Impact April 2017 by UTMB Health

UTMB NEWSLETTER • APRIL 2017

Best Care in Action: HR and Nursing Service team up to improve safety Spotlight on Tony Williams, Correctional Managed Care The art of anatomy

Delivering miracles at UTMB’s League City Campus

Two UTMB doctors, Jeffrey Aycock, DMD, an oral and maxillofacial surgery resident, and Dr. Andrew Grant, a professor of Internal Medicine and Microbiology and Immunology, were onboard an Atlanta-to-Houston Southwest Airlines flight when a passenger fell ill. Aycock, Grant and nearly 20 other physicians happened to be on their way back from a conference and were able to help. “It became obvious that it was an emergency and I rushed to jump right in, squeezing through the tight seats to get to the patient,” Aycock told NBC News. The patient was stabilized and able to deplane on his own. This event was reported in a large number of news stations and outlets across the country, including KVUE, Northwest Cable News, KVOA, 12 News Now, Medical Health News, NBC New York, MSN and many other outlets.

Candelaria. The article notes that Frontera, a student-run volunteer organization founded in 1998, originally provided basic medical care to the Rio Grande Valley, but as access to care improved in the Valley, Dr. Norma Perez, the program’s executive director, identified the Big Bend area for its next project. The Big Bend area is sparsely populated and some regions have very limited access to physicians, hospitals or ERs. Aycock

Grant

Gamboa and Voncannon

Joan Voncannon and Crystal Gamboa, birth registrars at UTMB’s Angleton Danbury Campus, recently received 2016 Five Star Service Awards from the Texas Department of State Health Services. The Five Star Award acknowledges partners who understand the importance of vital statistics and their impact on the citizens of Texas. This award honors those who go above and beyond the duties of birth and death registration by attending trainings and keeping up with the latest legislation and trends.

UTMB’s Frontera de Salud medical mission to the Big Bend area is featured in the latest issue of Texas Family Physician. Fourteen UTMB students recently helped physicians provide primary care at clinics in Alpine, Marfa, Presidio and

Dr. Owen Murray, UTMB’s vice president of Offender Health Services, has been named a commissioner on health care for the American Correctional Association’s Commission on Accreditation for Corrections for a fouryear term. The CAC is the official accrediting body of the American Correctional Association, which is responsible for accrediting nearly 1,400 facilities across the U.S. and around the world. Created in 1974, the commission includes professionals from all areas of the field, including Murray adult and juvenile corrections and detention, community corrections, probation, parole and correctional health services. UTMB provides health care services for most of the state’s inmates.

The School of Nursing master’s degree program recently ranked fifth nationally among institutions offering online nursing graduate programs, according to GraduatePrograms.com The website compiles more than 57,000 student reviews and ratings on more than 1,600 colleges into rankings to highlight the best graduate schools according to students. UTMB’s extremely high student satisfaction ratings placed it among the top programs in the nation. The full list and additional details are available at www.graduateprograms.com/school-rankings/nursing-online.

Dr. Rafic Berbarie, assistant professor, Internal Medicine; Dr. Megan Berman, assistant professor, Internal Medicine; Dr. Anita Mercado, associate professor, Internal Medicine; and Dr. Victor Sierpina, professor, Family Medicine, received this year’s John P. McGovern Academy of Oslerian Medicine Excellence in Clinical Teaching Award. Each year, up to four faculty members are selected for the award, which recognizes the fundamental concept exemplified by Sir William Osler that the development of outstanding physicians occurs primarily in clinical settings. Each recipient will receive $5,000 to support his or her professional development.

Mercado

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From the President Welcome to the newest edition of Impact! It’s hard to believe we celebrated the opening of the Jennie Sealy Hospital a year ago this month. As patients and families got their first glimpse of the state-of-the-art building, Jennie became a symbol of what vision and hope and hard work can inspire.

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The future of health care looks as bright today as it did on Jennie Sealy Hospital’s opening day. On April 7, we broke ground on the new Health Education Center on our Galveston Campus. It was an exciting day for the UTMB family, as we celebrated the upcoming facility that will allow us to continue our legacy of educating health care professionals to serve our state and beyond. The May edition of Impact will include full coverage of the HEC groundbreaking ceremony.

Best Care in Action: HR and Nursing Service team up to improve patient safety

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The start of spring also marks the start of commencement season for all four of UTMB’s schools. Graduating School of Medicine students kicked things off as they learned where they will complete their training in a residency program. You can read more about “Match Day” 2017 in this edition of Impact, as well as many additional stories about how our people are advancing our mission and defining the future of health care. Among them:

A day in the life of a Labor and Delivery nurse manager

• A Day in the Life of Tandra Medellin, nurse manager of the Labor, Delivery, Recovery and Post-Partum Unit at the League City Campus Hospital • A profile of Tony Williams, associate vice president of Inpatient Services, Correctional Managed Care • A Best Care in Action spotlight featuring a collaborative effort between Human Resources and Nursing Service to improve employee safety and patient outcomes • A new lung screening program at the Angleton Danbury Campus that aims to save more lives by detecting lung cancer earlier • A research study that discovered how a new gene interaction appears to be associated with increased risk of developing multiple sclerosis • Students and faculty taking an artistic approach to learning and remembering the body through the “Drop in and Draw Bones: The Art of Anatomy” event • Tips on how to be a lifelong learner by Faith Robin, senior talent and organizational development consultant at UTMB • Numerous accomplishments and kudos in the Working Wonders column and throughout the newsletter

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Spotlight on CMC’s Tony Williams

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I hope you’ll take some time to enjoy this issue, and please let the Impact team know if you have story suggestions for future editions. Thank you!

Drawing bones: The art of anatomy

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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: Tandra Medellin is joined by colleagues of the Labor, Delivery, Recovery and Post-Partum unit at UTMB’s League City Campus Hospital. As LDRP nurse manager, Medellin and her staff help deliver more than 60 babies a month. Staff pictured (L-R) include: Audrey Sanders, Sarah Menotti, Virginia Moore, Jean Race, Tandra Medellin (sitting), Janice Shinette, Michelle Williams and Dr. Crystal Alvarez. 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 Simone Parker Art Director Mark Navarro

B E S T CA RE IN AC TION

HR and Nursing Service team up to improve employee safety, patient outcomes BY KIRSTIANN CLIFFORD

Mobility is a critical piece of patient recovery. Research shows the “Staff has been amazed at how easy and simple the devices are,” said Roach. “They earlier a patient gets out of bed and starts moving, the better health outcomes they will experience. However, getting patients mobilized can pose a risk to health care personnel—lifting is dangerous and can lead to employee injuries. A recent collaboration between UTMB Human Resources and Nursing Service is helping to solve that dilemma. “Being a registered nurse is the fifth most dangerous job in America today,” said Kathleen O’Neill, UTMB’s director of Employee and Occupational Health. “People go into this profession to help—and end up as patients themselves. My goal is for every employee to go home the same way they came in.”

are now much more in the habit of reaching for the assistive devices instead of trying to move the patient without it.”

Most recently, a shipment containing 11 Livengood’s PACE devices arrived in March to be distributed to various hospital units, as well as UTMB-TDCJ Hospital Galveston. The device is basically a “souped-up” walker with shelves and hooks to hold all the patient’s equipment including ventilators, so all patients—even those in critical care—can take a stroll around the hospital.

“Now, patient equipment is clustered on one device, so they are holding on to it and moving with it and their tubes and lines are right there with them,” said Comeau. “This can help prevent inadvertent extubation, or pulling As an RN herself, out tubes and lines, O’Neill understands the while still mobilizing relationship between the patient. And staff patient mobility and is excited. They liked health outcomes. Her piloting this piece of office secured severequipment so much, al grants and began they kept asking when working with Nursing (Left) SICU employees test out the PACE device. (Right) Kathleen O’Neill (green shirt) stands these would arrive. By next to an assistive device with Nursing/SICU employees (from left) Dell Roach, Robert Ball, Service a few years providing them with Jason Lingo, Odette Comeau, Gopakumar Manikandaseril and Wendy Juarez. ago to bring assistive a more hands-free devices to UTMB, ultiapproach to ambulatmately increasing patient mobility and independence while improving employee ing patients, we think it will result in fewer lost days due to injury and improve safety. After collecting data on employee injuries and patient needs, the decision employee retention.” was made to order several different types of equipment, including patient lifts Along with the new assistive devices, Nursing Service is taking a deeper dive and standing aids. into patient mobility. They recently formed a workgroup that meets weekly on “These devices are a win-win for patients and employees,” said Odette Comeau, mobility issues and has incorporated mobility protocols into onboarding training DNP, adult critical care clinical nurse specialist. “There’s plenty of literature out for new staff. In addition, Nursing has designated new mobility technicians to there to support the improved outcomes of patients who mobilize sooner. That play a role on the overall health care team. includes things like shorter ICU and hospital stays and increased muscle strength. Along with that, employee safety is increased—when assistive devices are used, For O’Neill, this project has become her passion—and she’s already seen a positive fewer staff are needed to mobilize patients, and those that are assisting are impact. now freer from back injuries and other injuries.” “When we first got assistive devices in the Acute Care for the Elderly (ACE) unit, we Dell Roach, nurse manager of the Surgical Intensive Care Unit/Intermediate Specialty Care Unit, added that the devices have changed the patient care culture at UTMB. Gone are the days of extended bed rest for critically ill patients. Now, nursing staff is committed to getting patients up and active as soon as possible.

were able to get a woman who had not been out of bed for two years into a wheelchair to eat and go outside for fresh air—that meant a lot to that patient and their family,” said O’Neill. “Her caregivers were not only taking great care of their patient, they were also protecting themselves from injury. I’d say that’s Best Care at its best.”

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PAT I EN T CA R E

Screening to save lives UTMB program aims to make lung cancer screening as routine as mammograms, colonoscopies BY STEPHEN HADLEY

Lisa Rogers says there’s little doubt in her mind that lung cancer screening saves lives. The 62-year-old Rosharon resident continually battled pneumonia and was in and out of the hospital several times over the past two years. But in February, while in the hospital with complications from pneumonia yet again, Rogers met Dr. Ikenna Okereke, chief of Thoracic Surgery.

According to the Centers for Disease Control and Prevention, more than 156,000 people in the U.S. died from lung cancer in 2013, the most recent year data was available. That same year, breast cancer claimed the lives of 49,000 Americans while colon cancer killed more than 51,000 and prostate cancer led to 27,000 deaths. A program to which Okereke contributed while at Brown University VA Medical Center in Providence, Rhode Island, screened 1,832 high-risk patients over a one-year period. The screening program increased the rate of detection of Stage 1 and Stage 2 lung cancer—relatively early-stage cancers with a good chance of a cure and the ability to treat via minimally invasive surgeries—from 37 percent to 60 percent.

Okereke, who joined UTMB in 2015 and is a member of a lung cancer screening program at the institution, says the scan of Rogers’ lungs revealed what was causing her continual health issues: a cancerous tumor in the lower lobe of her right lung that had grown to nearly four inches. Within a week of her diagnosis, Okereke and his team of lung cancer specialists had removed the tumor minimally invasively, using cameras and small instruments, and Rogers began her road to recovery.

From left, Lisa Rogers and Dr. Ikenna Okereke, chief of Thoracic Surgery at UTMB’s Angleton Danbury Campus.

But Okereke says Rogers’ diagnosis could have come much sooner had she been involved in UTMB’s lung cancer screening program as a part of her routine preventive care.

“One of the benefits of lung screening programs is that they can diagnose cancer fairly early,” Okereke says. “Although Ms. Rogers’ tumor was a little more advanced, it was still caught in time to allow us to do minimally invasive surgery, which we can do for almost any lesion we detect through the screening program.” Okereke’s mission is to make lung cancer screening as ubiquitous as mammograms or colonoscopies for people who are considered at high risk of developing lung cancer: those between the ages of 55 and 77 who have a 30-pack/year history (the number of packs smoked per day multiplied by the number of years of smoking). “I’ve been in practice for about 10 years, and I’ve always been a big proponent of lung cancer screening,” says Okereke. “There are well-known screening programs for breast cancer, colon cancer and prostate cancer. But lung cancer kills more people in this country than breast, colon, prostate and pancreatic cancers combined. For decades now we’ve had no real screening modality for lung cancer, whereas those other cancers have. That’s what I’m working to change.”

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One of the impediments to making lung cancer screening routine was the cost. In the past, a typical screen cost between $300 and $400. But about two years ago, Medicare and most private insurers began covering the lung cancer screens.

The process now is as straightforward as most other screening protocols: Patients make an appointment with either Okereke or one of the pulmonology group members for a 15- to 20-minute consultation before they have a five-minute CT scan. From there, patients can usually expect to get their results within a day. Okereke says that comprehensive lung cancer screening nationwide, including in areas like Galveston and Brazoria counties, could potentially save 40,000 to 60,000 lives a year if the screens were a part of routine preventive care recommended by physicians to their high-risk patients. That population certainly includes Rogers, who had been a smoker for nearly 50 years. She quit two years ago, after her first bout of pneumonia. And now that the tumor has been removed from her lung, Rogers says she’s able to breathe again without trouble. “I have no doubt that this saved my life,” Rogers says. “I suspect that if Dr. Okereke had not caught this, the pneumonia would have done me in because the tumor wasn’t allowing the fluid to drain from my lungs. “Now, I can lie down at night and not cough. I’m not running a fever anymore. I’ve still got to get my energy level back up following the surgery, but other than that, I feel pretty good.”

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Researchers find new gene interaction associated with increased MS risk BY CHRISTOPHER SMITH GONZALEZ

R ESEARCH B R I E F S

Compiled from press releases written by Christopher Smith Gonzalez, Kurt Koopmann and Donna Ramirez. Find out more at www.utmb.edu/newsroom.

New research led by Dr. Fangjian Guo, assistant professor of Obstetrics and Gynecology at UTMB, suggests that the increase in women receiving BRCA gene testing may not necessarily mean better diagnosis of those at risk of certain types of cancer. Traditionally, women tested for mutations in the cancersusceptibility genes BRCA1 and BRCA2 have been those diagnosed with early onset breast or ovarian cancer in order to guide treatment options. However, the study findings published in the American Journal of Preventive Medicine found that during the past decade, the use of BRCA testing, a blood test that can identify harmful gene mutations, has gradually shifted from primarily cancer patients to women without breast or ovarian cancer. The research team found that

more than 60 percent of BRCA tests performed are in unaffected women compared to 2004 when only 24.3 percent performed were among unaffected women. Study findings attribute much of the increase in testing among unaffected women to the abundance of marketing targeting consumers, which increases interest in BRCA testing. Guo says effective testing strategies that promote equitable distribution and rational use of BRCA testing that also maximize the detection of mutation carriers are needed. The National Institutes of Health supported the study. Other authors include Jacqueline Hirth, Yu-li Lin, Gwyn Richardson, Lyuba Levine, Abbey Berenson and Yong-Fang Kuo. The Patient-Centered Outcomes Research Institute awarded a multidisciplinary team of UMTB data scientists and clinicians $525,000 to develop a new visual analytical method that would use large datasets to improve the prediction of hospital readmission in the elderly. Led by Suresh K. Bhavnani, PhD, associate professor of biomedical informatics in the Institute for Translational Sciences, the team will work to develop a

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RE SE A R CH

A person carrying variants of two particular genes could be almost three times more likely to develop multiple sclerosis, according to the latest findings from scientists at UTMB and Duke University Medical Center. One of these variants is in IL7R, a gene previously associated with MS, and the other in DDX39B, a gene not previously connected to the disease. The discovery could open the way to the development of more accurate tests to identify those at greatest risk of MS, and possibly other autoimmune disorders, the researchers said. The findings are published in the latest issue of Cell. A disease in which the body’s own immune system attacks nerve cells in the spinal cord and brain, MS is a major cause of neurological disease in younger adults from 20 to 50 years of age, and disproportionately affects women. While treatable, there is no cure for MS, which can lead to problems with vision, muscle control, balance and basic body functions, among other symptoms, and could lead to disability. Available treatments have adverse side effects as they focus on slowing the progression of the disease through suppression of the immune system. Thanks to the collaboration among scientists at UTMB, Duke, University of California, Berkeley, and Case Western Reserve University, researchers found that when two particular DNA variants in the DDX39B and IL7R genes are present in a person’s genetic code, their interaction can lead to an overproduction of a protein, sIL7R. That protein’s interactions with the body’s immune system plays an important, but not completely understood, role in MS. “We can use this information at hand to craft tests that could allow earlier and more accurate diagnoses of multiple sclerosis, and uncover new avenues to expand the therapeutic toolkit to fight MS, and perhaps other autoimmune disorders,” said Gaddiel Galarza-Muñoz, PhD, first author on the study and postdoctoral fellow at UTMB.

new visual analytical method to identify patient subgroups in large datasets such as Medicare data, and test whether those subgroups can help to improve the prediction of hospital readmission in the elderly. This is the first PCORI award that UTMB has received. Knowing which patients are more likely to be readmitted to the hospital after a procedure would be helpful to both patients and their health care providers. Doctors would be able to customize care for high-risk patients, which could result in reducing the personal and financial burdens associated with hospital readmission. Chad Mire, PhD, and Tom Geisbert, PhD, faculty in the Department of Microbiology and Immunology, have developed an antibody treatment that successfully protected nonhuman primates against the deadly Marburg and Ravn

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It can sometimes take years before an MS patient is properly diagnosed, allowing the disease to progress and resulting in further damage to the nervous system before treatment begins. With more accurate measures of risk, health care providers would be able to screen individuals with family histories of MS or with other suspicious symptoms. It could lead those with certain genotypes to be more vigilant. “One could envision how this type of knowledge will someday lead to diagnosing multiple sclerosis sooner and, now that we have promising therapies, a doctor could start the appropriate treatment more quickly. It is not out of the realm of possibility to imagine a path for screening for other autoimmune diseases such as Type 1 Diabetes,” said Dr. Mariano GarciaBlanco, professor and chair of the Department of Biochemistry and Molecular Biology at UTMB, and co-lead author of the paper. For Garcia-Blanco, the fight against MS is personal. He was already working on research related to MS when in 2012 he found out his daughter, then in her late 20s, had been diagnosed with the disease. Garcia-Blanco said this refocused his efforts on his MS-related work. “I’m much more aware now of how the work we do in the lab could someday lead to something that can be used to help those who have to live with MS,” Garcia-Blanco said. Other study authors include Farren B.S. Briggs, Irina Evsyukova, Geraldine Schott-Lerner, Edward M. Kennedy, Tinashe Nyanhete, Liuyang Wang, Laura Bergamaschi, Steven G. Widen, Georgia D. Tomaras, Dennis C. Ko, Shelton S. Bradrick and Lisa F. Barcellos. The research was supported by the National Institutes of Health, National MS Society Pilot Award, Duke University Whitehead Scholarship, Ruth and A. Morris Williams Faculty Research Prize funds from Duke University School of Medicine, start-up funds from UTMB, and funds from Mr. Herman Stone and family for MS research.

viruses even when given five days after infection. There are currently no vaccines or drugs approved for human use to protect against the two viruses. They are in the same virus family as Ebola, and cause severe and often lethal disease in people. Monoclonal antibodies are a technology that is currently in wide use for treating autoimmune diseases and cancers. “In this paper, we demonstrated that one monoclonal antibody is able to protect up to 100 percent of Marburg or Ravn virus-infected nonhuman primates when the antibody treatment is given up to five days following exposure to a lethal amount of the virus,” said Geisbert. “These findings extend the growing body of evidence that monoclonal antibodies can provide protection during advanced stages of disease with highly dangerous viruses and could be useful during an epidemic.” The findings are detailed in Science Translational Medicine.

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BY KIRSTIANN CLIFFORD

For more than two decades, Tandra Medellin has been part of patientsâ&#x20AC;&#x2122; most exhausting and most exhilarating momentsâ&#x20AC;&#x201D; when they welcome their baby (or babies) into the world.

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“Every single birth is exciting and gratifying,”

Medellin checks in with their nurse, who will care for both the says Medellin, nurse manager of the Labor, Delivery, Recovery mother and baby during their stay. In the LDRP unit, mothers and Post-Partum unit at UTMB’s League City Campus Hospital. and babies stay in the same room throughout their birthing “Our team gets to witness miracles every day, and that’s some- experience, from admission to discharge. One nurse will prothing we don’t take for granted.” vide “couplet care” by taking care of the family as a unit, rather than having a post-partum nurse take care of the mom and a As LDRP nurse manager, nursery nurse take care of Medellin oversees a staff of the baby. 34, including nurses, surgical techs, unit clerks and a patient care tech. The stateof-the-art unit opened in June 2016, and now averages about 2.2 births a day, or more than 60 births a month. However, those numbers spiked to about 120 a month in January and February, when deliveries had to be diverted to League City after the John Sealy Hospital fire.

“That one-on-one nursing care allows us to really build personal relationships with patients and their families,” says Medellin. “Since UTMB started the whole mother-baby movement a few years ago and shifted the way mothers and babies are cared for, we’ve seen satisfaction scores improve. The patients really like the personalized care and mention our staff by name in comments, including our housekeeper, Wanda. All our patients love her because she doesn’t just go in a room and clean, she’ll stop and spend time talking to the families.”

I meet up with Medellin on a Wednesday morning in March, when the number of daily deliveries has returned to previous levels. Even so, there is no shortage of action. “We already had a baby delivered at 6:52 this morning and currently have several patients in various stages of labor,” says Medellin as she greets a few nurses at the nurses station. “We also have a scheduled C-section at 11:30, so that patient should be here anytime.” Medellin looks over the patient list for the day and her face lights up—she recognizes the name of one of the patients who arrived earlier that morning.

As we head back to her office, Medellin points out that the unit does have a nursery, but it is typically reserved for newborns who are undergoing a procedure or require Level 2 care. “Level 2 is if the baby needs any kind of IV or oxygen therapy or beyond—they truly need to be on monitors and have a nurse practitioner watching,” she says. “But typically, we try to keep the baby in the room with the mom as much as possible. If a baby has jaundice, we can put the bili lights in the room with the mom, and if a baby needs to be in an isolette to help regulate their temperature, we can also do that in the room.

“Every time I see a healthy mom and baby leave the hospital, I’m so proud of my experienced team— they are talented, passionate and motivated, and I’ll do everything I can to support them.”

“We have to go say ‘hi!’” she says excitedly. “The patient is the wife of a UTMB construction contractor who helped build this hospital. He’s been so excited about this.”

We head down the hall to one of the 11 spacious birthing suites, where Medellin hugs the pregnant patient and her husband, “Most moms want their babies with them. Yes, they may want who are having their first baby after trying to conceive for 10 to get some sleep, but moms don’t sleep for at least 18 years years. It’s a happy time—despite being up all night, the couple anyway, right?” she says with a laugh. has never been more ready to become a family of three.

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As nurse manager, Medellin’s role includes a lot of behindthe-scenes responsibilities, such as running reports to make sure all patient services were correctly documented and charged, ordering supplies, and making sure all shifts are appropriately staffed. An employee calls in sick as she checks the staff schedule for the week. Within a few minutes, she’s made a few quick phone calls and has found another team member to cover the shift.

“This is a 24/7 operation, so staffing is huge,” Medellin says. “I always need to make sure we have enough nurses along with other staff at all times, and also need to be prepared to flex up or down according to census and acuity fluctuations. If the staff is happy, like their jobs and enjoy their patients, they will show up here and do a great job. My staff does just that—I’m lucky.” While she doesn’t provide as much direct patient care as the rest of her team, Medellin is always ready to step in when needed. She doesn’t see herself as a manager—but more of a leader. “It’s not like I’m a boss—I’m much more part of the team,” she says. “I try to support my staff so they can provide Best Care every time. I’ll help answer phones, fill in for a nurse’s shift or jump in to help transport a patient to the OR. Providing my team with all the tools they need is so important, since they are the main providers of direct patient care.”

heart rates have gone back to baseline range. No C-section is needed—at least not right now. With one obstetrician on call at a time, Medellin works closely with the doctor to make sure the laboring patient and her baby will be stable long enough for Alvarez to complete the scheduled patient’s C-section first. “Things can change in an instant,” says Medellin. “We might think we have a plan for the day, but if something emergent happens, we may have to be in the operating room and doing a C-section within a few minutes. Whether births are short and easy or long and complicated, it’s the same ending. Families are so excited when a healthy baby is put into their arms. It’s such a huge moment they remember forever.” Medellin points out that while Labor and Delivery is typically the happiest place in the hospital, it can also be one of the most stressful places when complications arise. She explains that if a baby is born before 32 weeks or needs additional support, mother and baby will be transferred to the nursery on the Galveston Campus, where faculty and staff are prepared to care for the highest acuity newborns. While it doesn’t happen often, Medellin and her nursing staff are grateful to be able to seek help from their Galveston colleagues when needed.

Medellin’s background includes experience in all areas of materI say goodbye to Medellin as she starts working on her “less nal and infant health. She began her 21-year career at UTMB as glamorous” tasks for the day, including writing a curriculum a hospital technical assistant with post-partum moms and, over for a new four-week birthing education class that UTMB will the years, worked her way up while attaining a nursing degree start offering this summer. and women’s health care nurse practitioner certification. Her two children, ages 9 and 13, were even born in the same unit She’s excited to provide more services for the growing community, and hopes more families will choose UTMB when it’s time she worked in at John Sealy Hospital. to welcome their little miracles into the world. “I stayed in the old unit, where the rooms were very small and had the airplane jet toilets that pulled out from under the sink,” “Every time I see a healthy mom and baby leave the hospital, I’m she recalls. “Things were so different back then. Here, we have so proud of my experienced team—they are talented, passionate spacious rooms with large restrooms, vanity mirrors, and com- and motivated, and I’ll do everything I can to support them.” fortable space for a guest to stay overnight. It’s been fun to see how everything has evolved.” As we discuss other innovations that have changed the way patients receive care, a nurse pops her head into Medellin’s office to let her know that a laboring patient is “crashing.” Medellin immediately jumps into action. “‘Crashing’ means the patient is having some sort of medical emergency requiring an immediate C-section to deliver the baby. In this case, the baby’s heart rate has gone down, and if it stays that way for more than a few minutes, we may need to rush the patient to the OR,” she says as she reviews the mother’s and baby’s heart rates on a large monitor at the nurses station. “It looks like the patient had been hanging out at 9cm dilated for a while but is now at 10cm, and every time she starts pushing, the baby’s heart rate goes down.” Medellin starts preparing a C-section operating room in the middle of the unit in case the obstetrician on call decides to go that route. However, Dr. Crystal Alvarez comes out of the patient’s room to tell Medellin that both the mom’s and baby’s impact

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For more information about UTMB’s Labor and Delivery services, visit utmbhealth.com/baby. Registration information and class dates for new Childbirth Education classes at League City Campus will be posted on this site soon.

L E A D ER S POTLIGHT

Spotlight on Tony Williams, associate vice president of Inpatient Services, Correctional Managed Care

Tony Williams joined UTMB’s Correctional Managed Care family more than 20 years ago, as assistant director of health information management. He also served as executive director of clinical programs prior to his current role as associate vice president of Inpatient Services. Williams was a system administrator for CMC’s electronic medical record and was instrumental in the development of many of the transcribed documents, chart management, appointment scheduling templates and diagnostic maintenance systems currently used today. His vast knowledge of information management and operational processes has been vital in the ongoing development and maintenance of the EMR system. Before joining UTMB, Williams worked with the Texas Department of Criminal Justice as a regional medical records administrator and was promoted to system-wide coordinator for medical records. He received a bachelor’s degree in medical records administration from UTMB and a master’s degree in business administration from Sam Houston State University.

What does Best Care mean to you and how do you contribute? Best Care is an opportunity for any health care entity to provide access to the highest quality of care to its patient population given the available fiscal and system resources. As a servant leader, I strongly believe in facilitating Best Care by ensuring health care staff has the resources needed to provide quality services that measure up well against industry metrics and standards.

What are the biggest challenges you face as AVP for Inpatient Services? There are three huge challenges in CMC Inpatient Services: the ongoing demand for infirmary beds for patients discharged from acute care settings, the effective management of end-stage kidney disease and chronic kidney disease patients, and limited inpatient mental health beds for a growing caseload in corrections. Caring for this population is even more complicated since the health acuity of offenders entering prison is typically higher than in the “free world” due to poor life choices such as drug abuse, high levels of violence, etc. The fact that the Texas Department of Criminal Justice prison population is aging and there are more patients with medical and mental health inpatient needs further complicates delivery of services. Although the challenges are plentiful, our CMC employees are committed to providing Best Care to all, and we continue to look for innovative, low-cost ways to provide health care without risking quality.

What inspired you to pursue a career in the correctional managed care environment? As a health information management student at UTMB, I read an article regarding the need for HIM professions in the Texas Department of Criminal Justice, known as TDC back then. I felt I would have a greater impact in a nontraditional health care setting and would be exposed to more opportunities to advance in the profession. Both proved to be true.

What was your first job? My first job was as a bus boy/dishwasher in a new steak house. This was a great experience that taught me how timely customer service and cleanliness is paramount in any setting.

What do you like to do outside of work? Most of my activities outside of work are fishing, hunting and volunteer civic support—I serve as the president of a memorial scholarship fund and am a member of a local Economic Development Corporation. My fishing excursions can be local trips along the Gulf Coast, as well as an annual fishing trip in Canada.

Do you have any hidden talents? Most people wouldn’t know that I’m a former professional saxophonist. I started playing the sax in the 7th grade and often volunteered to play at various fundraising functions. I also played in a jazz band at cocktail clubs in the Houston area and began cutting an album with a local R&B group before I started college.

What’s something you always wanted to do but have not done yet? I’d like to attend an Oakland Raiders football game in Oakland, California. I became a Raiders fan as a young child because they played an aggressive style of football that I liked. Also, a family friend (Lester Hayes) was actually drafted by the Raiders and won a Super Bowl with the team.

If you could travel anywhere in the world, where would you go and why? The Himalayas. It’s an extremely remote part of the world that has a landscape and wildlife that intrigues me.

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It’s a Match!

UTMB medical students celebrate next steps in their careers during Match Day 2017

BY SIMONE PARKER

ON MARCH 17, MORE THAN 200 SCHOOL OF MEDICINE STUDENTS gathered in Levin Hall to learn where they will do their post-medical school training, or residencies. Known as “Match Day” across the country, the annual event happens on the third Friday of March each year to announce the results of the National Residents Matching Program. One-by-one, graduating UTMB students walked to the front of the Galveston auditorium to pick up their “match” envelopes, which revealed the residency program that accepted them. It was a party atmosphere, with faculty, friends and family included in the celebration. Ashlee Gourdine, a fourth-year medical student and aspiring anesthesiologist, applied to more than five residency programs. She cried tears of joy upon opening her letter and discovering she was accepted by her first choice—Johns Hopkins Hospital in Baltimore, Maryland. “It’s incredible to be able to go where you want to go!” Gourdine said. “You work four years, through all the classes and board exams. I’m glad that it turned out this way. Medicine is a difficult field but it’s worth it.” Gourdine celebrated the good news with friends and family, including her father, Charles Gourdine. He was excited for Ashlee to move and work closer to the family’s home in Washington, D.C. “It is truly a blessing,” said Gourdine. “She has worked extremely hard to achieve her goal of becoming a doctor. As a parent, I am excited to see her dream come true.” UTMB’s Match Day ceremony was extra festive this year, since it coincided with St. Patrick’s Day—a day commonly known for people wearing green and shamrocks. Joseph Baratt and Kathryn Brand, also fourth-year medical students, coordinated matching green outfits to celebrate the holiday and their residency assignments. The couple had been anxiously waiting for several months to find out where they will live and work for the next three to four years. Both were matched to programs in Texas. “We decided not to couple’s match so we’re just excited that we ended up in the same state,” said Brand. “It’s been a stressful time. We’re thankful to be going to such great programs.” Brand was accepted at Dell Children’s Medical Center in Austin and Baratt will be working at Baylor College of Medicine in Houston. Congratulations to all UTMB graduating medical students as they prepare for this next stage of their careers.

2017 Class Highlights

216 total match participants

Students from SEVEN DIFFERENT COUNTRIES, including the U.S., Uganda, Taiwan, Mexico, Bosnia, India and Kenya.

53%

matched in Texas

32% 18% 45%

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matched at UTMB

matched in primary care

G OO D N EW S

GEM program encourages employees to recognize co-workers who ‘GO THE EXTRA MILE’

New UTMB clinics!

BY STEPHEN HADLEY

THE GEM (GOING THE EXTRA MILE) PROGRAM gives employees, students and volunteers an opportunity to recognize each other for exemplary service and dedication performed in their roles at UTMB. Launched in 2000, the GEM program reinforces the principles of UTMB’s Professionalism Charter and rewards employees for professional behavior in their daily activities in contributing to UTMB’s missions. “From the start, employees have embraced this program because it is a simple and easy way for them to recognize their co-workers,” said Phaedra Goffney, senior administrative manager of Human Resources Talent and Organizational Development at UTMB. “And it gives the recognized employees something tangible to show for their extraordinary efforts, things they are doing every day to make this an even greater organization.” It’s easy to award a GEM card to someone you see going above and beyond. Here’s how: 1. When you see a co-worker, student or volunteer going the extra mile by helping a co-worker or visitor, award that person with a paper GEM card or an electronic GEM card (available at www.utmb.edu/gem/ SendGEM) 2. Once an employee, student or volunteer has accumulated three GEM cards (either the paper version or the e-version), they are eligible to be entered into the annual prize drawing. Employees, students or volunteers must be entered into the drawing by the following: i. Employees – Submit to immediate supervisor

Women’s HealthCare Clinic 1505 Winding Way Dr., Suite 210, Friendswood, TX 77546 (832) 505-5050 Mon.-Fri. 8 a.m. to 5 p.m. www.utmbhealth.com/womens The clinic provides a complete range of women’s health services for every stage of a woman’s life, including primary and prenatal care.

ii. Students – Submit to Office of Student Life, Jamail Student Center, Room 2.110 iii. Volunteers – Submit to Volunteer Services, John Sealy Annex, Room 1.308 3. The drawing for UTMB-branded items will take place during Employee Service Day, which will be held on May 31 from noon to 1 p.m. in Levin Hall. From the list of those eligible for the drawing, 50 names will be selected for the prizes. 4. All participants in the drawing will receive an invitation to UTMB’s annual Employee Service Day ceremony. This ceremony recognizes employees for achieving significant service milestones as well as our GEM card honorees. Participants do not need to be present at the ceremony to win an award. Goffney said all supervisors and employees are encouraged to use the GEM program as a way to offer an acknowledgement of a job well done. “We believe this program improves productivity and certainly increases morale,” Goffney said. “This is a good example that something that seems relatively small can really have a lasting impact on someone.” For more information about UTMB’s GEM program, visit www.utmb.edu/gem/.

Angleton Urgent Care Clinic 2327 E. Mulberry St., Angleton, TX 77515 (979) 849-9557 Mon.-Fri. 6p.m. to 10 p.m. • Weekends 10 a.m. to 10 p.m. www.utmbhealth.com/services/uc-er/urgent-care The clinic is open evenings and weekends to provide quality care and prompt attention for injuries and illnesses that are not life threatening. Walk-in patients are welcome.

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An artistic approach to learning and remembering the body BY SIMONE PARKER

Students, faculty and members of the Galveston arts community recently took advantage of a rare opportunity to go inside the top floor of UTMB’s Ashbel Smith Building, known as “Old Red,” on the Galveston Campus for the “Drop in and Draw Bones: The Art of Anatomy” event. More than 90 visitors filled the third floor space, which had tables displaying real human specimens including skulls, a spinal cord, hand, foot and leg bones. “It’s incredible that we have some of Dr. William Keiller, UTMB’s first anatomy professor’s, hand-painted specimens,” said Paula Summerly, PhD, a research project manager with the John P. McGovern Academy of Oslerian Medicine. “I have photographed and created an inventory of his drawings—part of UTMB’s unique medical heritage collection of about 2,000 specimens.” Event attendees had the opportunity to let their artistic skills flow as they studied and drew the historical, anatomical and pathological specimens on display. Huy Nong, a first-year UTMB medical student, was fascinated by the bone collection and history of Old Red, which is the oldest medical school building in Texas. “It’s very interesting to think that students learned anatomy here and did their dissections of human cadavers,” said Nong. “I think it’s a completely different experience than what we have today in anatomy.” Nong and his friend Lillian Chen became interested in the event after seeing posters and advertising around campus. Chen, also a first-year medical student, said drawing bones can be fun and educational.

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“We get to better appreciate the anatomical features by drawing,” said Chen. “Most of the time, we’re in dissection classes and concerned about broad-level aspects. During this event, we were able to focus on the minute details like spine curvatures and appreciate them more.” Lisa Cain, PhD, is director of the UTMB Medical School Enrichment Program and an associate professor in the Department of Neuroscience and Cell Biology. She teaches gross anatomy and also paints in her spare time. Cain believes drawing helps medical students to reinforce their knowledge of anatomy. “Looking at art will increase your ability to view in detail,” she said. “It slows down your process of observation and makes you look at the subtle images that are associated with art and the human body.” José Barral, MD, PhD, University of Texas Distinguished Teaching Professor, also works in Neuroscience and Cell Biology and teaches gross anatomy. He encouraged students at the event to spend more time drawing and exploring their artistic talents. “I think it will help students to advance their knowledge,” said Barral. “When you’re concentrating, drawing and looking at the intricate details of a muscle or bone, you have more of a tendency to retain what you’ve seen.” This first drop-in-and-draw event at Old Red was a partnership of the Galveston Arts Center, the Old Red Medical Museum Task Force and the John P. McGovern Academy of Oslerian Medicine. Organizers hope the event brings more attention to the history of Old Red and UTMB’s historical medical heritage collections.

Top 10 characteristics of a lifelong learner By Faith Robin, senior talent and organizational development consultant at UTMB Lifelong learning blends formal education with continual professional and personal development. As technology advances quickly, lifelong learners have to learn new skills and adapt to rapid changes in professional and personal environments. The following tips can help you stay connected, stay motivated and identify new ways to grow and develop: 1. Know your interests. If you could learn a new skill, what are you most interested in learning? Is this new skill for professional or personal reasons or both? Even if you can’t apply it directly to your job, following new interests can help you become a more passionate, well-rounded professional. 2. Acknowledge your learning style. Everyone has his or her own way of learning new things. For example, do you learn best by reading, writing, listening, or by a hands-on approach? Choose lifelong learning resources that cater to your best learning style and preferences. 3. Set goals. Commit yourself to learning by setting clear goals for what you want to learn, how you plan to go about it and how long it will take. Don’t forget to reward yourself once you have acquired this new knowledge. 4. Develop good reading habits. When was the last time you read or listened to a good book? Good reading habits open up new adventures and explorations into other cultures and worldly experiences.

5. Seek resources. Find out about learning opportunities online, in your local library, or at your local college and university. Many offer continuing education opportunities that are fun and educational. 6. Join a group of like-minded learners. Have you heard of www. meetup.com? It is a great place to put in a few descriptors about yourself and find others in your area that enjoy the same experiences. 7. Get Involved. Volunteer in a church or in your community to help meet people, learn about various opportunities and give service to others in need. 8. Share your skills and knowledge. Do you crochet or cook or enjoy ceramics or drawing or music? Why not share your expertise with others? By communicating ideas to others, you are more likely to solidify that knowledge in your brain. 9. Take an online course or attend a course at your local college/ university. If you don’t have the time, find a webinar or four- to six-week course in your area that is interesting and fits your budget and schedule. 10. Stay curious. Lifelong learning is about staying active and staying curious in your mind, body and spirit. Pick one of these 10 ideas and begin today.

PA RTING S HOT

One year and counting…This month marked the one-year anniversary for UTMB’s Jennie Sealy Hospital, which officially opened to patients on April 9, 2016. To view a time-lapse video showing the construction of the 765,000-square-foot hospital from start to finish, visit https://utmb.us/3r. APRIL 2017

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