridge Run

Kathleen Brady, M.D., Ph.D., Associate Provost for Clinical and Translational Science, director of the S.C. Clinical and Translational Research Institute and Distinguished University Professor, was selected to receive the 2015 Marian W. Fischman Lectureship Award from the College on Problems of Drug Dependence. The award is gven to a female scientist who has made significant contriubtions to the drug abuse field.

The 38th Cooper River Bridge Run will take place on Saturday, March 28. MUSC’s Center for Drug and Alcohol Programs, one of the charity connections for this year’s event, needs 60 volunteers to assist at the start line.

A free T-shirt will go to all volunteers.

Contact riverssy@musc.edu.

Terry Day

Terry Day , M.D., professor and the Wendy and Keith Wellin Endowed Chair in Head & Neck Surgery, served as president of the American Head & Neck Society from 2013-2014.

His AHNS presidency culminated with their annual meeting featuring keynote speakers Michael Douglas, Catherine Zeta-Jones and Bud Selig. Day addressed a crowd of over 2,000 attendees with

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

Purses for Preemies photo provided

MUSC social workers gathered March 3 to read a proclamation signed

by City of Charleston Mayor Joe Riley and celebrate National Social Work Advocacy Day. Pictured are: Sherrell Thomas-Nelson, from left, Kesha Wall-Graham, Kelly Leighty, Elizabeth Britt, Erin Courtney, Mary Catherine Dubois and Renea Bligen. Not pictured are Natasha Davis, Joyce Rivers-Miller, Catherine Mattox, Kelly Finke, Cynthia Matthiesen, Angel Harmon and Tiombe Plair. his speach, “The Physician-Patient Relationship: the Ultimate constant in Head and Neck Oncology.”

C. Morrison Farish, M.D.

C. Morrison Farish, M.D., Department of Pediatrics, is the recipient of the William Weston Distinguished Service Award for Excellence in Pediatrics from the University of South Carolina. The award recognizes statewide pediatricians who have made contributions to pediatrics and health care.

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.

Gail Stuart

Gail W. Stuart, Ph.D., R.N., dean of the College of Nursing, has been appointed to serve a four-year term on the National Advisory Council of the Substance Abuse and Mental Health Administration. Stuart, a pediatric nursing expert, is the only nurse serving on this national board.

Organizers are seeking donations of gently used purses to be sold for the March of Dimes fundraising event from 10 a.m. to 2 p.m., Friday, April 17 in the portico. There are several ways to donate. Drop off locations are in the Children’s Hospital volunteer office, BSB room 443, ART Mezzanine near 105M, Rutledge Tower, RT 375 or Harborview Tower, room 105.

For information, call 792-2112 or messiere@musc.educ.edu.

YES Family Fund March 31 is the deadline for YES Family Fund Grant applications.

If you’re looking to fund a special program or research opportunity, apply for your grant today. The YES Family Fund provides grants to projects that impact the mission of MUSC through education, patient care and research.

Apply at http://tinyurl.coml2g4yfb.

THe CaTalysT, March 27, 2015 3

Safe Kids event to help kids stay active, healthy and safe

By Jennifer WinkelMann Trauma/Injury Prevention and Trident Area Safe Kids coordinator

M

ost people are surprised to learn that preventable injuries — things like car crashes, drownings, fires and falls — are the leading cause of death for kids in the United States. Safe Kids Trident Area is working locally to help change that.

On Saturday April 4, Safe Kids Trident Area, which is led by MUSC Children’s Hospital, will be hosting Safe Kids Day outdoors at the North Charleston Coliseum from 10 a.m. to 3 p.m. The free, family event, sponsored locally by Motley Rice Law Firm and MUSC Children’s Hospital, will celebrate kids and educate attendees about preventing injuries and saving lives.

Interactive activities will be hosted for kids and caregivers to learn about ways to stay safe at home, at play and on the way. Kids can take a "dip" in a ball pit pool after learning how to properly fit a life jacket; take a ride through a bicycle skills course with a helmet; learn to stay safe in a fire; show their knowledge about getting hydrated and stretching before playing sports; and take the home safety challenge.

Caregivers can also learn about installing car seats and making sure a child is as safe as possible when riding in a vehicle. That’s just some of the fun that will be going on.

Safe Kids Day is a national campaign being celebrated in more than 150 communities across the country throughout April and May. This is the first year the event is being held in the Tri-county area. Through Safe Kids Day, Safe Kids Trident Area is raising awareness and resources to support the work it does every day to keep kids safe.

Join Safe Kids Trident Area for Safe Kids Day to help keep kids active, healthy and safe so they can grow up to

photos provided Above photo: A City of Charleston police officer reviews some safety tips with participants prior to the start of a bicycle skills course.

Right: A mother demonstrates how to secure her child in a car seat as part of a child safety event. do all the great things kids were meant to do. Proceeds from Safe Kids Day support the injury prevention efforts of Safe Kids Trident Area and its partner, Safe Kids Worldwide, a leading global nonprofit organization dedicated to preventing childhood injury.

Funds raised enable the team to reach more families with life-saving prevention information, expand existing programs and launch new programs to protect kids in Charleston, Berkeley and Dorchester counties. Safe Kids Day is presented by Nationwide Insurance and supported nationally by founding sponsors Johnson & Johnson, FedEx, Chevrolet, Kidde Safety Products, and Tide.

Join the campaign to keep kids safe from preventable

Nominees sought for faculty service award

A

Nominations for the MUSC Foundation’s Distinguished Faculty Service Award are being accepted.

This annual award was enacted by MUSC’s board of trustees to recognize and honor faculty members of the institution who, over a substantial portion of their careers, have provided exceptional and sustained service and contributions in teaching, research, health care or public service to the university and the citizens of South Carolina.

Up to three awards may be made and each honoree will receive a $3,000 contribution. Nominations from faculty, staff and students will be accepted.

To nominate someone, a written justification to

include a typed or printed narrative of no more than two single-spaced pages directly addressing the contributions made by the nominee to MUSC and those the institution serves must be included. A copy of the nominee’s curriculum vitae or professional resumé also should be enclosed. Additional letters of endorsement are encouraged in order to demonstrate the breadth of the nominee’s contributions.

This deadline is April 24. For information, contact 792-2228 or email higakimc@musc.edu.

Nominations should be submitted to the attention of Mark S. Sothmann, Ph.D., vice president for academic affairs and provost, 179 Ashley Avenue, Colcock Hall, MSC 002, MUSC.

injuries and help Safe Kids Trident Area reach their goals by making a tax deductible donation at https:// give.safekids.org/trident. Any level of support is truly appreciated. Individuals can also create a fundraising page to inspire friends and family to take action to support Safe Kids Trident Area. For more information, visit http://on.fb.me/1zPFoMD.

Pink Out Night for the Cure Free Tickets

2015 Family Circle Cup Wednesday, April 8

MUSC Health has reserved 3,000 tickets for MUSC employees for Request tickets at https:// ociois.quickbase.com/db/biu55879a.

Outstanding Clinician Award nominations being accepted Nominations for the 2015 MUSC Foundation’s Outstanding Clinician Award are being accepted. The award honors fulltime faculty who have made outstanding contributions to patient care at MUSC. Currently active clinicians who commit a significant portion of their time caring for patients in ambulatory or inpatient settings are eligible for this award. Nominees should be role models for residents, students and their faculty colleagues. The deadline for nominations is April 24. Nominations may be submitted to Mark Sothmann, Ph.D., 179 Ashley Ave., Colcock Hall, MSC 002, MUSC.

4 THe CaTalysT, March 27, 2015

Research Impact Dr. Patrick Mulholland q Assistant professor, Department of Neurosciences and Psychiatry & Behavioral Sciences q NIH RO1 award: $225,00 (Year 1 cost) q Sept. 5, 2014 to June 30, 2019

Patrick Mulholland, Ph.D., assistant professor, Departments of Neurosciences and Psychiatry & Behavioral Sciences, received an R01 award to study, “Kv7 Channels and Heavy Alcohol Consumption.”

Current FDA–approved pharmacotherapies for treating alcohol use disorders (AUDs) cause deleterious side effects and are only effective in a subset of individuals. This signifies an essential need for improved medications.

Emerging evidence suggests that anticonvulsants are a promising class of drugs for treating individuals with AUDs. Mulholland’s preliminary data demonstrate that the anticonvulsant Retigabine, KCNQ (Kv7) voltage–dependent K+ channel positive modulator, significantly reduces drinking in two rodent models of voluntary alcohol consumption.

This study will advance knowledge on alcohol– associated neuroadaptations and help scientists understand, at a sophisticated level, the role of Kv7 channels in alcohol drinking.

Jordan J. Elm, Ph.D., assistant professor, Department of Public Health Sciences, plans to study “Established Status Epilepticus Treatment Trial (ESETT) — SDMC” as part of a multi–site Phase 3 clinical trial.

A Phase 3 clinical trial is conducted to provide

a definitive answer regarding the safety and

Heterotopic Ossification Following Extremity

efficacy of an intervention or to compare the effectiveness of two or more interventions.

Blast Injury with a Biomarker Assay.”

Heterotopic ossification (HO) is the formation

Elm serves as the director of the Statistical

of mature bone in the soft tissues and is a frequent complication after orthopaedic trauma;

Dr. Jordan J. Elm q Assistant Professor, Department of Public Health Sciences q NIH U01 Award: $365,374 (Year 1 cost) q Sept. 30, 2014 to Aug. 31, 2019

it is commonly seen after total hip replacement and acetabular fracture in civilian practice and occurs in up to two–thirds of patients who sustain severe extremity wartime wounds and multiple trauma by blast injury.

In recent military conflicts, there has been a marked increase in the number of combatrelated blast amputations of one or more

and Data Management Center. This project is linked with the proposal titled, “Established

extremities. Advanced battlefield evacuation capabilities and widespread use of body armor

Status Epilepticus Treatment Trial,” from the University of Virginia (Jaideep Kapur, contact

have substantially reduced mortality for soldiers with these severe limb–compromising events.

principal investigator).

These applications jointly describe the ESE

Having survived the initial trauma and limb amputation, several possible complications

treatment trial, which is designed to determine the most effective and/or the least effective

often arise in the residual limb related to HO including pain, overlying skin and muscle

treatment of ESE among children and adults by comparing three arms: fosphenytoin (FOS),

breakdown, a poorly fitting prosthesis, reoperation for revision of the amputated part,

levetiracetam (LEV), and valproic acid (VPA).

and delayed rehabilitation that can compromise overall function of the residual limb and jeopardize return to productive civilian life.

Dr. Vincent D. Pellegrini q Professor and Chair, Department of Orthopaedics q DOD award: $174,662 (Year 1 cost) q Sept. 30, 2014 to Sept.

29, 2016

With Department of Defense funding, Vincent D. Pellegrini, M.D., professor and chair, Department of Orthopaedics, is studying “Early Identification of Molecular Predictors of

The research objective is to identify a biomarker that can be used as an early diagnostic test by military doctors to identify patients that are likely to form HO following orthopaedic trauma related to extremity blast injury in the battlefield setting.

The Catalyst’s Research Impact column showcases the research community’s grant activities. For information about awards, visit the Office of Research & Sponsored Programs’ Monthly Reports at http:// academicdepartments.musc.edu/research/orsp/ reporting/ or email stories to research@musc. edu.

THe CaTalysT, March 27, 2015 5

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Drill Continued from Page One

by David McSwain, M.D., a pediatric critical care doctor, and Michael Haschker, a senior network engineer.

Haschker had the screen divided into five sections, which enabled the teams in both hospitals to see the three biohazard zones located in MUSC’s unit, where the SMT would be working with the patient, as well as the area surrounding the hospital entrance where the Meducare team would arrive and wheel the patient in the isolation pod (Isopod) from the ambulance to the SMU. MUSC’s specialized medical team is a specially trained cadre of health care providers who have volunteered to be on the front line during biohazard events such as those related to potentially fatal viruses like Ebola, SARS, MERS Co-V, Enterovirus-D68 or even bio-terrorism.

The team has been trained specifically in Ebola and infection control practices, biohazard waste management and core team concepts and practices.

Team members also are thoroughly trained on how to go through the painstaking process of suiting up and taking off personal protective equipment (PPE), or as it is called in medical terminology: “donning and doffing.” Properly donning the PPE is key to protecting team members against fluids that transmit the Ebola virus.

Correctly doffing a PPE that could be contaminated with the virus is equally critical.

The meticulous process requires partners to go through a 33–step check– list. The team uses the buddy system as it provides an extra set of eyes, at a time when lives literally can be at stake. They are trained to be deliberate and steady in the process. “If it’s happening fast – it’s happening wrong,” said LehmanHuskamp.

Lehman-Huskamp said that currently there are more than 60 employees on the SMT and that number is growing as more specialties become involved.

33 nurses – all ICU-level, 12 physicians and eight respiratory therapists have all volunteered to serve on the team.

In addition, 11 Meducare personnel are on the team: seven EMTs and four paramedics. She added that administration plays a vital role on the

photos by J. Ryne Danielson, Public Relations

Top left photo: Infection Prevention & Control manager Linda Formby, left, and Catalyst reporter Mikie Hayes stand in the yellow zone before the patient arrives, receiving updates on the Ebola drill. Above: Derrelle Green, hospital security officer, leads paramedic Willie Brown and the Isopod to the SMU. Bottom left: Respiratory therapists David Crout, center, and Chris Larimore, left, discuss checklists while Brandy Pockrus and Sethe Wetter prepare for the donning process. team, as Patrick Cawley, M.D., chief executive officer, and Danielle Scheurer, M.D., chief quality officer, are both physicians on the SMT. “I refer to this group as rock stars — they are the Navy Seals of the hospital.

Working with them has truly been one of the honors of my career. It’s an amazing group of people,” she said.

As each member of the SMT arrived, they received their marching orders and calmly went into preparation mode. No drama. No rushing around. It was as if there was all the time in the world. In actuality, it was the sign of professionals who had prepared again and again until they were comfortable drawing blood, intubating a patient or inserting a Foley catheter while wearing a Hazmat suit and gloves.

C.J. Kopeck, R.N., who works in the Surgical Trauma ICU, volunteered for the team because he felt his training lent itself to the job and prepared him for this type of work. Having served as an Air Force flight medic, his tours took him to many spots around the world, including Afghanistan, Kuwait, Bahrain, and Africa. He was no stranger to frontline action.

He believes their training keeps them out of harm’s way. “I think the perception that this is a dangerous or stressful thing to volunteer for is a bit misleading. The specialized equipment and extreme isolation precautions we use can be intimidating from an outside perspective, but as a team member, I am fully confident in my training, equipment and teammates. We live by

checklists and utilize crew resources in a way that mitigates a lot of the risk associated with caring for these types of patients. It all comes down to the fact that there is a potential that someone will need our help, and I’m glad I can be there to provide it.”

Brandy Pockrus, R.N., who works in the Medical ICU and serves as the clinical unit leader for the SMU, also brought a similar skill set and confidence to the team. “I guess I have always had an affinity for high stress situations. I was a volunteer firefighter for six years, and I have been an ICU nurse for about seven years. Once the U.S. started treating Ebola patients, I started thinking that it would be nice if MUSC had that

See Drill on page 10

THe CaTalysT, March 27, 2015 7

Telehealth brings added dimension to Ebola preparedness

Michael Haschker watches live feeds of a mock Ebola patient in a nearby isolation room with Brian Fletcher in the control room, and referring physicians at Georgetown Hospital, ensuring MUSC’s telehealth technology works perfectly in a real world scenario.

By J. ryne Danielson Public Relations

D

isaster program manager Brian Fletcher, R.N., Kathy Lehman-Huskamp, M.D., medical director for disaster preparedness, and Michael Haschker, IT manager for MUSC Telehealth, crowd into a small control room on the first floor of the main hospital. On the wall is a flat screen showing a patient being sealed into a bio–isolation pod at Georgetown Memorial Hospital, 60 miles northeast of Charleston. Doctors suspect the patient has Ebola and every precaution is being taken; Fletcher is making sure of that.

“We’re able to see what’s actually going on at Georgetown Hospital, in their emergency department,” he explains to MUSC staff. “You can see our folks in the room have just retrieved the patient and put her into the bio isolation pod. We have two-way audio and video. We can talk to them; they can talk to us.”

As the closest dedicated treatment center, MUSC is standing by to receive the patient. When she arrives by ambulance at the medical center, a little over an hour after leaving Georgetown, a team of nurses and a respiratory therapist are suited up and ready.

Like clockwork, the corridors are closed, the patient is wheeled into a specially prepared room, and the team takes over. The entire process is monitored and coordinated from the safety of the control room.

This time, it turned out to be a drill, but MUSC’s specialized response team didn’t know that. They performed as if it were the real deal, relying on their training and revolutionary new technology to keep everyone safe and ensure the best care possible for the patient.

From Uganda to South Carolina, telehealth is

Brian Feltcher and Kathy Lehman-Huskamp monitor a mock Ebola patient during a drill.

photos by J. Ryne Danielson, Public Relations

transforming medicine by expanding access to rural and impoverished areas and providing doctors powerful new tools to diagnose and treat patients at a distance.

Telehealth is benefitting a wide range of patients with an equally wide range of medical concerns, from weight management to infectious diseases.

When former Florida Governor Jeb Bush visited MUSC March 18 to brush up on health care policy for a possible presidential bid, telehealth was one of the subjects he was interested in.

“One of the things I want to talk to leadership of this incredible medical school about is technology,” he said.

“How do we harness technology so that people can be empowered to make better health care decisions for themselves? I think we’re on the verge of a revolution in information technology, combined with all sorts of medical devices, so that people don’t have to get in line to get care. They can empower their own care in ways that are pretty remarkable. Telehealth is part of that for sure.”

The South Carolina Telehealth Alliance, a partnership of MUSC Health, Palmetto Health, Greenville Health, and dozens of rural health care providers, is seeking to leverage this new technology to expand access and lower costs across the state. MUSC’s weight management center is using technology to teach virtual seminars and attend patients in remote, rural clinics. Doctors at MUSC are even helping to treat patients thousands of miles away, in remote areas of Uganda, using these new technologies.

But one of the most interesting applications of telehealth can be seen right here at MUSC, in the Specialized Medical Unit.

“In most telemedicine scenarios, doctors and patients are hundreds or thousands of miles apart,” David McSwain, medical director for Inpatient and Emergency Teleconsultation, explained. “Here, we’re connecting six rooms that are 20 feet apart.”

He continued: “When treating Ebola and other highly infectious diseases, taking the best possible care of the patient is paramount, but protecting our staff is equally important. That means limiting hands-on contact with the patient to a very select group of highly-

trained staff. Telemedicine provides an ideal means of doing that.”

Using high-definition cameras, doctors and nurses can see every part of the unit from a central control room. They are even able to monitor the patient miles away, at the referring facility, to coordinate care and make sure all teams are working together safely and efficiently.

“Telemedicine allows us to get the whole picture of a patient,” McSwain continued. “I can see the heart rate and blood pressure of the patient for myself. I can interact with the patient. I can listen, in real-time, with telemedicine-enabled stethoscopes.”

Using a detachable camera, McSwain said, he could even get close up views of patients, looking into their eyes or down their throats, all from the safety of the “green zone.”

But, as remarkable as the technology is, its potential is wasted if it doesn’t work. Michael Haschker is the person in charge of making sure telehealth lives up to its potential.

“We’re still refining our processes,” he said. “This hasn’t been done before. This is all new. That’s why we have drills like this, so that we can learn.”

He continued: “Georgetown Hospital has a telemedicine cart that was part of a grant-funded initiative for pediatric emergency medicine. We’ve put the cart to use in this case so we can watch our team, supervise how they follow procedures for donning protective gear and transporting the patient safely and securely. Our team verifies that our procedures and our protocols are sound, that we don’t have any holes in the system. Telehealth allows us to verify those procedures are being followed.”

Haschker believes telehealth technology will radically change medicine, making the delivery of health care less expensive and more equitable across the broader population.

“Telehealth allows us to provide services to areas we otherwise couldn’t reach,” he said. “Everything from Ebola patients in isolation units to patients in very rural areas in need of specialty care. That’s happening now.

And we’re only in the infancy of this technology.”

8 THe CaTalysT, March 27, 2015

Nurse with big dreams finds success along her journey

By CinDy aBole Public Relations

M

USC’s Joan Herbert has come a long way in her 40-year career as a

nurse.

The small town girl from Olanta in Florence County dared to dream big when it came to opportunities in her life. And nursing became her ticket to what has already been an exciting and fulfilling career.

Herbert’s commitment to patients, patient care delivery and advocating for employees are all attributes that distinguish her along with three other women leaders as part of this year’s Women’s History Month celebration at MUSC. The eldest of five siblings, Herbert always felt destined to do bigger things. a PersOnal Calling She was first exposed to hospitals and

the world of medicine in 1962 after her younger sister, Jane, was born with a congenital heart defect. Jane’s condition prompted her to see MUSC specialists on a regular basis. Sometimes, Herbert would travel the 100-mile journey with her parents for Jane’s checkups and annual heart catheterizations with her cardiologist. The experience, Herbert recalls, provided an early awareness of the impact an individual involved in health care can have on someone’s life.

When it came time for Herbert to think about her future, she somehow hoped she'd choose a career in health care that could support her sister.

Ultimately, she took a slightly different route.

A bright student, Herbert graduated early from high school and went on to pursue a BSN at MUSC’s College of Nursing. She became the first one in her family to attend college.

At MUSC, Herbert responded to her life's calling. Completing her clinical

photo by Anne Thompson, Digital Imaging

MUSC nurse and leader Joan Herbert has worked at MUSC for 24 years. rotations, she was attracted to psychiatric and home health nursing mostly because of its self-directedness and independent approach to patient care that was not primarily driven by prescriptive orders. “I saw in psychiatric nursing, nurses could

apply their own judgment and skills in a patient’s treatment plan.” At the time, she conducted her rotations at 10East and 10West of the University hospital — the dedicated psychiatric floor at that

See Journey on page 9

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WOunded WarriOrs dOminaTe ‘BaTTle Of CharlesTOn harBOr’

photos by J. Ryne Danielson, Public Relations

The Wounded Warrior Amputee Softball Team defeated the Citadel Alumni team 21 runs to 8 in the “Battle of Charleston Harbor,” Saturday March 21. The WWAST, who earlier visited with therapy students at the College of Health Professions, also played three innings against local celebrities from WCBD-TV 2, winning 13-3.

Journey

Continued from Page Eight

time, prior to the opening of MUSC's Institute of Psychiatry in 1988.

After graduating in 1975, Herbert worked one of her first jobs at Grady Memorial Hospital in Atlanta, Georgia.

Working in Grady’s Behavioral Health inpatient services area, Herbert saw how severely ill patients really were and noticed how quickly they would cycle through the system.

“Working in a place like Grady Hospital helped me understand that providing treatments for patients wasn’t enough to meet their real needs. In psychiatric nursing, clinicians must deal with a patient’s surroundings, support system and other resources to have a greater impact on a patient’s recovery,” Herbert said.

Her interests next led her to Baltimore, Maryland to earn a master’s degree in mental health nursing from the University of Maryland in Baltimore, where she specialized in family therapy.

Anxious to return to South Carolina, Herbert joined the College of Nursing as a psychiatric nursing instructor for

three years, followed by almost a decade working in various leadership roles in private, for-profit behavioral health specialty hospitals and facilities.

It was at this time that Herbert learned how health care’s fee-for-service billing model was shifting to managed care. She also observed how managed care worked rapidly in psychiatric care versus medical and surgical care. imPrOving The PaTienT exPerienCe In 1991, she began her career at the IOP, which at the time was among few mental health facilities in the state that offered comprehensive psychiatric and substance abuse treatment programs.

One example was electro-compulsive therapy for patients with severe depression who were unresponsive to other treatments.

Herbert thrived while working at the IOP, starting as a clinical nurse specialist working with treatment teams in a general adult unit to nurse manager of the child and adolescent unit. She also served as director of clinical services and then IOP administrator.

Among the highlights of her leadership were the facility’s reduced use

of seclusion and restraint as a means of behavior management among patients.

In the early 2000s, she and then IOP medical director Stephen McLeodBryant, M.D., set out to heighten understanding of and sensitivity to the experience of serious mental illness. This work led to the establishment of the first Patient and Family Advisory Council and “Listening Circles” so that providers and staff could hear first-hand how treatments and services were experienced by their recipients. In 2006, Herbert and another former IOP medical director Susan Hardesty, M.D., introduced the IOP’s Engagement Model of trauma informed care, which encouraged patient participation and engagement to establish a safe and trustful patient care environment. One of Herbert’s proudest moments was when the IOP was recognized by the National Alliance on Mental Illness SC as the South Carolina Psychiatry Hospital of the Year.

Herbert’s commitment also led to the IOP’s collaboration with the NAMI, to provide family-to-family education classes and consumer support groups on campus. Herbert has served on the NAMI SC board of directors and as the

state’s chapter president in 2012.

While at the IOP, she worked closely with fellow psychiatric nurse and nursing alumna Harriet Cooney, who today serves as IOP’s director of clinical services. Cooney recalls Herbert's leadership style, strong work ethic and commitment to improving the patient care and supporting the needs of her staff.

“Joan is a kind, thoughtful and caring person. She is continually devoted to improving the patient care experience and serving as an advocate for her staff. She has always been committed to improving the work environment and health care experience to create a partnership between staff, the patient and family,” said Cooney. “Joan’s legacy at the IOP will be that she prioritized the involvement of patients, families and employees in every stage of care.” aChieving qualiTy OuTCOmes In 2009, Herbert took on a new challenge and accepted the role of organizational performance director for the medical center.

See Journey on page 11

10 THe CaTalysT, March 27, 2015

Drill

Continued from Page Six

capability. When the events in Texas occurred, I became a bit worried that we were not prepared and started talking to my manager about what MUSC was going to do. Just a few days later, she announced that the hospital was looking for volunteers. Naturally I said, ‘That’s right up my alley. I’ll do it.’”

The team requires three to four members in the three zones: red, yellow, green. The hallway and areas in the control center are considered the green zone — people are free to move around; PPEs are not required in this area.

The team members in the yellow zone, signifying caution, are able to see in and serve as extra pairs of eyes —they are suited up and ready to step in to the red zone at any time. The high-definition camera system allows those in the green and yellow zones to closely observe the patient area or red zone.

The yellow and red zones are located in a non-pressurized set of rooms. The team members, in PPEs, enter into the yellow zone, an anteroom, and from there, can observe the patient and team member, or enter the red zones. The red zone includes the room in which the patient will be housed.

Before suiting up, the first thing the team must do is assign positions among themselves. For this occasion, Kopeck offered to run the red zone. That is a commitment of four hours in the room with the patient before he can leave, after which he would be replaced by Sethe Wetter, R.N., from the MICU, who had the yellow zone. Chris Larimore, a respiratory therapist, had the green.

Pockrus managed the dressing protocol and liaised with Lehman-Huskamp and Fletcher.

When the team is mobilized, Fletcher, Lehman-Huskamp or Pockrus will be in the unit 24 hours a day.

The PaTienT arrives While hospital security clear the halls, ensuring safe passage not only for the patient in the Isopod, but for all hospital employees and visitors as well, University Occupational Safety soaks a mat in bleach for the Isopod to roll over. With a team that looks like the Secret Service at a presidential event, security officers

Jim Bundo, supervising safety officer for the Meducare team, follows behind the Isopod announcing to hospital visitors that the event is a drill. stay in contact on walkie-talkies and ear pieces.

Meducare staff quickly and calmly guides the patient through hallways flanked with security officers to the SMU and into the red zone, where the team moves her from the Isopod onto a bed.

The two Meducare team members, jobs complete, doff their PPEs, while Kopeck, shrouded from head to toe in his PPE suit, hood and mask, peers through his visor while he speaks to his patient.

Kopeck’s job has just begun. He will be in the containment area with her for the next four hours, unaware that this has been a drill — an exercise aimed at making sure every person involved in the process is operating at peak efficiency and as prepared as humanly possible.

Why iT WOrks: CheCklisTs The MUSC SMT, according to Lehman-Huskamp, has gained a great deal of statewide attention predominantly because of the number and quality of their checklists. They have been invited to do presentations and participate on panels for disaster and emergency management panel. She explained, “We are a unit of checklists.

They change constantly because the team continually improves them. Our checklists are more refined than most hospitals.”

One of her proudest moments was when they discovered one of the protocols they had in place was something that not even Emory – which is considered a leader in biocontainment — had on its checklist. “We thought

about what happens when a team member goes down; they hadn’t.”

How MUSC’s program was developed differentiates it from other programs.

Many units around the U.S. were developed by infectious disease experts.

“With our unit,” she explained, “the initial development was through emergency management with a focus on hazmat. We developed it as a hazmat unit. Even how we zone our unit differs from calling them rooms. It enhances safety practices. From that perspective, you have to think about the potential hazardous outcomes — needle sticks, a hole in the suit, a team member goes down, PAPR tubing comes unattached, or battery dies when you’re in the red zone. Because we’ve taken this type of approach, we’ve thought about these things.”

Fletcher and Lehman–Huskamp both have hazmat backgrounds. “Brian likes to say, ‘This is like a journey to Mars,’ because it’s foreign in a lot of ways.

We’re treating a Third World illness in a First World building. We rely on clinical skills like we did back before we had advanced technologies.”

The team can look forward to another drill later this year. Each quarter refresher courses will be offered, where subjects such as other highly contagious infectious diseases and various biological terror agents will be covered. Fletcher said, “It comes down to training, training and more training." is anyOne sTill COnCerned?

It’s been several months since the Ebola scare dominated front pages and TV screens, not to mention the thoughts and fears of the American people.

In February there were three suspected cases being monitored in the Lowcountry. Currently, there is one patient at the National Institutes of Health who tested positive and 10 people throughout the U.S. being monitored as a result of high risk exposure while providing care in West Africa. Americans have largely moved on to issues that are more pressing in their own lives.

Still, new cases are still being reported in West Africa every day. Why does that matter in Charleston, South Carolina?

According to Fletcher, there are numerous reasons why we should continue to pay attention and the Medical University continues to prepare, train and retrain to deal with all types of highly infectious communicable diseases.

For one, every month container ships originating from West African countries such as Liberia and Sierra Leone dock in Charleston’s port, and members of the crew often disembark and head into town to enjoy all Charleston has to offer.

The port also receives ships from Asia and the Arabian Peninsula where other highly contagious viruses like the Avian Flu and MERS-CoV are prevalent. Not to mention, Fletcher added, the military continues to fly in and out of affected West African countries from Charleston, running support missions.

“The world, it seems, is a much smaller place,” said Lehman–Huskamp. She attributes the speed at which infectious diseases spread nowadays to global travel; people traveling far greater distances and more frequently than ever before. Before trans–oceanic ships or planes, a disease could only spread as far or as quickly as a person could walk or ride a horse.

Today, a disease spreading half a world away is something the U.S. health care community must pay attention to.

“With the world dealing with Ebola, bird flu, SARS, Mers Co–V, and Enterovirus–D68, MUSC leaders realized that there was value in not only having this specialized team, but in continually training and sustaining them. It’s the way of the future,” said Lehman-Huskamp.

THe CaTalysT, March 27, 2015 11

Journey Continued from Page Nine

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Her knowledge and background with surveys for measuring patient experiences and satisfaction are invaluable, said Betts Ellis, Institutional Relations administrator for the medical center. Herbert was already widely recognized for her expertise in coaching leaders and preparing staff to enhance the patient experience and Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) results, a survey tool used to measure overall patient satisfaction.

“I would characterize Joan as the ‘conscience’ of our organization,” said Ellis. “She’s the in–house subject expert on employee engagement and satisfaction. Joan has a gift for coaching leaders on best practices and methods to evaluate employee engagement and has been the point person for creating our organizationwide action plans.”

Herbert said the best part of her job has been working directly with managers and employees from Environmental Services to Central Supply, Hospital Patient Accounting to outpatient clinics, and all areas across the organization. “Each one of us has to be able to do our jobs well in order to provide quality care for our patients. And so far, the work that I do to support this has been fun,” she said with a smile.

Most recently, Herbert has been involved with the development of the medical center’s communications team. Her creativity and talent as a strong communicator has helped the team articulate key messages and contribute to the clinical enterprise communications plan.

In 2012, MUSC Medical Center Chief Executive Officer W. Stuart Smith asked Herbert to join Willette Burnham, Ph.D., MUSC director of Student Programs and Student Diversity, to attend the Association of American Medical Colleges and Georgetown University’s Strategic Diversity and Inclusion Management Certificate Program. The duo worked together, with the support of campus leaders, to draft a proposal for developing the institution’s inaugural Diversity and Inclusion Strategic Plan in fall 2014.

The actualized plan defines a strategy and provides guidelines for campuswide diversity and inclusion efforts and initiatives.

“I never anticipated having such a life-changing educational experience so late in my career,” Herbert said. “I can honestly say that the last three years have been among the most fulfilling to me. Not just for my career, but also my life. I have really enjoyed the opportunity to collaborate with so many new colleagues on campus. I have learned much, grown as a person and appreciate everyone who has helped to make that journey so meaningful.”

So what’s next for the veteran nurse, clinical leader and communicator?

Herbert looks forward to seeing MUSC’s employee engagement results reach the top 10 percent among

all U.S. hospitals (In 2014, those results were at 34 percent). “We’ve got some work to do,” she said. “Our organization is focused on laying down the groundwork to achieve this. MUSC is an exceptional organization already. When we achieve this level of engagement, enthusiasm and innovation, the services that we provide for our patients will be unmatched. I look forward to seeing a waiting list of people who can’t wait to join our organization because of the standard of excellence that we set for our patient care and the rewarding employee experience that comes from being part of the MUSC team.”

Editor’s note: In honor of Women’s History Month, The Catalyst is featuring women who make a difference at MUSC. A

New resource to share research successes Do you have exciting research news or findings that you would like to see shared with the MUSC community, other scientific institutions and/or the general public?

Send an email to research-comm@musc. edu with some basic information about what you would like to have shared, and you will be contacted by a communications expert who will help deliver your message to the appropriate audience(s).

12 THe CaTalysT, March 27, 2015

JeB Bush visiTs musC TO exPlOre PresidenTial run Former Florida Gov. Jeb Bush made an impromptu visit to MUSC March 18. He toured the campus with MUSC President Dr. David Cole, taking pictures to share with his mother, former first lady Barbara Bush, who attended Ashley Hall girls’ school, just east of the MUSC campus, in the 1940s.

After his tour, Bush met with Dr. Cole and university leadership to discuss health care policy, something he said he wishes to learn more about. Bush said his visit to Charleston was a first step in his “journey to explore the possibility of running for president.� photo by Sarah Pack, Public Relations

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