MMC U Connections
ne ws for the University of M aryland Medical Center
community
WINTER 2012
“They who dream by day are cognizant of many things which escape those who dream only by night." EDGAR ALLAN POE
ALL THROUGH THE Message from the CEO EXCELLENT CARE – ANY TIME, ANY DAY Of all the qualities that make UMMC a great hospital, one of the most important is our culture of delivering the highest quality
NIGHT
The staff is ready for anything, at any time. Hospitals across Maryland transfer critically ill patients to the University of Maryland Medical Center, where highly skilled teams are in action around the clock in cardiac surgery, stroke intervention, trauma, organ transplant, neonatal intensive care and other critical fields. Illness and injury don’t keep regular hours. And UMMC’s specialized intensive care units are a resource for the entire state and the Mid-Atlantic region. See pages 2 and 3 to look behind the scenes on a typical winter night at the Medical Center.
care in a personal way. Our staff members save lives – and enhance them, too. Throughout this issue of UMMC Connections, you’ll see examples of that. UMMC serves as an important
UMMC DOES IT AGAIN!
resource for the Mid-Atlantic
UMMC Earns
region by taking the toughest cases referred by other hospitals, no matter what time of day, as
Leapfrog Top
our cover story illustrates. Our Great Stories program (pages 4-
Hospital Status
5) illustrates how our physicians, nurses, technicians, chaplains, social workers and others – even staff whom patients don’t see – never lose sight of each patient as an individual, connected to a family or community that cares about him or her. Our profile continues to rise to the top nationwide, as University of Maryland surgeons continue to increase the amount of research dollars they obtain to develop the best options in patient care (page 7). And through research and recruitment of top physicians and other professionals, our services are expanding. That allows us to meet the changing needs of patients, such as those who survive to adulthood after
T
he Leapfrog Group has, for the sixth year in a row, ranked the University of Maryland Medical Center as a “Top Hospital” for patient safety and quality care. UMMC is one of only two hospitals in the United States to make this stringent list every year since its inception six years ago. The Leapfrog Group annual Top Hospital List provides a public comparison of hospitals on key issues, including patient outcomes. Each year, Leapfrog expands the criteria for hospitals to meet its standards. “The top hospital designation for 2011 reflects our unrelenting commitment to excellence in patient care, embraced at every level, from doctors, nurses and pharmacists, to therapists, technicians and support staff,” says Jeffrey A. Rivest, UMMC president and chief
executive officer. “That this recognition has continued for six years in a row is testimony to the culture of excellence that drives the Medical Center’s approach to patient care.” “A collaborative, professional and meaningful environment for our nurses and other patient care staff provides a solid foundation for high-quality patient care,” says Lisa Rowen, DNSc, RN, senior vice president for patient care services and chief nursing officer. Leapfrog’s criteria center on evidence-based best practices, such as electronic ordering of medications and tests. “Our terrific physicians, nurses, pharmacists and other staff are devoted to building safety, quality and a superior patient experience into a highly reliable system of care,” says Jonathan Gottlieb, MD, senior vice president and chief medical officer. Research has shown that staffing hospital intensive care units (ICUs) with physicians who have specialized training in intensive or critical care significantly reduces mortality rates. The University of Maryland Medical Center has more ICUs than most hospitals in the country – 10 units, including surgical, medical, neurological, cardiac surgery, trauma and pediatric ICUs, all staffed by intensive and critical care medicine specialists. UMMC scored well on safe practices, such as nurse staffing, hand hygiene and communication of critical information to patients. Rivest adds, “The Leapfrog recognition continues to validate our collaboration with the UM schools of Medicine, Nursing, Pharmacy, Social Work and Dentistry. Their faculty members participate in research-driven, quality-of-care projects that help us to elevate quality and patient safety.”
treatment for cancer or congenital heart defects
PAGE 3
(page 6). All this, and more, is what makes UMMC a place where everyone strives to care for patients the way they’d want their own loved ones cared for.
Behind the Scenes at Night
pages 2-3
Great Stories Abound at UMMC
pages 4-5
page 4-5
Quick Responses Save Runner’s Life
President & Chief Executive Officer
PAGE 8
INSIDEConnections: Employees of the Month
JEFFREY A. RIVEST
PAGE 7
page 7
Children’s Heart Center and Childhood Cancer Survivor Services Expand Nursing Leadership Award and Other People Spotlights
page 7
page 8
We Heal > We Teach > We Discover > We Care > We Heal > We Teach > We Discover > We Care > We Heal > We Teach > We Discover > We Care > We Heal > We Teach > We Discover > We Care >
C O V E R
S T O R Y
2 UMMC Connections ALL THROUGH THE
COVER STORY:
ALIVE with ACTIVITY In the daytime, sunlight floods the Weinberg Atrium as hundreds of staff and visitors pass through on their way to care for patients, or visit a loved one or friend.
Janet Tchouaff-Emtcheu, medical lab scientist in the Shock Trauma Satellite Lab.
UMMC Connections is produced by the Office of Corporate Communications and Public Affairs for the UMMC community. 22 South Greene Street Baltimore, Maryland 21201 410-328-6776 www.umm.edu Jeffrey A. Rivest President and Chief Executive Officer Mary Lynn Carver Senior Vice President Communications and Public Affairs Anne Haddad Editor and Publications Manager Frank B. Moorman Director, Strategic Internal Communications Linda Praley Creative Director Marc Laytar Photography Linda J. Lynch Staff Assistant Alexandra Bessent Sharon Boston Meghan Scalea Kathy Schuetz Karen Warmkessel Contributors Fax news and story ideas to UMMC Connections at 410-328-3450 or email ahaddad@umm.edu.
At night, the lights dim, foot traffic subsides and things look quiet. But looks can be deceiving. The operating rooms, patient care floors, MRI suites, pharmacies and labs – along with the teams that support them – are alive with activity. We took a stroll through the Medical Center one night in January, and here is just a glimpse of what a typical night looks like: As expected, the Adult Emergency Department and Pediatric Emergency Department are always busy, 24/7. The emergency staff takes on whatever patients – and paramedics – bring them: heart attack, sprained ankles, frostbite, ear infections and asthma flare-ups. “There really is no downtime,” says Thomas Crusse, BSN, RN, CEN, nurse manager for emergency services. In the large operating room specially equipped for liver transplants, a surgical team was working steadily into the night on a case. The patient’s family, whose hopeful waiting for a donor liver had finally ended, was in the Healing Garden in the Weinberg Atrium, some of them stretching out on the sofas and chairs to read or catnap while they awaited word on the outcome of the surgery. Meanwhile, in another OR, a cardiac surgery team had begun a heart transplant at 7 pm. The team continued past midnight, sending a surgical support technician twice to UMMC’s Blood Bank to replace what the patient was losing. The technician quickly returned to the OR with a cooler containing the ice-packed units of needed blood. Busy operating rooms mean it will be a busy night in the Blood Bank. Urgent requests from an OR, from the Trauma Resuscitation Unit (TRU) or other units in the hospital set off an all-hands-on-deck response: Blood Bank staff pull together to match the patient’s blood type, label and pack the units needed, and hand the cooler to the waiting technician to deliver. Once the urgent delivery is carried back to the patient-care team, the Blood Bank scientists and technologists resume their nighttime work, including cross-matching antibodies in units of donated blood products to prepare for transfusions scheduled in the morning. Next stop, the Pediatric Satellite Pharmacy, where we found a pharmacist and pharmacy technician filling night orders for immediate delivery to the children in the pediatric units, and preparing medications for the next day. The R Adams Cowley Shock Trauma Center has its own satellite pharmacy, and even a satellite laboratory, to save every possible second of the “Golden Hour” when injured patients are brought in to the Trauma Resuscitation Unit. If patients are stabilized within one hour of their injury, their chances of survival are much better. The Shock Trauma Center, whose founder and namesake developed the Golden Hour concept, has a 97 percent survival rate. Medical lab scientist Brittney Howard, MS, never meets her patients face-to-face, but she still visualizes them as individuals. “If it’s an older man, I think of my grandfather. If it’s a 24-year-old, I think of my younger brother,” she says. “I sort of relate them to myself.”
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2
3 1 Allen Norris, left, and Roland Nichols, Jr., distribute, clean and decontaminate medical equipment throughout the hospital. 2 Thomas Walker, Sr., surgical support technician 3 Mwaamba Kabunda, ASCP, medical lab scientist in the Blood Bank 4 Michelle 4
Watkins, certified pharmacy technician, and Amjad Ahmed, BS, RPh, clinical pharmacist, staff the Pediatric Satellite Pharmacy, working with nurses such as 5 Casey Liberto, RN, CPN. 6 Brittney Howard, MS, medical lab scientist II, focuses on accurate results in the fastest possible time in the Shock Trauma Satellite
5
Laboratory.
6
We Heal > We Teach > We Discover > We Care > We Heal > We Teach > We Discover > We Care > We Heal > We Teach > We Discover > We Care > We Heal > We Teach > We Discover > We Care >
WINTER 2012
Brain Attack Team MARSHALS FORCES Prompted by a call to the Maryland ExpressCare offices on the ground floor, the Brain Attack Team had kicked into action for a patient who had a stroke and needed the expert neurologists and neurocare nurses at UMMC, a designated primary stroke center equipped to deal with the most advanced treatments and the serious risks that are associated with those treatments. Nothing illustrates the concept of patient-centered teamwork better than the way the Brain Attack Team, ExpressCare, Neurocare Intensive Care Unit staff, Patient Placement Center, Admissions and other departments deploy a highly developed plan to save a stroke victim. The call on this winter night was centered on patient Paul Sargent, 45, of Manchester, Md. ExpressCare staff in their ground-floor communication center set up a conference call between the community hospital and the Brain Attack Team, including Marcella Wozniak, MD, PhD, interim medical director of the team and associate professor of neurology, and John W. Cole, MD, MS, associate professor of neurology. Once the patient transfer was determined to be necessary and the Patient Placement Center confirmed that a bed could be ready for Sargent in the Neurocare ICU, a UMMC admissions specialist obtained the patient information that Sargent and his wife had already given the transferring hospital, so that his wife would not need to supply it again once they arrived at UMMC. This allowed Sargent’s family to go straight to his unit to meet him after his transfer and evaluation. The Brain Attack Team arranged for the local hospital staff to begin the time-sensitive administration of the clot-busting tissue plasminogen activator (t-PA). While that drug, administered in an IV, made its way to dissolve the clot that was impeding blood flow in his brain, Sargent was on his way to UMMC via ground ambulance. On the Neurocare Intensive Care Unit (NCICU), charge nurse John Pfeifer, RN, updated staff nurses who would be waiting to care for Sargent and accompany him to the MRI suite. Staff from Housekeeping Hospitality Services were making sure the room was cleaned and ready for the new patient, while nursing staff reviewed his case to be ready to care for him when he arrived. Seconds after Sargent arrived, nurses and physicians moved him from the stretcher to his bed, while Ermias Aytenfisu, MD, a neurology fellow at UMMC, introduced himself to Sargent and began asking questions to assess his condition. “What is your name?” “How old are you?” “What month is it?”
“Can you hold your right hand up like this while I count to 10?” “Where am I touching you now?” Sargent was able to answer most questions, but with enough impairment that an MRI would be needed to determine whether and where he had a clot impeding blood flow in his brain, and which path of treatment was most appropriate. “We’re going to do an MRI, so we need to take your jewelry off,” Aytenfisu told him. Another physician had been standing by since Sargent arrived: Joao Prola Netto, MD, a fellow in neuro-interventional radiology, was following Atyenfisu’s assessment to help determine not just whether they could get an image of the blood clot on the MRI, but whether they could use the latest interventional radiology techniques to remove it, should that become necessary. Nurse practitioner Karen L. Yarbrough, MS, ACNP, acute care nurse practitioner and programs director for the Maryland Stroke and Brain Attack Center, was observing and making notes to determine whether Sargent qualified for inclusion in any clinical trials, should he choose to participate. One of the reasons Sargent was transferred was that he received t-PA, the clot-busting drug that must be administered within three hours of the onset of stroke symptoms, or the treatment becomes too risky. Even when administered within that three-hour period, t-PA carries a risk of hemorrhage. But after three hours, the blocked blood vessel is weakened from lack of blood flow. A sudden return of blood flow could cause it to bleed. Because of this risk, the patient must be in a hospital with intensive care nurses and vascular surgeons when t-PA is administered, so they can manage any complications. Once Sargent was out of danger, UMMC rehabilitation staff – occupational, physical and speech therapists – began working with him. “As soon as someone is stable medically, we want them to start rehab,” says Cole. “The sooner, and more consistent, the better the outcomes.” Paul Sargent is back on his feet and doing well. To read about his recovery, go to the UMMC blog, Life in a Medical Center (http://medcenterblog.org).
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A BEACON for the Region’s Most CRITICALLY ILL For more than 15 years, Maryland ExpressCare has provided a system for transporting patients directly from community hospitals to the Medical Center for specialized care, with admissions staff taking care of the paperwork while the patient is en route, in most cases. The premise consists of two components: quick consultation with a UMMC physician expert, and safe transport by ground or air with skilled nurses and emergency medical technicians on board. Hospitals around the region know they have to dial just one phone number to the ExpressCare Communication Center to set everything in motion. “The ExpressCare Communication Center is fully staffed day and night,” says Marcia Stalter, senior director for Maryland ExpressCare. “Likewise, the highly skilled critical care transport teams are available for both adult and pediatric transports at any time.” There is a very slim margin of downtime, she says. Calls and activity slow down at about 2 am, but kick up again within a few hours at 6 am. As for any slowdown around the holidays, the opposite is true. “The number of inter-hospital transfers to UMMC via Maryland ExpressCare typically spikes during the holiday season,” Stalter says. “It is not uncommon for the majority of transfers to occur in the evening and at night. By providing access to higher level (tertiary) care to patients who cannot be managed in community hospitals with fewer resources, we are ensuring that patients across the region receive the most appropriate care at any hour.”
John Cole, MD, (center) leads the Brain Attack Team and Neurocare ICU nurses as they prepare a stroke patient for an MRI.
We Heal > We Teach > We Discover > We Care > We Heal > We Teach > We Discover > We Care > We Heal > We Teach > We Discover > We Care > We Heal > We Teach > We Discover > We Care >
4 UMMC Connections
Storıes
Great E
very day, patients and their families express gratitude to Medical
Center staff members for the care and service they provide. Staff mem-
bers notice when one of their own does something extraordinary, too.
Four times a year, the Great Stories program selects from among the many emails and letters about staff members or teams that exceed standards and expectations to enhance a patient’s experience. Patients, patients’ families and staff are encouraged to submit examples to greatstories@umm.edu.
Dear Nicolle and all your “Joy in July” Helpers, Thank you so much for coordinating and hosting the “Joy in July” party for children and families on the Pediatric units. What a wonderful way to give back as hospital employees and as a department! The toys, craft kits, stuffed animals, games, puzzles and so much more were all a hit and children and families enjoyed picking out their gifts. You provided so many wonderful items that some children took quite a while deliberating about their selection —– which is all part of the fun as well! The face painting and door signs were a perfect addition to the festivities. And based on the creativity of both, you have some multi-talented staff in your department. I’ve continued to see the door signs hanging from IV poles and patient room doors following your visit. The extra toys you provided are being given out through our birthday closet, our treasure chests for kids following challenging procedures, and our prize booth for our Carnival in August.
Members of the Laboratories of Pathology team who organized and hosted a “Joy in July” party for the Pediatric units. Team members pictured from left to right are: (front) Phil Stanek
The hospital setting is often frightening and lonely for children. Sometimes hospitalized children and families feel like the world goes on outside the hospital walls, and that they are forgotten. It means so much when individuals like you provide something special for them. Please pass our thanks on to all the wonderful Laboratories of Pathology staff who helped make this party possible —– your generosity made a difference in the lives of these children and families!
and Erin Bellamy from the Medical Laboratory Scientist-Laboratory Integration Team; and Terri-Ann Smith, phlebotomist, and (back) Heather Adkins, Stephanie Dampier, Anatomic Pathology (AP) office supervisor, and Diana Macfarlane of the Integration Team. Nicolle Borys, assistant director for Laboratories of Pathology, and John Elder, AP technician, (not pictured) also participated. Borys, whose daughter, Xavia Pirozzi, 15, was a patient on the unit at the time, coordinated the event.
Sincerely, Shannon Joslin, MS, CCLS, Child Life Manager
December employee of the month
January employee of the month
Debbie Kirby, BSN, RNC, has played a key role in helping the University of Maryland Center’s Center for Advanced Fetal Care (CAFC) become a worldclass treatment center for women with high-risk pregnancies. “Since 1996, Debbie has served as the nursing cornerstone of the program,” says Monika Bauman, MS, RN. “She has been instrumental in the evolution of what is now the Center for Advanced Fetal Care. She stands out because of her operational excellence. She’s very passionate about what she does, and she leads by example. Debbie has an exceptional relationship with all members of the CAFC multidisciplinary team.”
As a multitrade specialist in the Department of Facilities Operations and Maintenance, January’s employee of the month, Michael Layfield, does it all, and does one thing best of all: He is skilled in several trades, but mostly is known as the go-to expert on more than 100 icemakers and refrigerators that preserve blood products, produce ice packs, store vaccines and medications, keep food fresh and provide comfort and hydration to patients and visitors. “Mike is an exceptional employee who desires to meet our core objective of patient care,” says Carl Johnson, plant manager.
DEBBIE KIRBY, BSN, RNC Senior Clinical Nurse I Center for Advanced Fetal Care
MICHAEL LAYFIELD Multitrade Specialist Department of Facilities Operation and Maintenance
We Heal > We Teach > We Discover > We Care > We Heal > We Teach > We Discover > We Care > We Heal > We Teach > We Discover > We Care > We Heal > We Teach > We Discover > We Care >
WINTER 2012
5
Abound @ UMMC August 25, 2011
When the Cure Comes with a Price
Dear University of Maryland Shock Trauma Center, My daughter was a patient at University of Maryland Shock Trauma [Center] August 11-23. Although I am not in the medical field, having spent 12 days with my daughter, it was not hard for me to recognize outstanding quality care. • Dr. Sharon Henry and Trauma Team C took the lead with her care. A special thank you to the entire team. Resident Dr. Christopher Dang went above and beyond and possesses such an excellent bedside manner.
Melissa Parker, administrative assistant in the Adult Echocardiography Lab, says she and her family received outstanding care even before staff realized she also worked at the Medical Center.
For Great Stories On June 26, 2011, I was admitted to the University of Maryland Shock Trauma Center on life support after being transferred from an area hospital that had given up hope in my recovery. I was given outstanding care from the time of my arrival by Dr. Thomas Scalea, along with Shock
• When my daughter first arrived, Andy and Sarah, medical students, were there by her side to reassure her, since my husband and I were on our way driving there from Delaware.
Trauma nurses, doctors and staff, Maryland ExpressCare, Hospitality Services, Security, Pastoral Care, Dietary, Kernan Hospital staff and Patient Transportation. This care was given without knowing I was an employee of the Medical Center. Being an employee of the Medical Center for the past four years in the Cardiology Department, Echo Lab, I have seen the compassionate care given to our patients and
• University of Maryland Shock Trauma nurses and physicians treated my daughter with dignity and the utmost compassion.
families during their time of need. That was also present in my care. The unit staff kept my family informed of my progress and provided much-needed assistance, such as change of clothing and food, along with Pastoral Care to comfort my family and friends.
• These nurses should be commended: Beth McDavid Pruitt, Amelia McGovern, and Victoria Dornon cared for my daughter as though she were one of their own family members. These nurses remained with her until her pain diminished and took extra time to make sure she was as comfortable as her condition would allow.
I never once imagined being on the other side of such critical care. My family and I are grateful and will always remember the services exceeding our expectations during my stay, until my discharge to Kernan Hospital for rehabilitation. The mission of the Medical Center, “We Heal, We Teach, We Discover, We Care,” was represented with the highest degree of efficiency. In my recovery today, my family and I have visited with other patients at Kernan to encourage hope and acknowledge the great behind-the-
Please do not underestimate the superior care given by the above-named individuals. I thank you for restoring my daughter and for the excellent care, and offer my gratitude to each of you for restoring our faith.
scenes miracles that take place every day here at the University of Maryland Medical Center. Lovingly Submitted, Melissa Parker
My daughter continues to recover at home with us in Delaware. May you all be blessed for the good work you do. Sincerely, Elizabeth Walls Georgetown, Delaware
DEPARTMENT OF FAMILY AND COMMUNITY HEALTH 655 West Lombard Street Room 616 Baltimore, MD 21201-1579
Kevin Cullen, MD, Professor of Medicine and Director University of Maryland Marlene and Stewart Greenebaum Cancer Center
Beth McDavid Pruitt, BSN, RN, left, and Amelia McGovern, BSN, RN, were among the many staff members who cared for Elizabeth Walls’ daughter.
Dear Dr. Cullen, I wanted to let you know about the amazingly positive experience I have had as a patient at the Greenebaum Cancer Center. During the past year, I was diagnosed with Stage 3 ovarian cancer and had surgery at UMMC on October 29, 2010. This was followed by four months of outpatient chemotherapy. My surgeon and oncologist is Dr. Sarah Temkin. The experience my family and I had with Dr. Temkin and her team was quite remarkable. I found her to be both brilliant and amazingly caring. She is the kind of physician who comes in on the weekends to check on you, even though I am sure that can be delegated to others. She is very “down to earth” and comforting in her communication, and she always communicated her availability. It was also very advantageous to have my surgery and chemotherapy provided by the same doctor. I understand from the literature that this increases good outcomes. As I am a faculty member at the University of Maryland School of Nursing, I am very familiar with what good health care is. My care experience with Dr. Temkin was exemplary, and I am so grateful to have her as my physician. I look forward to continued good health, and I wanted to let you know about my very positive experience at the Greenebaum Cancer Center. Sincerely, Patricia Harris
Patricia Harris, MS, APRN, CRNP-PMH, (left) a psychiatric nurse practitioner, and her doctor, Sarah Temkin, MD.
February employee of the month
March employee of the month
Howard McCray was once a victim of Baltimore’s violent streets. Now, as a community outreach worker for the Violence Intervention Program (VIP) for the R Adams Cowley Shock Trauma Center, he assists others who were harmed by violence by helping them to turn their lives around. “Howard is tremendous,” says Carnell Cooper MD, associate professor of surgery and VIP founder. “He goes to patients’ bedsides, engages them and talks to them about what has happened and what they’re going to do when they leave the hospital. He’s very dedicated.”
Rebecca Heinlein, data coordinator for Maryland ExpressCare, translates the work of the department into numbers and reports that will ultimately help the Medical Center do a better job of providing services. “Becky has been a great addition to our team. She had worked in the ExpressCare communications center for several years, and she’s an EMS provider, so she has a great perspective on the total business of what we do,” says Theresa Drayer, RN, CCRN, NREMT-P, the department’s manager. “If I ever have a question or need something, Becky says ‘Okay, we’ll get it done.’ She’s extremely helpful and pleasant to be around.
HOWARD MCCRAY Community Outreach Worker Shock Trauma Violence Intervention Program
REBECCA HEINLEIN Data Coordinator Maryland ExpressCare
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6 UMMC Connections F E A T U R E S
Robert Rodriquez
Four New Specialists Join Children’s Heart Program Bringing Expertise and Leading Research he Children’s Hospital at the University of Maryland Medical Center has expanded the level of care it provides for children, adolescents and adults with congenital heart conditions by adding four physicians, including a pediatric heart surgeon. This growth increases the hospital’s ability to treat complex pediatric heart disease patients and provide continuous care of pediatric patients through adulthood. Sunjay Kaushal, MD, PhD, is the new head of pediatric cardiac surgery in the Division of Cardiac Surgery. Kaushal specializes in pediatric cardiovascular thoracic surgery, neonatal surgery, valve repair, and adults with congenital heart disease. He receives funding from the National Institutes of Health (NIH) to investigate treatment for hypoplastic leftheart syndrome, a congenital disorder that carries a 15 percent mortality rate before affected children reach school age. “Dr. Kaushal’s work with the Children’s Heart Program will help to build a nationally recognized center of excellence in pediatric cardiac care,” says Stephen T. Bartlett, MD, professor and chair of the Department of Surgery at the School of Medicine and chief of surgery at UMMC. “Additionally, he adds even more research energy to the growing scientific programs of the Department of Surgery, which is currently ranked eighth in the United States in annual NIH funding,” Bartlett says. “The ability to conduct more research means more potential treatment options for our patients.”
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Also joining the program is non-invasive imaging specialist Alicia Chaves, MD. She will work closely with community obstetricians to identify congenital heart disease in utero and create advanced care plans for mothers and infants before, during and after birth. Sudhir Vashist, MD, specializes in electrophysiology, which helps doctors search for and identify heart rhythms and abnormalities. Pediatric cardiologist Phat Pham, MD, treats children with complex medical problems through interventional cardiology instead of surgery, when possible. “These new team members are crucial in making sure we deliver the latest and best care to our patients, even those who come to us with the most complex cardiac conditions,” says Steven J. Czinn, MD, professor and chairman of pediatrics and chief of pediatrics at the Medical Center. When the expanded pediatric cardiology services began growing to meet the demand, so did the multidisciplinary team, which includes nurses, nurse practitioners, sonographers and technicians. Eveena Felder, BSN, RN, nurse manager, oversees patient care services throughout pediatric cardiology. In addition, Beth Sherfy, MS, RN, a quality improvement coordinator, focuses on patient outcomes and on the quality of nursing practice within pediatric cardiology. “The staff work closely with the medical team to provide high-quality care with a family-centered approach,” says Mary W. Taylor, MS, RN, director of women’s and children’s services at UMMC. “It’s inspiring to see how the team enhances the patient's and family's quality of life.”
“This expansion of the Children’s Heart Program speaks volumes to the importance we place on providing the best care for our families,” says Geoffrey Rosenthal, MD, professor of pediatrics and director of the Pediatric and Congenital Heart Program and executive director of critical care services at the UM Children’s Hospital. “Our goal continues to be to provide the most compassionate and comprehensive care to patients with heart disease from before birth through adulthood.”
NEW PEDIATRIC ONCOLOGY PROGRAM TO FOLLOW CANCER SURVIVORS THROUGH ADULTHOOD
Patricia Shearer, MD, MS, (left) and nurse practitioner Diane Keegan Wells, RN, MSN, CRNP, are developing a program to provide follow-up care for adult survivors of childhood cancer.
ediatric oncology has become so successful at curing most child-
P
hood cancers that it has led to a subspecialty dedicated to adults
who survived cancer as children. UMMC is in the early stages of developing a program to support these survivors throughout their lives as they face lasting side effects or complications from the treatment. Patricia Shearer, MD, MS, FAAP, the new division head of Pediatric Hematology/Oncology at the University of Maryland Children's Hospital and a professor of pediatrics at the School of Medicine, has established a new Cancer Survivor Program. The program focuses on childhood cancer survivors of any age, including individuals who may have gone through cancer treatment many years ago. “The cure rate for childhood cancers is now 80 percent, so we expect that most patients will become long-term survivors,” Shearer says. “However, the disease and/or its treatment may put as many as two-thirds of survivors at risk for other complications that they need to know about.” Some examples of late effects include problems with growth or development, problems with vital organ function, hormonal issues and secondary cancers. Modeled after the program that Shearer started at the University of Florida in 2008, the Cancer Survivor Program at UMMC will be designed to: • Help survivors and their families understand the late effects of treatment, including surgery, radiation and chemotherapy. • Help survivors monitor and manage current health or developmental issues. • Take a proactive approach to problems that may occur in the future. Following Patients into Adulthood Survivors of pediatric cancers of any age may enter the Cancer Survivor Program when they are off therapy for two years and are tumor-free. “Even though I am a pediatric oncologist, in my survivor programs I’ve had patients who were in their 30s and 40s,” Shearer continues. She recommends that survivors of childhood and adolescent cancers be followed for life so they can benefit from new research.
“We give specific information to each survivor about how often to have tests such as blood counts, hearing evaluations, echocardiograms, pulmonary function tests and mammograms. We discuss options for fertility and provide referrals to other specialties,” Shearer says. Equally important, the staff can reassure survivors about when it is safe to discontinue routine tests to monitor return of the primary cancer. The Cancer Survivor Program addresses the whole person, including anxiety, pain, depression, fatigue, mobility problems and difficulty getting insurance. “Many survivors report academic challenges, including having difficulty with memory, concentration or processing. We can take that information and communicate with the teachers, school board or even colleges to facilitate an ideal educational experience for our cancer survivors,” Shearer says. A Network of Caring Another advantage of the program is that it serves as a resource to primary care providers in the community so they know what to look for and what to do when caring for these patients. To contact the Cancer Survivor Program, call 410-328-2808.
We Heal > We Teach > We Discover > We Care > We Heal > We Teach > We Discover > We Care > We Heal > We Teach > We Discover > We Care > We Heal > We Teach > We Discover > We Care >
7
WINTER 2012
UniversityCare Leading the Transformation of Primary Care niversityCare at Edmondson Village, one of UMMC’s ambulatory care centers, has achieved the highest level of recognition as a “patient-centered medical home,” or PCMH – an advanced model of primary care that uses a team approach to provide continuous and coordinated services for all of a patient’s medical needs. The approval as a Level-III PCMH came in January from the National Committee for Quality Assurance (NCQA), a private, 501(c)(3) not-for-profit organization dedicated to improving health care quality. UniversityCare was the first practice in Baltimore city to be recognized as a PCMH when it gained the designation in July 2010. The practice was developed by UMMC to provide under-served areas, such as the West Baltimore neighborhoods surrounding Edmondson Village, with a primary care model similar to private physician practices in more affluent areas. Medical director for
U
UniversityCare’s three locations -- Edmondson Village, Waxter Center and Shipley’s Choice (Anne Arundel County) – is Russell Lewis Jr, MD. As a leader in Maryland, UniversityCare is part of a statewide pilot program evaluating the impact of this model of care on reducing the need to re-admit patients to the hospital because of a complication after they’ve been discharged, decreasing unnecessary emergency department visits, and promoting positive patient outcomes. “This recognition for UniversityCare Edmondson Village will position the center to contribute in a major way to the organizational initiative of reducing re-admissions at UMMC,” says Joanne Riley, vice president for ambulatory services. “The PCMH is the foundation to ensure that our recently discharged patients receive longitudinal coordinated care from the high-quality physicians in our network.”
NO HEATSHEET FOR THIS RUNNER: QUICK RESPONSES, THERAPEUTIC HYPOTHERMIA AND CARDIAC CATHETERIZATION SAVE HIS LIFE
DEPARTMENT OF SURGERY CONTINUES TO LEAD THROUGH INNOVATION
UM Department of surgery rises to 8th in nation for NiH funding
As
leaders in their field, University of Maryland surgeons are securing significant research opportunities to advance the science of medicine and improve patient outcomes. According to data released this fall by the National Institutes of Health, the UM School of Medicine Department of Surgery has the most NIH research funding of any department of surgery in Maryland and Washington, DC. In 2005, the department was ranked 17th in the nation for NIH funding, and it is now ranked 8th. The new funding data is for fiscal year 2011, which ended Oct. 31, 2011.
In a time when the NIH is being asked to cut its budget every year, the Department of Surgery continues to obtain funding for biomedical research despite increasing competition. “NIH research funding is an objective measure that we use to reflect the excellence and quality of our research program as we develop the latest treatment options for patients,” says Stephen T. Bartlett, MD, professor and chair of the Department of Surgery and chief of surgery at UMMC. “We have built this department with the goal of becoming a top-three NIH-funded research program.” Recently, a five-year $3.5-million
“These were all vital links in the chain of events that saved this man’s life,” said Brian Browne, MD, professor and chair of emergency medicine at the UM School of Medicine and chief of emergency medicine at UMMC, who spoke at a ceremony arranged by the race organizers to give Robert Pohl the medal he earned and recognize all those who saved his life.
Stephen T. Bartlett, MD
grant was awarded to Richard N. Pierson, III, MD, professor of surgery and director of the surgical care service at the VA Maryland Health Care System to study coagulation control in lung and liver xenografts.
New Way to Deliver Cancer Treatment Originated from Research at UMMC
In
the war on cancer, surgeons and oncologists are waging a fierce battle against one particularly formidable enemy, metastatic melanoma, in the operating rooms at the University of Maryland Medical Center’s Marlene and Stewart Greenebaum Cancer Center (UMGCC). UMGCC was one of the major institutions that helped conduct a national clinical trial evaluating the utility of a method to deliver highdose chemotherapy directly to the liver of patients with metastatic melanoma, for which there are no other known effective therapies. This serious condition affects thousands of people in this country every year. H. Richard Alexander, Jr., MD, is an internationally recognized surgical oncologist and clinical researcher. He treats cancer patients at the Greenebaum Cancer Center and is associate chairman for clinical research in the UM Department of Surgery. Alexander is recognized for devel-
oping innovative techniques to treat patients with advanced cancers of the gastrointestinal tract. One example is percutaneous hepatic perfusion, a way to circulate high doses of chemotherapy directly into the liver. When people develop metastatic melanoma to the liver, survival will very frequently be measured in just months. With percutaneous hepatic perfusion, doctors deliver very high doses of chemotherapy directly to the liver via a catheter positioned into the artery that feeds the liver. Then, by placing a second catheter behind the liver in the vein that drains blood from the organ, they collect all of the blood and filter the unused chemotherapy drug before it ever gets into the body, thereby eliminating any unnecessary side effects. “We found in our preliminary studies that the results of this treatment were quite striking, and it led to a definitive national trial to test this therapy and to demonstrate its effectiveness and benefit for patients,” Alexander says. The trial has now been completed.
H. Richard Alexander, Jr., MD
The results were far better than what researchers had expected. Because of this, the data have been presented to the US Food and Drug Administration (FDA) in the hope that this treatment will become more widely available. “What I am particularly excited about is the fact that we are going to be looking at expanding this type of technology for other types of cancer that can spread to the liver,” says Alexander. “For example, patients with colon cancer often develop liver metastases. We are very interested to find out whether this type of percutaneous liver perfusion can be used to help patients with that very difficult condition.”
IT STARTED OUT AS A REGULAR RACE DAY when Robert Pohl of Frederick, Md., began the half-marathon at the 2011 Baltimore Running Festival Oct. 15. But just before the finish line, he collapsed of a heart attack. Several other runners around Pohl – including a Baltimore City Police officer – immediately recognized the emergency and began CPR. That was just the first of a cascade of responses that saved Pohl’s life. Because he collapsed near the finish line, he was only about 100 feet from the medical tent, where physicians from Union Memorial Hospital led by Cynthia Buchanan-Webb, MD, director of medical care for the festival, quickly assessed him, recognized the arrythmia, defibrillated his heart and secured his airway. Paramedics transported him within five minutes to the UMMC Emergency Department, where a team that included Michael D. Witting, MD, MS, associate professor of emergency medicine, and Bethany Radin, MD, a resident in emergency medicine, immediately instituted a therapeutic hypothermia protocol, slowing the chemical reactions that can cause cell death in major organs. R. Michael Benitez, MD, professor of medicine, led the cardiology team that found a complete blockage in one of Pohl’s coronary arteries and treated it. Pohl recovered in the Cardiac Care and Progressive Care Unit under the care of Erika D. Feller, MD, assistant professor of medicine. An article about Pohl’s experience in The Baltimore Sun quoted Feller, who marveled at the succession of responses by the team in the field and in the hospital that gave Pohl such an excellent prognosis. “One missing link and it wouldn't have worked out the way it did,” Feller told the Sun reporter, adding that she expects Pohl to run again some day. “I can’t imagine being in a better place than I was, here,” Robert Pohl says in a video interview on the Medical Center’s website, www.umm.edu. “As I progressed further, and asked more questions, I understood how lucky I was.” Karen Pohl, his wife, praises UMMC physicians and nurses for their clinical skills, compassion, patience and continuity. “When I would arrive, [the nurses] would greet me by name,” Karen Pohl says. “When I saw a doctor in the hallway, they would stop and talk to me. Their compassion was amazing.”
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8 UMMC Connections
Winter
PEOPLE SPOTLIGHT
Honored > > > Denise Choiniere, MS, RN, sustainability manager for UMMC, has been awarded the first annual Nursing Leadership in Environmental Health Award from Maryland Hospitals for a Healthy Environment (MD H2E). As the first full-time sustainability manager in a Maryland hospital, she has spearheaded a number of environmental initiatives at UMMC, including managing hazardous pharmaceutical waste, a weekly farmers’ market, sustainable product procurement, energy conservation, waste minimization, toxicity reduction, and air- and water-quality improvement. She coordinates the assessment, development, implementation and tracking of programs that improve the environmental health of staff, patients, and the community. Brian D. Hayes, PharmD, DABAT, clinical pharmacy specialist in emergency medicine and toxicology at UMMC and clinical assistant professor at the School of Medicine and School of Pharmacy, received the Jeffrey Ensor Emerging Leadership Award from the Maryland Society of Hospital Pharmacists in November. The award is given annually to a society member for leadership, excellence and the ability to inspire others. Shortly before learning of this award, Hayes had achieved certification from the American Board of Applied Toxicology as a clinical toxicologist.
Blazing a Trail for Other Hospitals With leadership from the Green on Greene Street Team, UMMC won another Trailblazer Award from Maryland Hospitals for a Healthy Environment (MD H2E) this winter for lighting conservation and upgrades during 2011. The project included turning off lights when not in use and when daylight is sufficient in atriums and hallways, replacing light bulbs with more efficient models, and installing occupancy sensors and photo cell sensors to conserve lighting energy. • As a Trailblazer Award winner, UMMC agreed to host an educational event here in 2012 to demonstrate how it achieved success and share lessons learned with other hospitals so that they can replicate the results in their facilities. • MD H2E is a technical assistance and networking initiative that promotes environmental sustainability in health care. Participants include hospitals, clinics, nursing homes, research laboratories and other ancillary health care providers in Maryland.
Kathryn T. Von Rueden, MS, RN, ACNS-BC, FCCM, a clinical nurse specialist at the R Adams Cowley Shock Trauma Center, has been selected by the Society of Trauma Nurses (STN) as the recipient of its 2012 STN Trauma Leadership Award, to be presented this spring at the society’s annual meeting. She also is associate professor and Interim Specialty Director of the Trauma/Critical Care/ED Advanced Practice Nurse graduate program at the University of Maryland School of Nursing. Her professional career includes leadership roles in hospitals and the biotechnical industry, and her clinical research most recently has focused on secondary traumatic stress in nurses and delirium in trauma patients. A Fellow of the American College of Critical Care Medicine, she is a recognized expert in areas related to care of critically ill and injured patients and clinical outcome management, and has been invited to lecture internationally. Her work is published in several peer-reviewed journals and textbooks, and she is a member of the Editorial Board of the Journal of Trauma Nursing.
Expanded Role > > > Lisa Rowen, DNSc, RN, FAAN, senior vice president for patient care services and chief nursing officer at UMMC, has been appointed clinical associate professor of nursing at the University of Virginia, in addition to three other faculty appointments she currently holds. She is also associate professor at the University of Maryland School of Nursing, as well as adjunct nursing faculty member at both Johns Hopkins University and Northeastern University. Involved > > > Donna Bandzwolek, BS, RN, director of post-acute services, has been elected to the board of the Chesapeake Chapter of the Case Management Society of America. She has worked at UMMC for nearly 17 years.
OUR TOP DOCS WE KNOW OUR UMMC DOCTORS ARE GREAT,
selected by their peers as outstanding practicing doctors in the Washington,
national and regional media think so too.
DC-Baltimore-Northern Virginia area.
Congratulations to our “Top,” “Best” and
And in November, 27 University
“Super!” doctors. U.S. News & World Report expanded its 2011 Best Hospitals lists with a new element:
of Maryland doctors appeared on Baltimore Magazine’s 2011 list of “Top Doctors.”
an online listing of some the nation’s “Top Doctors,” featuring more than 60 from UMMC. The Super Doctors® supplement, published
You can read more details on these prestigious rankings by searching for articles on the
in the Washington Post’s magazine in October,
Medical Center’s website,
listed more than 120 UMMC doctors who were
www.umm.edu.
UMMC Connections
Lead at National Level
Sitting in front from left to right are Linda Pham and Jane Gerber. Standing from left to right are Shelley Cheatham, Leah Luby and Gracie Moore-Greene.
Social workers in UMMC’s Department of Social Work and Human Services who specialize in working with patients in the Division of Transplantation have been leading several local and national initiatives in their profession, which plays a critical role in patient support for both donors and recipients during the organ transplantation process. Gracie Moore-Greene, DrPH, MSW, LCSW-C, clinical team leader for social work in Transplant, is first author on “Chronic Stress and Decreased Physical Exercise: Impact on Weight for African-American Women” in Ethnicity & Disease, the peer-reviewed journal of the International Society on Hypertension in Blacks. Kristi Silver, MD, associate professor of medicine at the University of Maryland School of Medicine, is a co-author.
IN THE NEWS
but three recent rankings make it clear that
UMMC Transplant Social Workers
Moore-Greene and co-presenters Leah Luby, MSW, LGSW, kidney pre-transplant social worker, and Shelley Cheatham, MSW, LGSW, in-patient kidney transplant social worker, led a session at the Society of Transplant Social Workers’ International Conference in October that inspired the society to begin developing an assessment tool to be used by transplant social workers across the country. Moore-Greene serves on the society’s committee to provide direction and oversight for this national initiative. Luby and Linda Pham, MSW, LGSW, kidney pre-transplant social worker, conducted an in-service to local dialysis center social workers at the request of the Maryland Council of Nephrology Social Workers about the kidney transplant process, from evaluation through post-surgery. And Jane Gerber, MSW, LCSW-C, liver transplant social worker, has provided professional expertise to the North American Liver Transplant Social Workers Association as current chair of the membership committee.
is available on the Intranet and at www.umm.edu/connections.
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