Volume 25
Number 4
February 21, 2014
Hospital of the University of Pennsylvania
Ringing the Bell:
Recognizing an Achievement
As pancreatic cancer patient Verolga Nix-Allen walked slowly through the waiting room of Radiation Oncology in the Perelman Center – flanked by her son and daughter – the room erupted with clapping, smiles, and tears. Wearing a graduation cap and gown, she arrived at a large bell and pulled its cord sharply. The sound rang out. In other departments, this might be an unusual event but not here. This celebration happens, on average, 10 times a week and it’s always for good reason: It signifies that the patient has completed radiation treatments. Office supervisor, Chris Hartman has seen many variations of the ringing. Some are low key – a patient comes with one or two family members – while others are much more elaborate. For example, NixAllen held a special celebration — with many well-wishers — during which her choir sang “I’m a Survivor,” a composition she had written. Another patient “belonged to a motorcycle club and they all came!” Hartman said. “People bring balloons, roses… It’s incredible.”
The bell ringing is truly a rite of passage for these patients who endure so much to fight their cancer.
“It helps people mark a successful completion but also recognizes that just making it through the weeks of treatment is an achievement,” said Theresa Myers, BSN, RN, OCN, nurse manager. “It’s hard to come here, every day, for weeks, getting radiation and coping with side effects. Patients watch others cross the finish line and look forward to when it’s their turn.”
Inside Smart Diagnosis Now Possible with Smartphones.....................2
`` Verolga Nix-Allen finished her radiation treatment by ringing the bell and celebrating with family and friends.
Hugs for the patient are a big part of all ringings — from family members and friends, other patients, and staff. “We all get to know each other well. There’s a great deal of camaraderie.” Hartman said. Indeed, patients who have finished treatment will often come back to say hi during follow-up visits or to witness other patients they’ve befriended ring the bell. Ending treatment is bittersweet, said patient John Day, who recently completed treatment. “I’m excited that I’m done but I’ll miss the radiation team who made the treatments so much easier, the other patients in the waiting room, the front desk staff… So many great people.”
Navigate Your Health...Safely 3
Ringing the bell wasn’t always a part of radiation treatment at Penn. When patient Frank McKee came for treatment in 2011, “your treatment ended and that was it. It was such an empty feeling. Your whole life changes during treatment. You become a part of a community…and then it’s over.”
eMed Students Sponsor Blood Drive................................4
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A New Patient- and FamilyCentered Initiative.....................3
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Ringing the Bell:
Recognizing an Achievement
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After hearing about another proton center that used a bell to recognize completion, he decided this was exactly what Penn needed. A lifelong sailor, he donated the bell from his own boat. It took a while to put the bell into action (it was so big, it required HUP’s carpentry shop to build a stand to hold it!) but by 2012, the ritual was on its way to becoming a tradition. And not only outpatients get to ring the bell. “We’ll wheel patients out on a stretcher if they want to ring the bell,” Hartman said. There is also a handheld bell for those who cannot make it out to the main lobby. One person, who heard a ringing when he arrived for a family member’s first radiation treatment, explained its impact in a letter. On exiting the elevator leading to Radiation Oncology, “we found a large group of people clapping and cheering. Not the atmosphere we were expecting… It was memorable, as I type I am tearing and will probably have some difficulty reading this out loud… There is a bonding going on, very positive in nature, always a nod or a smile, never a negative feel... I have seen about five or six now and each time I’m elated to the point that I may be leaning a little more optimistically.” “The bell ringing is truly a rite of passage for these patients who endure so much to fight their cancer,” said Amy Avellino, MS, RN, director of Nursing in Radiation Oncology. She recently brought a group of “seasoned clinicians” on a tour of the department. Ending the tour in the main waiting room, the group was able to witness a bell ringing. “The group I was with all stopped and gazed at the display of triumph and joy on the gentleman’s face with his family taking pictures. When the bell actually rang and the entire room yelled out with cheers, there was not a dry eye in the house.” `` Patient John Day was excited on his last day of treatment but will miss “so many great people.”
Why a Bell?
A plaque on the bell stand explains HUP’s bell ringing tradition:
Bell Ringers As the sailing ships of another generation relied on their ship’s bell to signal their position in the fog, may this bell enable you who ring it to navigate your way through life free of cancer.
Smart Diagnosis Now Possible with Smartphones Thanks to a new smartphone app to diagnose skin conditions, Penn dermatologists are providing special care in Jonathan Lax Center, Sayre Health Center, and the nine city health centers operated by Philadelphia’s Department of Public Health. Not only are they treating patients who may not otherwise receive this care, each case is an educational opportunity for dermatology residents.
How Does It Work? When patients enter the health clinic, their primary care provider photographs the skin condition and sends that, along with relevant clinical information, to a team of resident and attending dermatologists at Penn Medicine. After a resident evaluates the case, the diagnosis and treatment recommendations are reviewed by an attending and sent to the primary care provider. Residents can also view the attending’s response and receive immediate feedback on their recommendations. Because the technology uses cloud servers, everything is synced automatically and nothing is saved on the user’s phone. Now a Penn Medicine CAREs grant helps ensure those using the app are using it most most effectively. It supports hour-long training sessions for providers at each clinic, during which Caroline Nelson, a fourth-year Perelman School of Medicine student, demonstrates how to use the program’s software. She also explains the proper
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way to consent patients for an active research study evaluating teledermatology’s impact on patient care and access to Philadelphia dermatologists. Penn Medicine dermatologists see all patients who exhibit more complex cases and require an on-site visit. The grant also provides digital cameras (for the web-based version) for clinics that do not have cell phones available.
How Did it Begin? Carrie Kovarik, MD, of Dermatology and Dermatopathology, began her journey with this technology in 2007, partnering with a dermatologist from Austria to create africa.telederm.org. The website is still a valuable resource, enhancing access to dermatology services in African countries that have few dermatologists available.
Navigate Your Health….Safely Patient Safety Awareness Week is an annual education and awareness campaign for health-care safety. This year’s theme — Navigate Your Health… Safely — recognizes the advances made in the patient safety arena while acknowledging the challenges that remain…and committing to work on them, every day. Clinical Effectiveness and Quality Improvement (CEQI), in partnership with several departments, is leading Penn Medicine’s efforts to showcase our strong commitment to the safety of our patients, our community and our staff.
`` The new Care Partner Shower Facility is a big plus for family members of HUP patients spending the night in the hospital.
A New Patient-and Family-Centered Initiative HUP’s policy promoting family presence and participation in care enables a patient’s loved ones to spend the night. While the presence of these “Care Partners” improves the patient experience, having no dedicated space to attend to personal hygiene needs can be hard on family members. Indeed, a family member of an ICU patient, who lives three hours away and had been at HUP for a few days, noted, “I brought toiletries with me but there was not even a sink here I could use. The situation is hard enough without this concern.” Now, that has changed. HUP has created a Care Partner Shower Facility for family members of HUP patients. The full bathoom includes a shower and access to towels and indivual bottles of shampoo and soap. A unit-specific passcode, provided to family members by unit secretaries or clinical nurses, provides access to the room, which is located on 1 Gates. The multidisciplinary project has proven very successful. In the first two weeks of its opening, 24 family members have used the facility. The MICU family care partner, who was the first to use the shower, gave it a thumbs up. “It was incredible!”
HUP’s annual Patient Safety Awareness Fair will be held on Wednesday, March 5, from 10 am to 2 pm. Tables on the Ravdin Mezzanine will offer information on several topics for HUP’s health-care providers, including infection control, look-alike medications, fall prevention, and care for the care provider. Information tables for patients and visitors, located on the atrium upper level in the Perelman Center, will provide information on hand hygiene, preventing skin cancer, fall prevention, drug interaction and other safety topics. In addition to the information tables, a Performance Improvement in Action exhibit will be on display in Perelman. A Penn Medicine Safety Net refresher training will take place on March 5 and 6, from 9 am to noon in the Founders 2 training room. To learn more about lectures and additional activities during the week, go to http://uphsxnet.uphs.upenn.edu/ceqi/.
That program started the loop of sending clinical information and photos via phone to clinicians and receiving the answer back through the phone, without a physical Internet connection. “Now you can send encrypted messages through your phone and securely transmit data,” she said. After success in other countries, the group brought the technology to the United States. In 2012, a company contracted by the American Academy of Dermatology developed a HIPAA-compliant and secure iPhone, iPad, and Internet system for use on personal phones. This platform, implemented in Philadelphia health centers in December 2012, is enjoying growing popularity. “This program allows patients without access to specialty care to receive consultations in an effective manner,” said Kovarik. “Primary physicians are able to quickly and easily send consults using their personal phones, and most patients are able to be managed with their primary care team. This technology has the potential to revolutionize the way we provide care.”
`` (L. to r): Carrie Kovarik, MD; William James, MD, vice chair of Dermatology; and Caroline Nelson show the evolution of tools used in Telederm’s success.
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eMed Students Sponsor Blood Drive Students from Penn’s Engineers in Medicine (eMeds) program sponsored a blood drive at the Penn Medicine Blood Donation Center, which resulted in 40 Penn students coming to donate. The group is planning to continue promoting these blood collections to the University student body, helping the Center meet the hospital’s demand for blood. Indeed, each year HUP patients need approximately 63,000 units of blood products! You can also help ensure a continuous, uninterrupted supply of blood for our patients. Donating blood is easy — the actual donation part for whole blood only takes about 10 minutes. Your body will replace the donated blood within one month. People can safely donate blood every two months. Penn’s Blood Donation Center also has a Platelet Collections Program, in which apheresis is used to specifically collect platelets. This blood component is essential to patients undergoing bone marrow transplantations or receiving many forms of chemotherapy. It is a longer donation process – closer to an hour – but each platelet apheresis donation provides 12 times as many platelets as does a whole blood donation. Located on the Penn Tower Bridge level, the Center is open 8 am to 4 pm weekdays. To schedule an appointment to donate, go to PennMedicine.org/give-blood.
Mark your calendars for the first annual Million Dollar Bike Ride on Saturday, May 3, to raise money for rare disease research. The ride is organized by the Penn Center for Orphan Disease Research and Therapy and Rare Disease Cycling. The event will start and finish at Highline Park (31st and Chestnut) on Penn’s campus. There are 3 route options — 11, 35 and 73 miles. All participants will receive free gear, including a Million Dollar Bike Ride jersey. Individual cyclists can register and raise money for their specific orphan/rare disease foundation. For more information and to register, go to www.milliondollarbikeride.org.
Date: Friday, February 28, 2014 Time: 12:30 pm Topic: Spotlight on Nutrition: Using food to help manage symptoms You can access the chat at oncolink.org/webchat.
Helping People All the Time
Congratulations to October’s winners in the Helping people All the Time raffle. If you’d like to submit someone’s name, simply go to pennpoint.uphs.upenn.edu/sites/HUP/hupse and click on “HUP Service Excellence Nomination” and then “New” at the top of the chart. You can also submit someone’s name on a paper form available at various locations throughout the hospital. Guy Bodarky. . . . . . . . . . . . . . . . . . . . . . Respiratory Katie Burke. . . . . . . . . . . . . . . . . . . . . . . . . Nursing Nathaniel Butler . . . . . . . . . . . Telemetry Transport Carrie Defeo. . . . . . . . . . . . . . . . . . . . . . . . Nursing Nancy Dugan . . . . . . . . . . . . . . . . . . . . . . . Nursing Rebecca Farrell. . . . . . . . . . . . . . . . . . . Transplant Bill Gibson . . . . . . . . . . . . . . . . . Transport Services Azael Hernandez. . . . . . . . Pulmonary Diagnostics Tra’chelle Lewis . . . . . . . . . . . . . . . . . Admissions Veronica Malenka. . . . . . . . . . . . . . . . . Respiratory Yvonne Mapp . . . . . . . . . Oncology Nursing Support Marcia McNeely. . . . . . . . . . . . . . . . . . . Radiology
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Adrianna Messina. . . . . . . . . . . . . . . . . Nursing Bridget Morrin. . . . . . . . . . . . . . . . . . . Radiology Sunny Pallose. . . . . . . . . . . . . . . . . . . . . Nursing Donna Rucci. . . . . . . . . . . . . . . . . . . . . Radiology Samantha Saia. . . . . . . . . . . . . . . . . . . . Nursing Pasquale Sferra. . . . . . . Materials Management Tyrone Taylor . . . . . . . . . . . . . . . . . . . . . Nursing Trudy Thomas. . . . . . . . . . . . . . . . . . . . . Nursing Erin Tolosky . . . . . . . . . . . . . . . . . . . . . . Nursing Katie Trifiletti . . . . . . . . . . . . . . . . . . . Respiratory John Truitt. . . . . . . . . . . . . . . . . . . . . . . . . . . CRM Jim Trunkwalter. . . . . . . . . . . . . . . . . . Radiology David Yost. . . . . . . . . . . . . . . . . . . . . . . Radiology
HUPdate Editorial Staff Sally Sapega Editor and Photographer Tara Skoglund Designer
Administration
Susan E. Phillips Senior Vice President, Public Affairs Holly Auer Director of Communications Contact HUPdate at: 3535 Market Street, Mezzanine Philadelphia, PA 19104 phone: 215.662.4488 fax: 215.349.8312 email: sally.sapega@uphs.upenn.edu
HUPdate is published biweekly for HUP employees. Access HUPdate online at http://news.pennmedicine.org/inside/hupdate.