Impact November 2017 by UTMB Health

UTMB NEWSLETTER • NOVEMBER 2017

There’s no place like homecoming at UTMB

UTMB celebrates military heroes past and present Best care in Action: Timing it right with patient length of stay Spotlight on Gary Eubank, chief nursing officer, Correctional Managed Care

Several UTMB employees received President David Callender’s Way to Go Award during the Nov. 1 Town Hall. Lonnie Winston and Seth Grimes, materials handling techs, were recognized for their actions going above and beyond to ensure a young patient at Jennie Sealy Hospital received a special package. The patient, who collapsed during a high school football practice, was flown by helicopter to UTMB in critical condition. The J.J. Watt Foundation found out about the player and arranged for the Houston Texans to send a special package; however, it was addressed to a family member of the patient, not the patient, so UTMB could not deliver the package. Winston and Grimes came in on a Saturday, their day off, to locate the package in the Materials Management Warehouse and ensure its delivery to the young man and his family. Dr. Leah Low, lead physician advisor and assistant professor in the Department of Internal Medicine; Rebecca Castro, social work practice manager; and Yvette Castellanos, utilization review manager; received President’s Way To Go Awards for leading the efforts during and after Hurricane Harvey to get the inpatient status down to appropriate levels so there was capacity for patients who needed hospitalization. The community resources for discharge support were strained, but Low, Castro, Castellanos and the care management team worked to get the job done, and were key in ensuring the successful discharge of more than 50 patients a day to safe locations that had resources available to them when they arrived. Tia Jaynes, a pediatric social worker at Bay Colony, received a President’s Way To Go Award for providing support and comfort for a family after the death of their young child. Not only did she help the family deal with their grief, she also secured financial resources so they could bury their son. The parent of the patient expressed sincere gratitude for Jaynes and all the help she was given. “It brings tears to my eyes,” said Callender. “Great work, thank you so much. This is exactly what we want to see every day in support of our patients.”

Whitney Vrba, a second-year Doctor of Physical Therapy student, and Dr. Alison Vargo, an assistant professor of instruction in the Department of Physical Therapy, School of Health Professions, recently participated in a freelance dancers screening event developed by the USA Task Force on Dancer Health as a part of Dance USA. Vrba and Vargo, along with local clinicians and physical therapy students, screened more than 50 dancers in Houston, providing physical assessments and expert health information to professional performance artists. Dr. Thomas Geisbert, a professor in the Department of Microbiology and Immunology, was awarded $4.3 million from the National Institute of Allergy and Infectious Disease to develop a vaccine against Lassa virus and to evaluate a first-in-class immunotherapeutic antibody cocktail to protect against the disease and to treat it after exposure. Lassa fever is an often-fatal viral hemorrhagic fever that has no approved treatments or vaccines. The study will be conducted with Dr. Robert Garry and colleagues at Tulane University. In recognition of UTMB’s outstanding support of organ, tissue and eye donation, Donate Life presented UTMB with a 2017 Donate Life Champion award. The award is given to members across the country who have inspired others to give the gifts of life, sight and mobility. Thanks to UTMB’s efforts, 33 lives have been impacted. The Donate Life Champion award is part of a national initiative to increase organ, eye and tissue donation. For more information or to join your state’s donor registry, visit www.donatelife.net. Shannon Guillot-Wright, a doctoral candidate in the Graduate School of Biomedical Science’s Institute for the Medical Humanities and fellow in Health Policy and Legislative Affairs, created a short video about migrant health in Texas that was accepted to the National Academy of Medicine’s “Visualize Health Equity” nationwide community art project. Her video was on display as part of a pop-up gallery during the National Academy of Medicine’s national stakeholder meeting on Nov. 9 in Washington, D.C., as well as part of a permanent online gallery. To view her video, “Anonymous Health,” go to https://vimeo.com/223525507.

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From the President The 2017 State Employee Charitable Campaign (SECC) came to a close at midnight on Nov. 3 and our UTMB family showed that when we come together, we can accomplish anything.

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Many of our employees have faced tremendous challenges because of Hurricane Harvey, yet our SECC campaign raised $538,765, or nearly 98 percent of our goal for the benefit of others. In this month of Thanksgiving, I want to express my heartfelt gratitude to each and every one of you who helped lead UTMB to a successful SECC campaign, as well as those who were able to contribute to our employee and student Harvey Relief Funds. Your commitment to your communities is remarkable.

Best Care: Timing it right with patient length of stay

This issue of Impact highlights many people who make up our diverse workforce, including the thousands of veterans who have found a second career home at UTMB. On Nov. 2, we held the first Veterans Day Luncheon celebration to honor our faculty, staff and students who have served. It was my honor to moderate a panel discussion of military veterans who described their experiences and the challenges they faced when transitioning from the military to the civilian world. We are thankful to all our veterans for their years of service to our nation and for their continued service to UTMB.

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You can read more about the Veterans Day event, along with many other stories, including: • A day in the life of Kim Barfield and UTMB’s Alumni Relations team during the recent Homecoming Weekend • A profile of Gary Eubank, director of nursing for UTMB Correctional Managed Care • A Best Care in Action spotlight highlighting UTMB’s efforts to address patient length of stay (LOS) • An “A” grade from the Leapfrog Group recognizing UTMB’s accomplishments in making patient safety and quality a priority • A $10,000 donation of medical equipment and supplies that is helping a pediatric hospital in Puerto Rico following Hurricane Maria • How feedback from more than 1,000 employees will help guide the Impact newsletter’s path forward • A research study that has given new insights into what factors lead to preterm birth • The 10th anniversary of UTMB’s Academy of Master Teachers • The annual Hector P. Garcia Awards Luncheon, featuring winners of the essay and poster contests • Tips for creating a better family health history by Dr. Michael Thanh Nguyen, assistant professor of Internal Medicine • Numerous accomplishments and kudos in the Working Wonders column and throughout the newsletter As always, I hope you enjoy reading this issue of Impact, and, in this season of thanksgiving, I am truly grateful to each of you.

Day in the Life: Alumni Relations

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Spotlight on Gary Eubank, Correctional Managed Care

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Veterans Day Luncheon celebration

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Dr. David L. Callender UTMB President

Impact is for and about the people who fulfill UTMB’s mission to improve health in Texas and around the world. We hope you enjoy reading this issue. Let us know what you think! ON THE COVER: Kim Barfield, assistant director of Alumni Relations and Annual Giving, and UTMB’s Alumni Relations team welcomed more than 400 UTMB alumni and their guests to this year’s Homecoming Weekend in October. For more about “a day in the life” of Barfield and her team, go to pages 8-11.

P R INT E D B Y U T MB G R A P H IC D ES IG N & P RIN TIN G S ERVICES

Vice President Marketing & Communications Steve Campbell

Associate Vice President Marketing & Communications Mary Havard

Campus mail route: 0144 U.S. Postal address: UTMB Marketing & Communications 301 University Boulevard Galveston, TX 77555-0144

Editors KirstiAnn Clifford Stephen Hadley Shannon Porter Art Director Mark Navarro

BEST CARE IN ACTION

UTMB’s Acute Care for Elders (ACE) Unit discusses patient care plans during their daily Progression of Care Round.

UTMB inpatient units focus on appropriate length of stay, planning for safe discharge BY KIRSTIANNN CLIFFORD

Every morning between 8 and 9 a.m., groups of interdisciplinary teams meet at all inpatient units in Galveston, League City and Angleton Danbury to discuss each and every patient in the hospital. They’re called “Progression of Care Rounds,” or POCR (pronounced “poker”) rounds, and for the past year, they have been making a difference in both patient outcomes and length of stay, which is the period of time (in days) that spans from a patient’s admission to the hospital to the time they are discharged. “No matter how good the view is in Jennie Sealy Hospital, our patients would rather be at home than in the hospital,” said Deb McGrew, vice president and chief operating officer of UTMB Health System. “The main goal of the rounds is for care teams to come together to talk about each patient’s plan for the day, plan for the stay and the plan for the way back to their home or community.” She emphasized that the focus of POCR rounds is to improve coordination of care and ensure appropriate length of stay for each patient to help support the best possible outcome. “It’s about providing Best Care,” said McGrew. “We don’t want to shorten length of stay to the point that we have unplanned readmissions, because that’s not good for the patient. But we also don’t want to keep patients in the hospital longer than is medically necessary. It’s a balancing act.” Included in the rounds are the patient’s primary nurse, case managers, social workers, utilization review nurses, a patient care facilitator and, depending on the hospital unit, physical/occupational therapists, physicians, pharmacists, nutritionists, respiratory therapists and speech therapists.

The POCR rounds have also helped identify delays in the system that have affected patient length of stay. For example, some routine radiology services were only available on weekdays, which meant patients who were admitted on Friday may have had to wait until Monday for imaging diagnostics. After further examination, Health System leadership decided to make more imaging services available seven days a week so patients didn’t have to spend excess days in the hospital. In addition to POCR, three part-time physician advisors to the Care Management Department have been put in place to help determine each patient’s status, assist with clinical documentation to support continued stay, and focus on resource utilization. Dr. Leah Low, an assistant professor of Internal Medicine and lead physician advisor, has traveled to all three campuses to educate physicians on appropriate patient status (inpatient or outpatient) and how that impacts length of stay. These sessions also have provided front-line physicians an opportunity to voice concerns and highlight additional opportunities to improve efficiency, quality of care and patient experience. For patients who are at a high risk for readmission or require complex care following discharge, physician advisors take part in a review process to ensure patients have an appropriate plan of care and to help remove obstacles to being safely discharged. “We have put in a lot of leg work up front, but we are making progress and seeing results,” Low said. “It’s a culture change, but if we can make things better for our patients, we have done our job.”

By getting all care team members together, Dr. Josette Armendariz-Batiste, director of patient care services and assistant chief nursing officer, said coordination of care has gone from a fragmented system to a well-oiled machine, with improved communication and proactive planning for patient discharge.

Length of stay makes up half of the “efficiency” domain in the national Vizient Quality and Accountability Study. Since the Best Care initiative began, UTMB has gone from an efficiency ranking of 98 to 27. Through UTMB’s targeted efforts to provide appropriate care and remove barriers, the average length of stay has been reduced by .84 days, resulting in more than $5 million in savings. Additionally, during this same time period, the inpatient satisfaction scores have climbed to the 99th percentile.

“Nurses are expected to present on their patients in two minutes, so these rounds are quick and very focused,” said Armendariz-Batiste. “Length of stay is in the back of team members’ minds, absolutely. But nobody sits there and says, ‘Well, this patient has been here for 10 days, so we need to get them out of here.’ It’s truly more about the challenges our patients face and what we can do to deliver more efficient care while also focusing on their safety and well-being.”

“At the same time we have reduced length of stay, we haven’t seen an uptick in readmissions—which means we are planning more effectively and making sure the plans we make for each patient’s discharge are appropriate and aren’t causing them to come back to the hospital too soon,” said Dr. David Marshall, chief nursing and patient care service officer. “We’ve come a long way. It’s been an institution-wide effort and we aren’t done yet.” n NN OO V EV M B EB RE R2 02 10 71 7 EM

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UTMB scores an A for safety and quality BY KURT KOOPMANN

UTMB RECENTLY ANNOUNCED that the Health System has received an “A” grade from the Leapfrog Group for its accomplishments in reducing errors, infections and accidents that have the potential to harm patients.

2017 Vizient Bernard A. Birnbaum, MD, Quality Leadership Award. UTMB was one of 12 academic health centers in the U.S. to earn the recognition and the only one in Texas to receive a five-star rating. “Alone, each of these recognitions is a tremendous accomplishment,” Sollenberger said. “Together, they signify the progress that we are achieving to provide the best care to every patient, every time. The recognitions are the result of our faculty physicians, house staff, nurses, other care providers and those in support functions working together to meet the highest standards of patient safety.”

The Leapfrog Hospital Safety Grade assigns grades to hospitals “based on their record of patient safety, helping consumers protect themselves and their families from errors, injuries, accidents and infections,” according to its website. “UTMB continues to make patient safety a priority as part of our Best Care initiative,” said Donna K. Sollenberger, executive vice president and chief executive officer, UTMB Health System. “Receiving an ‘A’ grade from Leapfrog reinforces the results we have achieved through our efforts.” Leapfrog is a nonprofit organization founded in 2000 with the goal of providing information that helps the public make better decisions about their health care. UTMB’s success in achieving an “A” for excellence in safety and quality is the latest kudo for the university. In September, UTMB was honored to receive the

According to Dr. Gulshan Sharma, UTMB’s vice president, and chief medical and clinical innovation officer, “Receiving an ‘A’ score confirms that our efforts to continually provide high-quality patient care throughout our health care system are paying off for our patients.” The Best Care initiative, implemented in 2016 at UTMB, resulted in significant improvements in quantitative measures of quality and safety, leading to UTMB receiving the top grade from Leapfrog and the Vizient award. n

Helping Puerto Rico UTMB collaborates with nonprofit organization to collect much needed medical supplies for pediatric hospital following Hurricane Maria BY SHANNON PORTER

During Hurricane Harvey, Dr. Maria Belalcazar saw firsthand how a natural disaster can devastate a community. So when Hurricane Maria hit Puerto Rico in September, leaving residents without power and running water—and hospitals without supplies—she wanted to do whatever she could to help. During Harvey, Belalcazar and her family were literally inches away from being flooded out of their home. “My neighbors and many friends were not so lucky,” said Belalcazar, associate professor of internal medicine and director of UTMB’s inpatient diabetes programs.

It wasn’t just one person from UTMB who helped get the supply donation together. First, Frank Reighard, associate vice president of supply chain management, was contacted by Dr. David Marshall, chief nursing and patient services officer, after Belalcazar reached out to him.

As soon as the water receded, like many in the UTMB community, she began help- “Once we received confirmation ing friends and family remove damaged furniture, soggy carpets and wet Sheetrock from the President’s Office that Dr. Supply Chain Logistics team members, from their homes. Less than two weeks later, Hurricane Maria hit Puerto Rico. Callender approved the $10,000 Dr. Maria Belalcazar and Dr. Patricia Maeso stand with UTMB’s $10,000 “We were right in the middle of our community’s own recovery effort when donation of supplies, I reached medical supply donation. Hurricane Maria hit,” Belalcazar said. “I was so alarmed to hear about all of out to Ricky Flores, who got me the devastation that occurred. Puerto Rico was totally isolated, had poor com- in touch with Karina Iglesias at the Puerto Rico Pediatric Hospital who reviewed munication, no water, no power—and hospitals were running out of supplies.” with the hospital surgeons to prioritize their supply needs,” Reighard said. Belalcazar reached out to a friend and former UTMB faculty member from Puerto Rico and asked her how best she could help. “She was the one who made me aware of a pediatric hospital in San Juan and how a group here in Texas was organizing efforts to get supplies to them,” Belalcazar said. “I thought, ‘I’m sure if I share this request with our leadership that we as a UTMB family can come together to make a difference—and that’s exactly what happened.” Belalcazar connected with Texas United for Puerto Rico, a grassroots organization that has been collecting supplies to take to island. Currently, the organization has two warehouses in Houston with nearly half a million pounds of supplies.

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The Puerto Rico hospital then sent back a “priority wish list” that StJohn Sturton and Rachael Haring, both from Supply Chain Logistics, coordinated and filled within the donation limit. In total, UTMB donated $10,000 worth of pediatric neurological supplies to the cause. “We have been able to reach 20 municipalities across the island to disperse help,” said Dr. Patricia Maeso, an otolaryngologist and member of Texas United for Puerto Rico who picked up the donated supplies from UTMB’s Galveston Campus. The supplies collected are being sent out every week, Belalcazar said. UTMB’s donation will be sent directly to the pediatric hospital in San Juan. “I think this really represents who we are at UTMB,” she said.

The results are in! Feedback from more than 1,000 employees will help guide Impact newsletter’s path forward BY KIRSTIANN CLIFFORD

The print edition of UTMB’s employee newsletter, Impact, has been back on newsstands for two years after becoming online-only following Hurricane Ike. UTMB’s Marketing and Communications office re-launched the print edition in 2015 in response to employee survey and focus group input and as part of a larger effort to strengthen internal communications. A recent employee survey aimed to find out whether employees prefer the print or online edition of Impact, how they access it, what types of articles they like most and what suggestions they may have for improving the newsletter. After combing through more than 1,000 responses and taking notes on what you love—and don’t love—about Impact, it’s time to reveal the results: • The overall impression of Impact is positive. Overall, 97 percent of survey respondents who had heard of Impact were either “very” or “somewhat” satisfied with the newsletter, and nearly half of respondents read Impact every month. Readers like that Impact is about people, and they enjoy seeing friends and colleagues featured in it. The “Day in the Life” series is a reader favorite, along with employee features, health tips and articles about UTMB news. • Employees read Impact because it keeps them better informed about other areas of UTMB. More than 80 percent of survey respondents said they feel more informed, and many employees mentioned that they like the diversity of articles and mission areas included. • The print version is preferred. Across all entities—Academic Enterprise, Health System, Institutional Support and Correctional Managed Care—the print edition of Impact is the No. 1 choice among those expressing a preference. Overall, 48 percent of respondents preferred the print edition, 27 percent preferred online and 25 percent had no preference. We received several comments favoring the print edition, such as “There is something special about reading articles that aren’t electronic, but are still on paper you can hold and read,” and “I like having a printed copy because I can take it home. My husband reads it, too!” We also received many great story ideas and suggestions for improvement. Based on your feedback, the Impact team will be making additional modifications this fiscal year to make the newsletter even better. Among them:

• Improve access to print edition. Some employees said they preferred the print edition but indicated they were only getting Impact online. To improve access to the print edition, the Impact team will adjust news rack locations to high-traffic areas and will add a few racks to the Galveston and Angleton Danbury campuses. The number of printed issues will stay the same (about one issue for every three employees); however, the number of issues per rack will be adjusted based on usage patterns over the past couple of years. Impact will continue to be produced in an economical fashion by utilizing UTMB’s in-house digital printing and distribution capabilities through Printing Services. • Revamp Impact website. The internal communications team is in the planning stages of making improvements to the Impact website. To better organize stories and make the site easier to navigate, the current blog roll-style format will be transformed into a landing page similar to UTMB’s Newsroom website www.utmb.edu/newsroom, with stories separated under various subject headings. The goal is to make it easier to read and find information relevant to you. • Continue adding diversity. Many employees said they appreciated how Impact includes features on employees from all areas and job titles around the institution, but a greater focus on front-line staff was desired. The Impact team will work to bring greater balance to our coverage, in terms of mission areas and roles throughout the institution. • Spice up the “Leader Spotlight.” This series gives a candid look at leaders’ personal and professional priorities in a question-and-answer format. Future segments will switch up questions regularly and will be less text-heavy, focusing more on photos and short-answer responses. • Include more interactive elements. Backed by popular demand, the “Did You Know?” section of Weekly Relays will soon be regularly featured in Impact. In addition, the “Parting Shot” will evolve and the space will also be used to share other news, as well as trivia questions. Impact readers will be invited to submit their responses for the chance to win a small prize, and winners will be listed in the following month’s issue. The Impact team is also looking into including a “Hidden Talents” segment, where UTMB employees can submit photos and information on their talents for possible inclusion. n

Thank you to everyone who participated in the survey. With your help, we are improving our system of communication and staying connected to one another and to our university’s mission. Your feedback helps guide the newsletter forward and ensures the inclusion of useful news and engaging stories about UTMB faculty, staff and students, and the great work going on at UTMB locations throughout the state. There is a lot to be proud of at UTMB, and we want the pages of Impact to tell those stories.

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RESEARCH

Oxidative stress produces damage linked with increased risk of preterm birth BY DONNA RAMIREZ

A GROUP OF SCIENTISTS led by Dr. Ramkumar Menon at UTMB have gained new insights into what factors lead to preterm birth. These findings could help pregnant women decrease their risk. This study is currently available in The American Journal of Pathology. When a woman is pregnant, the amniotic membranes serve important developmental and protective functions for the growing fetus. As a woman nears the end of her pregnancy, the amniotic sac develops fractures and eventually ruptures, causing her water to “break.” “Small fractures in the amniotic membranes called microfractures build up as pregnancy progresses, producing an inflammatory response that is tied to labor and delivery,” said lead author Dr. Gracie Vargas, a UTMB professor in the Department of Neuroscience and Cell Biology. “When microfractures accumulate earlier in the pregnancy than expected, the woman’s water can break early, increasing the risk of infection and preterm birth.” The researchers sought to understand what leads to early microfractures and focused on oxidative stress. In the process of breathing in oxygen, our bodies produce byproducts such as reactive oxygen, also called free radicals. Oxidative stress happens when a body’s system is unable to remove the sometimes toxic byproducts in reactive oxygen that often results in an imbalance in the system. “Oxidative stress is a source of damage that is the total stress placed on bodily tissues by normal functioning combined with outside stressors such

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as infection, poor nutrition, being overweight, smoking and taking illicit drugs,” said lead author Lauren Richardson, a UTMB graduate student in the departments of Neuroscience and Cell Biology and of Obstetrics and Gynecology. “An effort to decrease oxidative stressors is one of the reasons for the popularity of antioxidant-containing foods, beverages, skin care products and vitamins.” “Oxidative stress induced more microfractures in the amniotic membranes of women whose water broke prematurely than in women who gave birth at the end of their term,” said Menon, senior author and principal investigator, and assistant professor in UTMB’s Department of Obstetrics and Gynecology. “We are seeing this for the first time because earlier microscopic methods were not sensitive enough to detect these fractures.” The researchers acquired amniotic membranes donated by women about to give birth and exposed the tissues to cigarette smoke extract in the laboratory. Using a combination of specialized microscopic techniques, they studied the impact of the smoke extract on microfractures. They compared normal, full-term amniotic membranes donated by women in labor at the end of their term and from women not in labor but preparing for a cesarean section with the donated membranes of women who delivered prematurely and women whose water broke early. Other study authors include UTMB’s Tyra Brown, Lorenzo Ochoa, Samantha Sheller-Miller and Dr. George Saade, as well as Dr. Robert Taylor from Wake Forest School of Medicine. n

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A day in the life of

Alumni Relations BY KIRSTIANN CLIFFORD

IT’S 8 A.M. ON A SATURDAY and Kim Barfield is in the midst of two days of nonstop receptions, luncheons, speakers and reunion dinners. More than 400 UTMB alumni and their guests have descended upon the San Luis Resort in Galveston for Homecoming Weekend—an October event that Barfield, assistant director of Alumni Relations and Annual Giving, and her team have been preparing for all year. “Good morning, are you all checked in?” Barfield says as she smiles and greets a group of alumni who walk up to the registration table, which is set up in the hotel lobby. She sifts through hundreds of nametags and explains that this year’s homecoming is honoring the 50th anniversary of the Class of 1967, as well as the classes of 1972, 1977, 1982, 1987, 1992, 1997, 2002 and 2007 from all four UTMB schools. Proud alumni have traveled from as far away as Anchorage, Alaska, for the festivities.

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“It says a lot about the institution when the alumni are really proud of where they came from; UTMB has a pretty cool story, so our alumni are very passionate,” says Barfield. “There are so many

By 10 a.m., the large crowd that had formed near the registration table disappeared into a conference room to hear UTMB President David Callender provide an update on the university. Barfield takes the rare opportunity to sit for a moment and describe her responsibilities outside of homecoming weekend. “Homecoming is just one small part of my job. I see my role as part of a continuum, to build connections between students and alumni,” said Barfield. “I work closely with all our school alumni associations, the Student Government Association, and even helped establish a parent program that is very active. When everyone is engaged and supporting their alma mater by committing time and personal resources, UTMB can truly thrive.”

facets to this weekend and it’s not just about our events and raising money—it’s also about building relationships. We want people to love UTMB so much that they want to stay connected—and it’s a home to them. When alumni arrived on campus this weekend, we told them ‘Welcome home!’ and they were all excited—a lot of them haven’t been here for a long time.” As Dr. Callender’s presentation ends, Barfield helps direct people Barfield took the lead on organizing the School of Medicine’s upstairs to the President’s Luncheon, which will honor the class of homecoming events, and tells me her role that day will be to ’67 and recognize distinguished alumni. Although she is in contact act as the “home base” person—keeping the registration area with thousands of alums each year, she recognizes many names going, answering questions and making sure everything runs and faces—and even gets some people involved in a friendly smoothly. It’s obvious that Barfield has done this before. In fact, competition to get their friends to join the alumni association. this is the 10th year she has helped coordinate homecoming “We just started offering a challenge coin—much like the coins and the myriad of events that come with it. collected by military service members—to those who are cur-

“It really is a team effort to pull this all off,” she says, pointing rently in an alumni association and challenge another alumnus to her small team of Alumni Relations colleagues. “Between to join, as well,” says Barfield. “People have gotten pretty excited the six of us, there are so many different details to keep track about it. And it’s a way for us to show our appreciation. of, from planning the agenda to promoting and managing “We try to add a personal touch to everything we do and make RSVPs and making sure everything goes well during the actual sure everyone knows they are appreciated, whether they volunteer events. I print everything out and put it in a binder to refer or give $5 or $500. Our assistant vice president (Kevin Haslam) back to—it’s a ‘Kim’s mind in a binder’ kind of thing. But we is a big proponent of hand-written thank you letters—he has a all work together so well—it’s this crazy family dynamic and massive pile of pens in his office.” it just clicks.” Barfield’s energy and enthusiasm is contagious. Several alumni are drawn to her outgoing personality and excitedly launch into stories about how UTMB was in the “old days.” “It’s always fun to talk to doctors and their spouses about their days here at UTMB and how much it’s changed,” she says. “It was a different dynamic decades ago because there weren’t as many women in medical school. To see how it has changed over the years is amazing.”

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As the afternoon transitions into evening, the team members As if the two days of events weren’t enough to tire a person out, I turn their focus to the Alumni Reception, which includes a learn Barfield is getting married at the very same location—the cocktail hour and School of Medicine class photos. Barfield San Luis Resort—the following weekend. She still has much to hands out signs with the various class years printed on them to do to plan for that event, but it doesn’t faze her. As the mother of help gather SOM alumni with their classmates. It’s a little chaotic a 3-year-old and a self-professed Wizard of Oz fanatic, Barfield at first, but Barfield is in her element, corralling the excited and is happy to be right where she is, discovering her own path in distracted physicians, then taking the microphone to announce life and enjoying the journey. which classes will be first to have their photos taken. “You could say I’ve scoped the venue out pretty well,” she laughs. “Kim is very detail-oriented, as you can see, and prepared for “It’s been a little overwhelming at times but I’d much rather be anything,” says Haslam. “We really have a blast. Our team is a busy and feel challenged than be bored. A lesson I take to heart bunch of really passionate people who genuinely care about each from the Wizard of Oz is when in doubt, look within. We are other and work tirelessly to make UTMB successful.” all more powerful than we think.” n Once all class photos have been taken and alumni and their guests have been escorted to their various dining locations, I say goodbye to Barfield. It’s going on 8 p.m., but she wants to stay “just to make sure” the night ends without a hitch.

UTMB alumni by the numbers • 32,588: Living alumni • 25,789: Alumni who live in Texas • 8: Number of degrees conferred in 1892

• 1,189: Number of degrees conferred in 2017 for all four UTMB schools

• 41,858: Estimated number of

degrees, diplomas and certificates conferred from all UTMB schools 18922017 – Medicine: 14,755 – Nursing: 12,230

(Photo above) Kim Barfield and the Alumni Relations team (L-R): Kevin Haslam, Jennifer Crawford, Lisa Loney and Marie Ann Marczak. (Photo to left) Barfield and Julie Cantini, director of alumni and parent relations

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– Health Professions: 12,148 – Biomedical Sciences: 2,192 – Pharmacy: 533 (School of Pharmacy moved to Austin in 1927)

LEADER SPOTLIGHT

Spotlight on Gary Eubank chief nursing officer, Correctional Managed Care Gary Eubank joined UTMB Correctional Managed Care’s management team in 2005. In his role as chief nursing officer, he oversees the nursing services provided to approximately 120,000 offenders at 83 prisons in the UTMB sector. Prior to UTMB, Eubank had served as a chief nursing officer at tertiary-level hospitals in the not-for-profit and for-profit sectors since 1983. He has had the opportunity to redesign the health care delivery system in several hospitals in Texas, Kansas, Missouri, Florida and Ohio. He has participated in the building of two acute care hospitals, and continues to provide consulting services to acute care hospitals focusing on staffing plans, assessing productivity and implementing budgeting systems. Gary Eubank enjoying a trip to Austria with his church choir.

Eubank first began his career in health care in 1970, as an orderly while working toward a bachelor’s degree in nursing at the University of Oklahoma. He received a master’s degree in Nursing from Texas Woman’s University.

We’ve just celebrated UTMB’s tremendous success with Best Care. UTMB CMC is a national leader in providing the highest quality of care at the lowest cost and is known for its innovative programs and creative solutions in the fields of correctional health care. What are your thoughts on how UTMB can maintain its high performance long-term? It is so valuable to always strive to make improvements—and track your progress—when it comes to providing evidence-based care to patients. For example, UTMB CMC has created a clinical dashboard that clearly illustrates key system information to all stakeholders and also provides a means for data-driven decision-making in our improvement activities. This includes a review of specific patient outcomes, important information for medication management, access-to-care indicators, specialty care information and telehealth activity. The dashboard is designed to provide multiple layers of reporting, including overall system information, regional information, facility information and individual patient information. Using the clinical dashboard, we have exceeded goals set within the last few years. One clinical indicator we recently completed was to get 80 percent of patients with diabetes who were continuously incarcerated during the last 12 months to have a nephropathy screening completed by May 31, 2017. By being able to target specific patients and track our progress, we went beyond that goal and got 88 percent of those patients screened—leading to quicker treatment and better health outcomes.

What challenges do nurses face in the correctional managed care setting? Nurses in a correctional environment must have a vast array of assessment and interventional skills. We treat patients with fungal diseases, rashes, sore throats—and we must also respond to emergency situations as the first responder. Nursing is the patient’s lifeline for health and wellness. We have to be excellent outpatient nurses while at the same time, care for those patients whose acuity requires an inpatient level of care at one of our infirmaries.

What would you tell nurses who are thinking about transitioning to correctional managed care? Several of our nurses have told me they felt a “calling to corrections.” Providing excellent nursing and medical care behind bars is one of the most rewarding opportunities one can experience. Our patients do not have a choice as to where they go for their health care. We are their only choice. It is incumbent upon us to provide our patient population with the highest level of health care, employing the values that UTMB stands for, and exemplifying the pride of the university as we care for a less-fortunate population. This is how we go about working together to work wonders in correctional health care!

What inspired you to pursue a career in correctional managed care? I was working out of state, but my heart was still in Texas. I got a call from Dr. Owen Murray, our vice president for Offender Health Services, telling me about this opportunity to come to prison. He is so energetic when he describes correctional health and the joy of working for UTMB. I was quite skeptical at first, but Murray described the vast array of challenges and rewards one receives from working in a correctional environment. I accepted his offer and believe my position as CMC chief nursing officer was an answer to prayer. I have thoroughly enjoyed my 12 years here.

What is your proudest accomplishment? I have two beautiful adult daughters. My oldest lives in a suburb of Kansas City with her husband. They are both elementary school teachers. My youngest daughter lives in Katy with her husband and 10-year-old daughter. He is completing his final Cedillo with Ninfa,ofatHouston. Great Smoky Park in Tennessee. yearJosé of law school at his the wife, University She isMountains a programNational officer for Fund for Teachers, a nonprofit organization. She and her husband are providing me with another granddaughter in March!

What’s the best advice anyone’s ever given you? John Donne wrote, “Any man’s death diminishes me, for I am involved in mankind.” I read that in English class my junior year in high school. It has had a profound impact on me and I often reflect on those words as I care for the patients and staff at UTMB CMC.

What is your favorite book? The Bible. I continuously read it over and over again.

Movie? The Lion King. I love the music and the storyline. I have even seen the live performance at the Hobby Center in Houston.

What do you like to do outside of work? In addition to spending time with my family, I can also be found with my yellow Lab named Boomer and a miniature schnauzer named Sooner.

What’s something people would be surprised to know about you? I am very active in the music ministry of my church in The Woodlands. Our choir is made up of over 100 singers and a full orchestra that plays each Sunday. There’s a group of us who pay our own way to go on tour every two years in countries across Europe. The people there love to see and hear a choir from Texas. Everyone wants to know where our cowboy hats are and if we still ride horses and have cattle and all the other stereotypical Texas stuff. So far, we have gone to Austria, Germany, Switzerland, Ireland, Italy, Israel, Poland and the Czech Republic. n

NOVEMBER 2017

impact

Honoring all who served University recognizes military heroes past and present with first-ever UTMB Veterans Day Luncheon celebration BY KIRSTIANN CLIFFORD

UTMB honored faculty, staff and students who have served in the military with its first-ever Veterans Day Luncheon celebration on Nov. 2 on the Galveston Campus. More than 200 people filled the Levin Hall Dining Room to capacity for the event, which was organized by the UTMB Veterans Resource Group (VetsRG) and several community and institutional sponsors.

and Tina Brown, a senior IT training specialist and U.S. Navy and Navy Reserves veteran, also took part in the panel discussion. Dr. Callender encouraged all veterans at UTMB to continue the dialogue on how the institution can further support veterans and make UTMB an even more welcoming place to work.

“Veterans play a critical role here and bring us experiences that translate into helping UTMB be more successful,” he said. “We want to continue to be vetWith about 9.5 percent of UTMB’s workforce self-identifying as military veteran friendly and show that we are inclusive—veterans are a tremendous erans or active duty personnel, UTMB President David Callender moderated asset to UTMB.” a panel of four UTMB veterans who provided candid responses to questions about why they joined the military, what they learned from the experience and how the university can better support veterans.

“We need to continue educating recruiters to understand what military people are trying to say in their resumes and translating that into civilian jobs.”

Along with the panel discussion, the luncheon featured music by the Ball High School Choir and a video created by the VetsRG showing the many faces of UTMB’s veteran workforce.

“It’s important to encourage a mindset of feeling Marcel Blanchard, associate vice president of Utilities committed to a greater cause—and that will and Services and a Vietnam-era veteran, gave closcontinue to draw people with our backgrounds ing remarks. He recalled the lack of support he and other veterans coming home after Vietnam received and compared that to the to UTMB,” said Anthony Curry, UTMB assistant police chief and U.S. Army, Army numerous services available today. Reserve and Army National Guard veteran. “We have been part of something bigger than ourselves and we are looking for another stop with that same kind “Once we returned to the states, we were wished good luck and that was it! You of connection. When I came here in 2002, my training officer told me, ‘Give it were on your own to figure the rest out. It was a very traumatic event for me two years. If you stay here two years, you are here for life.’ And 15 years later, and my family,” said Blanchard. “When I contrast that to the services we have here I am. I’ve felt a part of something. UTMB really is a family.” available today through UTMB leadership and the Veterans Resource Group, it is encouraging to know that our new veterans will be better served and more Lori Blackwell, a U.S. Navy veteran and senior administrative manager with prepared for the future.” University Events and Conferences, talked about the difficulty she had applying to jobs more than 13 years ago, when she transitioned from the military to The VetsRG was formed about two years ago and was the first employee the civilian workforce. resource group to be created by the UTMB Diversity Council. Its mission is to “One issue I faced was explaining to recruiters what I did in the military and how it could apply to a job in the civilian world,” she said. “We need to continue educating recruiters to understand what military people are trying to say in their resumes and translating that into civilian jobs.” Juan Guerrero, a business operations manager and U.S. Marine Corps veteran,

promote an inclusive university environment for military veterans and their allies through transition support, education, career enrichment and outreach. For more information or to join the VetsRG, visit https://hr.utmb.edu/diversity/veterans. To view more photos from the Nov. 2 luncheon, visit UTMB’s Flickr page at www.flickr.com/photos/utmb. n

Some of the veterans recognized at the Nov. 2 luncheon. Veterans make up about 9.5 percent of UTMB’s workforce.

impact

NOVEMBER 2017

EDUCATION

Growing a community of educators UTMB’s Academy of Master Teachers celebrates 10 years of recognizing outstanding teachers, promoting educational excellence BY KIRSTIANN CLIFFORD

There’s no question—Dr. Ruth Levine has always loved teaching. “When I see students get that ‘spark’ of understanding and start putting things together, it’s exciting for them—and me,” said Levine, assistant dean for educational affairs and director of the Office of Clinical Education within the School of Medicine. “Any kind of learning should be fun. If it’s not fun, you’re not doing it right.” If you ask students, she is doing it right. Since joining UTMB as a faculty member in the Department of Psychiatry and Behavioral Sciences in 1991, she has served in numerous educational roles and received many teaching awards, including the University of Texas System’s highest teaching honor, the Regents’ Outstanding Teaching Award. It’s only fitting that Levine also was chosen as the inaugural director of UTMB’s Academy of Master Teachers. The AMT is an honorary service organization formed in 2007 to recognize UTMB’s top teaching faculty from all four schools and allow them to give back to the educational community. Over the last decade, the AMT has grown from an original membership of 18 to 63—it’s even helped inspire the creation of other academies on campus focused on master clinicians and research mentors.

(L-R) Former AMT directors Drs. Ruth Levine, Vicki Freeman and S. Lynn Knox with current director, Dr. Bernard Karnath. As AMT director, Karnath looks forward to expanding the academy’s impact throughout the region by continuing to collaborate with UT Houston’s McGovern Medical School and Baylor College of Medicine on a spring symposium that supports lifelong learning and growth for faculty throughout the area. He also wants to further collaborate and build bridges with the existing academies at UTMB by co-sponsoring activities and bringing in visiting professors.

Each member is selected through a rigorous peer-review process, with applications for membership accepted on an annual basis. The academy provides faculty development opportunities, mentoring and peer evaluation of teaching activities, as well as resources and recognition for innovative programs and educational scholarship. “We have built a great academy and I want to continue to grow in terms of opportunities for our faculty,” said Karnath. “It means a lot to our educators to know “One of the biggest accomplishments for the AMT has been the way it has enabled there is an academy that will provide support to them in terms of resources and educators from all four schools to come together,” said Levine, who served as AMT continuing education.” director for five years. “Interprofessional education is something we talk about all the time now, but it wasn’t a thing 10 years ago. The academy has given us the Levine said Karnath will do an excellent job and looks forward to seeing how the opportunity to get to know our colleagues in the other schools in a way we never have AMT evolves and continues to promote the art of teaching. before and learn from them and collaborate with them. It’s been really meaningful.” “We have the opportunity to influence quality of patient care through the way we Levine and two former AMT directors, Dr. Vicki Freeman and Dr. S. Lynn Knox, were recognized during the AMT’s 10-year anniversary celebration Sept. 22 on the Galveston Campus, along with the academy’s newest director, Dr. Bernard Karnath. A professor with tenure in the Department of Internal Medicine, Karnath joined UTMB as a medical student in 1990 and has been a faculty member for the last 20 years. Inspired by Sir William Osler’s humanistic and holistic principles of the practice of medicine, Karnath always tries to engage students by teaching at the bedside. You won’t see him giving any long lectures in the Practice of Medicine class; he prefers hands-on activities to help students understand the value of bedside diagnostic skills. “I try to help students through the process of active learning—we are getting away from passive learning where you sit in a classroom all day,” said Karnath, who has received numerous teaching awards and was inaugurated in 2008 as a William Osler Scholar in the John P. McGovern Academy of Oslerian Medicine, the highest honor bestowed to teaching faculty at UTMB. “I also teach students that medicine requires lifelong learning. Even 20 or 30 years out of medical school, you need to study every day.”

teach our learners, so providing a good education is paramount,” she said. “We are bringing up the next generation of health care providers. What’s more important than that?” n

Welcome to the newest members of the Academy of Master Teachers, who were inducted on Oct. 17: • Dr. Claudia Hilton, associate professor of Occupational Therapy, School of Health Professions • Dr. Patricia Lea, associate professor and program director of the School of Nursing’s Baccalaureate and RN-BSN Programs, School of Nursing • Dr. Harold Pine, associate professor of Pediatric Otolaryngology, School of Medicine • Dr. Dawnelle Schatte, associate professor of Psychiatry and Behavioral Sciences and director of undergraduate education, School of Medicine • Dr. Dana Wild, associate professor of Physical Therapy, School of Health Professions

NOVEMBER 2017

impact

EDUCATION

Incorporating cultural competence to provide quality health care to all 2017 HECTOR P. GARCIA CONTEST WINNING ESSAY AND ABSTRACT ANNOUNCED BY SHANNON PORTER

Stephanie Tutak is inspired by Dr. Hector P. Garcia’s story, his commitment to service and his role in improving access to health care.

“I believe medicine is a social responsibility and I try to advocate for my patients as much as possible during my clerkships in medical school,” Tutak said.

So when the fourth-year medical student was named the winner of the 2017 Hector P. Garcia, M.D. Cultural Competence Award during the annual luncheon Oct. 6 on the Galveston Campus, she felt honored to play a part in carrying out his legacy.

Tutak’s essay shared her own personal reflection of one patient who had been diagnosed with HIV and went on to face a lack of cultural competency throughout her treatment. Tutak analyzed patient dissatisfaction throughout her treatment, examining how greater sensitivity to the patient’s culture could have improved her experience and her care.

The program, sponsored by the Office of the President and the Hispanic Center of Excellence under the direction of Dr. Norma Perez, recognizes a student who “demonstrates commitments to providing quality health care to all by incorporating cultural competence in his or her service to others.” The award is named in honor of Dr. Garcia, who graduated from the UTMB School of Medicine in 1940 and became well-known throughout Texas and the U.S. as a trailblazer in the fight for civil rights for Mexican-Americans in Texas. Like Garcia, Tutak has an interest in health disparities, which first piqued during her studies at the University of Texas at Austin. She enrolled in a course on health inequity after an experience on a medical mission in Honduras, which drove her to question the ethics of her involvement in providing transient medical care to a Spanish-speaking patient population with a culture and language different from her own.

To read Tutak’s winning essay, visit the online version of Impact at www.utmb. edu/impact. First-year medical student Florentino Saenz was presented with the winning award for his poster highlighting his work in the Rio Grande Valley. His project focused on reducing stress levels and looked at the effects of yoga and other body management techniques on the levels of cortisol in his study’s participants.

Left to right: Dr. Danny Jacobs, James Akers, Cecilia Garcia-Akers, Stephanie Tutak, Dr. David Callender

The luncheon, attended by members of Garcia’s family, also featured a keynote speech by his daughter, Cecilia Garcia Akers. Akers is the founding member of the Dr. Hector P. Garcia Memorial Foundation and serves as its board president and chair. n

Disaster Day simulation sets example for interprofessional education at UTMB BY STEPHEN HADLEY

UTMB’s Interprofessional Scholars Program recently hosted its first Disaster Day, a student-led, large-scale simulation aimed at preparing and educating health care professional students on responding to a crisis. School of Nursing students Casey Schneider, Sophia Hashemi and Madison Lankford collaborated with other schools at UTMB to gather about 200 students and faculty volunteers for the Nov. 4 simulation at Moody Methodist Church in Galveston. The goal of Disaster Day was to foster interprofessional teamwork and provide the opportunity for the next generation of health professionals to practice skills learned in the classroom and apply them in a simulation of a potentially catastrophic event they could face in the future, said Shelley Smith, UTMB director of Interprofessional Education and Practice. Smith said Disaster Day is an example of interprofessional education espoused in the new IPE2Practice Quality Enhancement Plan underway at UTMB. In this instance, the simulation was a hydrofluoric acid release caused by the landfall of a tropical storm. Student organizers of the event worked with the UTMB Hydrofluoric Acid Symposium and UTMB’s Office of Interprofessional Education and Practice to review 40 case studies to make the simulation as realistic as possible. As part of the event, third- and fourth-year medical and nursing students teamed up as volunteer first responders who “treated” patients affected by the acid release. The patients were student volunteers from all four UTMB schools.

impact

NOVEMBER 2017

During the simulation, there were four waves of patients with a large variety of diagnoses, such as mental illness, burns, abrasions, a woman in labor and more. As students worked together to treat the patients, faculty members provided instruction and assistance. Afterward, responders discussed lessons learned during the simulation and faculty provided feedback on the students’ performance. “During this simulation, students learned about interprofessional communication, the triage system and how to effectively organize their team and prioritize to provide effective health care in the event of an emer- From left, Sophia Hashemi, Casey Schneider and Madison gency,” Smith said. Lankford helped organize the first UTMB Interprofessional “The students hope Scholars Program Disaster Day on Nov. 4. to continue this simulation each year to foster the culture of interprofessionalism at UTMB.” n

Seven tips for a better family health history By Dr. Michael Thanh Nguyen, assistant professor of Internal Medicine and medical director of Internal Medicine at the UTMB Multispecialty Center and Stark Diabetes Clinic As you attend family gatherings this holiday season, don’t just ask your loved ones to pass the turkey. Ask them about their health history. It’s the perfect time to gather important information that you and your doctors can use to create a plan for preventing disease. Follow these tips for compiling a detailed family medical history: 1. Start with those closest to you. First-degree relatives such as your parents and siblings are the most important to gather information about. Gather information about them first, and then expand your search to include grandparents and aunts and uncles. If you are adopted, you might consider checking with the agency or organization that facilitated the adoption to find out what medical records are available. 2. Find your family’s historian. Oftentimes, our eldest family members are the best sources for obtaining history. Many people may suffer short-term memory loss, but their recall of past details can be remarkable. Even if the actual diagnosis is not known, recalling a family member who had “some type of stomach cancer or blood disorder” can be useful. 3. Make it fun. Keep the conversation lighthearted and remind everyone that it is for everyone’s benefit no matter how embarrassing or personal. If necessary, talk to your relatives about health history in private. They may open up more one-on-one than at the dinner table. 4. Use a negative situation to make a positive impact. Unfortunately, the only time some families meet is during hardship or funerals. Use that time wisely to have meaningful, open and frank conversations regarding your family health history. See if anyone else is at risk for the cause of illness or death that prompted the gathering. For example, discuss whether anyone is dealing with untreated high blood pressure, high cholesterol or diabetes. 5. Pass it around. Don’t lock your family health history up in a drawer; make it a “living document” that can be updated continually. The Surgeon General’s “My Family Health Portrait” tool (https://familyhistory.hhs.gov/FHH/html/index.html) is a good option. Once you’ve done your part, you have the option of sharing it with other family members, if you wish.

6. Don’t overthink it. Give your doctor all health history you gather, no matter how small the detail may seem. Let your physician be the judge. For example, you may not have sought treatment for a skin rash five years ago, but are now having a burning pain in the same area. Those details may prompt your provider to discover you have a recurrent bout of shingles and get you treated much more quickly. 7. Update your provider via an online patient portal (such as MyChart), letter or printout to be given at your next visit. This could be especially meaningful if the information you send now could relate to a problem you presented to your doctor’s office months ago. For example, if you have a sibling who recently suffered a heart attack, it could prompt your provider to revisit symptoms such as shortness of breath or fatigue you had complained about at a previous checkup. To sign up for UTMB MyChart, go to https://mychart.utmb.edu/mychart.

PARTING SHOT

Celebrating 60 years at UTMB September 5, 1957—that was Adeline Smith’s first day as a nurse’s aide on UTMB’s Galveston Campus. She would later transfer to UTMB’s Food and Nutrition Services team. Now, 60 years later, she’s still feeding patients and bringing a smile to everyone she meets—with no immediate retirement plans. On Oct. 30, representatives from UTMB food service provider Morrison Healthcare and its parent company, Compass Group, held a special reception for the organization’s first employee to reach such a milestone. Jay Niner (pictured left), regional vice president with Morrison, presented Smith with an award recognizing her achievement. Smith even made a special menu request—fried pork chops, collard greens, black-eyed peas and cornbread—now (unofficially) renamed the “Adeline Special.”