Impact February 2018

UTMB NEWSLETTER • FEBRUARY 2018

Best Care: Rethinking blood transfusions Transplant patient celebrates wedding anniversary after journey from near-death to new life Spotlight on Dr. Vicki Freeman, interim dean, School of Health Professions

Door-to-doctor service with a smile

Raymond (Sonny) Morales, construction manager; Leonard LaComb, principal facilities project manager; and Joel Long, maintenance customer service manager; received UTMB President David Callender’s Way to Go Awards for their dedication to helping the patients and families staying at the Ronald McDonald House in Galveston. The building recently underwent seven months of construction and, while it has reopened to patients, there was a problem with one of the rooms that needed to be fixed.

However, the patient staying in the room was severely burned and could not be moved into another area while the repairs were made. Without hesitation, the three men rushed over within minutes—even though it was after their regularly scheduled work hours—to help remedy the problem and make sure the patient was safe. “There are no words that I could come up with to let you know how thankful we are that they took the time to take care of the problem,” said Margie Chavarria, executive director of the Ronald McDonald House of Galveston.

“People like Leonard, Sonny and Joel are what make this world a better place to live in.”

Robert Hastedt, nurse manager; and Josette Armendariz-Batiste, director, patient care services and assistant chief nursing officer; also received Way to Go Awards at the Jan. 24 Town Hall for their critical thinking to meet the needs of patients who need dialysis treatments at the Angleton Danbury and League City campuses. When Hastedt and Armendariz-Batiste faced a critical patient care situation—the sudden termination of a dialysis contract—they came up with an innovative and new approach to deliver bedside dialysis services at ADC and LCC. Thanks to their dedication and hard work, UTMB can now offer dialysis services at the bedside at all three of its campuses.

President David Callender presented Jeanene Trochesset, transplant coordinator; Daniel Madrigal, blood bank technologist; Velvet Maragh, blood bank technologist; and Maryam Noor, of the tissue antigen lab, with a “Team Award” for their excellent multidisciplinary communication and close attention to detail. While completing a workup for a kidney transplant offer for a UTMB patient, Trochesset collaborated with the blood bank and tissue antigen laboratory staff to prevent a serious adverse event from occurring after it was discovered that the donor’s blood sub-type was different from what an outside lab had reported. Because of their quick action and attention, the kidney transplant offer was declined and the mismatch was avoided.

The patient was informed of the situation and expressed appreciation for the efforts of the team to safeguard their health.

A group from UTMB’s Doctor of Physical Therapy program volunteered at the Chevron Houston Marathon on Jan. 14. Forty-five students from the classes of 2019 and 2020 provided massages for marathoners who had just finished running the 26.2mile course. The massage therapy included emergency cramp management and care for injuries. “The runners were very appreciative of the hard work and service, and the students represented UTMB well!” said Dr. Alison Vargo, assistant professor of instruction in the Department of Physical Therapy, School of Health Professions.

Dr. Norma Perez, director of UTMB’s Hispanic Center of Excellence, is the 2018 recipient of the Freeman Endowment Fund for the Development of Minority Faculty. This endowment is intended to provide support to faculty, programs and projects that advance UTMB’s core value of diversity and its institutional efforts to increase and support the development of minority faculty of underrepresented ethnic groups.

Its aim is to help create and encourage a racially diverse workforce in medical research.

UTMB Angleton Danbury Campus nurses Michelle Grace and Mindy Carroll recently received DAISY awards for their quick actions and critical thinking during recent emergency events. Grace, a nurse in the emergency department, managed a patient with a gunshot wound who arrived to the ADC ED in the middle of Hurricane Harvey. The patient needed to be transferred to the Galveston Campus for surgical intervention; however, flooding made transporting the patient impossible. As soon as the water began to recede, Grace, who is also a licensed paramedic, located an ambulance, gathered supplies and had respiratory therapist Vincent Grace Showalter accompany her and the patient for the one-hour transport. The patient was safely transCarroll ferred and survived their wounds. Carroll, a nurse in the Angleton cardiology clinic, acted quickly and calmly when a patient began experiencing adverse effects during a procedure. She immediately called for the cardiologist, contacted 911, notified the ED and explained the situation to the patient and their spouse. “She thought of every possible detail that was important to the care and outcome of this patient’s condition,” said Cynthia Nelson, nurse manager of ADC ambulatory clinics. “Mindy displayed great leadership while directing her team, demonstrated compassion while calmly talking with her patient, and assured that the family was involved.”

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From the President Welcome to the February issue of Impact. We closed out last month with a Jan. 24 Town Hall that covered a variety of topics, including financial and construction updates and FY18 Institutional Priorities.

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Right now, health care organizations across the country are being challenged financially. At UTMB, we are facing those same challenges. During Town Hall, I had the opportunity to talk about steps we are taking to get back on track with our FY18 budget, including: continuing to improve clinical coding and documentation; increasing patient volume, access and satisfaction, while decreasing wait times; managing labor and supply costs; accelerating our energy savings program; and reducing travel expenses. I truly believe that if anyplace can successfully overcome these challenges, it’s UTMB. We know how to do this. We are strong, and we are resilient. I appreciate the hard work that each and every one of you does every day to accomplish our mission more effectively and efficiently.

Best Care: Rethinking blood transfusions Page 4

You can view the Town Hall video at www.utmb.edu/townhall. And please plan to attend or view one or more of the Mondays in March sessions, beginning March 5, where we’ll continue the discussion on our plans for the future. For more information about this year’s series, please visit www.utmb.edu/ mondays-in-march.

This issue of Impact includes a tribute to UTMB Police Chief Tom Engells, who passed away suddenly in January. He was an extraordinary man who made tremendous contributions at UTMB, across UT System and the law enforcement world, and he will be greatly missed.

Transplant patient celebrates anniversary, new life

Other stories you’ll find in this edition:

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• A day in the life of patient transporters Jeimmy Banegas and Darion Alexander • A profile of Dr. Vicki Freeman, professor and interim dean of the School of Health Professions • A Best Care in Action segment highlighting UTMB’s Blood Management Program • A story on how a UTMB liver transplant recipient was able to celebrate her 10th wedding anniversary after a journey from near-death to new life • How the creation of the Sealy Institute for Vaccine Sciences will expand vaccine research and development at UTMB • An article about how Dr. Jose Rojas discovered the value of interprofessional education • Construction updates from around our growing Galveston and League City campuses • Nutrition tips for a healthy heart by Blair Brown, registered dietitian nutritionist with UTMB’s Texas Transplant Center • A Heart Month edition of the “UTMB Trivia” question to test your knowledge and enter your name for a chance to win a UTMB swag bag • Numerous accomplishments and kudos in the Working Wonders column and throughout the newsletter I hope you enjoy reading this issue. If you have any story suggestions for future editions, please let the Impact team know. Thank you!

Day in the life of patient transporters Page 8

Spotlight on Dr. Vicki Freeman, interim dean, School of Health Professions Page 12

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: Patient transporters Jeimmy Banegas and Darion Alexander greet every patient and visitor with a smile. Stationed next to the parking garage behind UTMB Health Clinics on the Galveston Campus, the two help transport about 60 to 70 patients a day by wheelchair to the outpatient clinics— which cover a variety of specialties such as dermatology, cancer care and endoscopy.

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 Editors KirstiAnn Clifford Stephen Hadley Shannon Porter Art Director Mark Navarro

CONTACT US Email: impact.newsletter@utmb.edu Phone: (409) 772-2618 Campus mail route: 0144 U.S. Postal address: UTMB Marketing & Communications

301 University Boulevard

Galveston, TX 77555-0144

BES T C A R E I N AC T I O N

Rethinking blood transfusions UTMB’s Patient Blood Management Program focuses on better blood use, better patient outcomes

BY KIRSTIANN CLIFFORD

WHEN DR. ABE DEANDA TRAINED IN CARDIAC SURGERY years ago, he was given some dangerous advice.

multidisciplinary group tasked with adding “teeth” to UTMB’s Patient Blood Management Program (PBM)—which uses evidence-based guidelines to promote the appropriate use and management of blood—and reducing unnecessary blood transfusions.

“There were a lot of old rules of thumb such as, ‘If you need to give one (unit of blood), give two,’” recalled DeAnda, who is now professor and chief of cardiovascular and thoracic surgery at UTMB. “Every resident memorized that about “Right now, we are analyzing data to see which services use the most blood blood transfusions. It was probably the most dangerous rule you could learn and if there are certain groups where one physician uses no extra blood and another one uses a lot of blood—why is that?” he said. “One of the first steps in medicine.”

While DeAnda is quick to point out that blood transfusions can be life-saving is to figure out the practices that people are using. Once we do that, we’ll know when necessary, he often sees scenarios where the risks outweigh the benefits. where changes are needed to ensure the best outcome for our patients, based on the most current evidence.

Blood transfusion has been named one of the top five overused procedures in U.S. hospitals—and studies over the past two decades have found that liberal transfusion practices make patients more susceptible to infections and increase the risk of poor outcomes such as longer hospital stays and even death.

“Physician education is going to be No. 1. We are going to have to meet with a lot of people, give grand rounds, give lectures, explain why this is important, and show them the literature—there’s thousands of papers written on this subject, yet, we still need to shift our mindset. It’s going to take some time.”

“It’s a patient safety issue,” Part of the physician educahe said. “While blood is tion will emphasize how to generally very safe, there proactively plan to avoid the are always risks for the need for transfusion in the first receiving patient, such place. For example, if a patient as cardiac overload, lung has preoperative anemia, instead of relying on transinjury and infections—and Dr. Abe DeAnda performs a heart surgery without blood transfusion. the risks are higher if you fusion as a quick fix, a more get more blood. Again, if sensible approach may involve you need a transfusion, you should get a transfusion. The caveat to that is if postponing an elective procedure and giving the patient iron, or screening at-risk you don’t need a transfusion, the blood can hurt you.” individuals weeks in advance to make sure anemia is managed appropriately.

DeAnda started using less blood—even performing bloodless heart surgeries— “There are certain things we can do on all fronts to decrease the need for transnearly two decades ago, when he started a heart program at another institution fusion and improve patient outcomes,” said DeAnda. “We have a target of where to treat Jehovah’s Witnesses who refused donated blood on religious grounds. we would like to see transfusions based on national guidelines. Right now, we He found that the cardiac patients got out of the ICU and hospital faster with are well above that target. So, we have work to do, but I know we can do it.” significantly better outcomes, so he began fine-tuning ways to apply these Ultimately, DeAnda would like to see UTMB attain Patient Blood Management techniques to provide care to the broader population. As an added benefit, Certification from the American Association of Blood Banks and The Joint Comthe techniques helped conserve blood—a precious resource—and reduced mission—a distinction that may take several years to attain, but is the right hospital and patient care costs. thing to do for patients.

“I don’t think most people realize how much blood products cost,” he said. “A “It’s all about providing the best care possible for patients,” said DeAnda. “What unit of blood can be upwards of $1,500 when you take into account processing, we do know is that when we do fewer transfusions, lengths of stay go down, lab and delivery costs—it all adds up. So, for big programs that use a lot of hospital-acquired infection rates go down and patients do better—that’s what blood, that’s a significant amount of money going out the door—and it’s not it’s all about.” n always to the benefit of the patient.”

UTMB recently received the first-quarter performance report for the Blood management was recently introduced by Health System leadership as 2018 Quality and Accountability Study. To check our progress and read one of five focus areas that builds upon the Best Care initiative to help UTMB more about UTMB’s efforts to become a high-value practicing organization, become a high-value practicing organization. DeAnda was appointed to lead a visit intranet.utmb.edu/best-care.

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PAT IENT CARE

A second chance at life UTMB liver transplant recipient celebrates 10th wedding anniversary after a journey from near-death to new life

BY SHANNON PORTER

At a young age, Amanda Johnson made a promise to herself to never take life for granted. That promise was put to the test late last year as serious health problems had her fighting for her life and wondering if she would be around to celebrate her 10th wedding anniversary.

Johnson’s transplant went well and her recovery was faster and better than expected, considering her condition before the surgery. Johnson was only in the hospital for two weeks after the transplant when some transplant patients have to stay longer. The average length of stay is 17 days, Fair said. Johnson credits her fast recovery to the outstanding care she received from the entire UTMB staff.

“We had planned to have a vow renewal, but I thought I was going to have to cancel,” Johnson said.

“Every nurse from ICU to the surgical floor, doctors, physical therapists, even the housekeeping staff were all so encouraging and sweet,” Johnson said. “When you become a patient at UTMB, you become family—they really care.”

In the weeks leading up to her Dec. 1 anniversary, Johnson was in need of a life-saving liver transplant. She was extremely ill, suffering from nonalcoholic cirrhosis of the liver, also known as nonalcoholic fatty liver disease.

Johnson, who never drank alcohol, was surprised to hear the word “cirrhosis” in her diagnosis. She—like many people— associated the word only with the effects of long-term heavy drinking. In reality, cirrhosis means scarring of the liver, regardless of underlying cause, said Dr. Jeffrey Fair, chief of transplant surgery at UTMB and Johnson’s surgeon.

By the time she was released, her 10th wedding anniversary date had already passed, but Johnson still wanted to celebrate. So, on Jan. 13, surrounded by friends and family, she and her husband commemorated her recovery and their marriage.

Amanda and Keith Johnson smile for a photo as they cut into their vow renewal cake.

And, she’s keeping her original promise not to take life for granted. “I want to make this new life better than my life before,” Johnson said.

It turns out that Johnson’s condition was related to weight issues she had dealt with most of her life. She suffered from diabetes that was difficult to manage with medicine and diet and ultimately had bariatric surgery to help her with weight loss. But soon after the weight loss surgery in 2015, she started experiencing significant swelling in her legs and feet.

That includes pursuing a passion that had been hindered by her illness: singing. Johnson is now the music director and youth leader at her church, and she’s making plans to learn how to play music.

She also wants to explore a career in health care, where she can advocate for and share her experience with others.

After meeting with doctors at another hospital, a friend recommended Johnson come to UTMB to find out what was wrong. Testing confirmed that Johnson was in liver failure and would need a transplant.

“I was so close to death and didn’t even know it until I came to UTMB,” Johnson said. “I have been given a second chance. Now I have a new body, a new life— I couldn’t be more thankful.” n

She was quickly referred to the UTMB Liver Transplant Program, which was established in 2008. The program offers patient-centered care and focuses on liver transplants; management of chronic liver disease, cirrhosis and liver failure; and other hepatobiliary services. Fair came onboard in 2016 to lead the program. Since then, UTMB has performed 34 liver transplants with a 97 percent survival rate.

Johnson stayed on the transplant list from her initial diagnosis in 2015 until Nov. 27, 2017—a day she will never forget.

“They called that day and told me, ‘We have a liver for you,’” she said. “I just couldn’t believe it.”

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DID YOU KNOW? UTMB has been a pioneering force in transplantation since 1967, when one of the first kidney transplants in Texas was performed on the Galveston Campus. UTMB performed its first liver transplant in 1992 and its first heart transplant in 1993.

Through a grant from The Sealy & Smith Foundation in 2007, UTMB established the Texas Transplant Center. Today, the center offers heart, liver, kidney and pancreas transplant services to the greater Texas Gulf Coast and has completed more than 3,300 transplants to date.

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RESEARCH

UTMB establishes institute to lead research, development of vaccines

Startup plans include five-year competition for research dollars with Sealy & Smith Foundation support

BY RAUL REYES

RES EARC H B R I E F S

Compiled from press releases written by Donna Ramirez. Find out more at www.utmb.edu/newsroom.

Dr. Scott Weaver named National Academy of Inventors 2017 Fellow

is also the recipient of the Robert C. Gallo Award for Scientific Excellence from the GVN. “This is an incredible honor, with selection being made by noted authorities from organizations including the National Academies UTMB’s Dr. Scott Weaver was named as a Fellow by the National Academy of Sciences, Engineering, and Medicine, and U.S. Patent and Trademark of Inventors and will be inducted into the academy on April 5, 2018 during Office, as well as National Academy of Inventors Fellows,” said Dr. David its annual conference in Washington, D.C. Weaver, globally recognized Niesel, UTMB senior vice president and dean of the Graduate School of for his expertise in mosquito-borne diseases, is the director of the UTMB Biomedical Sciences, and chief research officer. “Dr. Weaver is one of our Institute for Human Infections and Immunity and scientific director of the leading scientists who is making substantial contributions to emerging Galveston National Laboratory. His work has been widely published and infectious disease research.” The Academy stated that election to NAI Fellow status is the highest professional he holds nine patents in vaccine accolade bestowed to academic inventors development. He is the chairman “Dr. Weaver is one of our who have demonstrated a prolific spirit of the Global Virus Network’s of innovation in creating or facilitating leading scientists who is Zika Task Force and co-chairman outstanding inventions that have made a of the Chikungunya Task Force, making substantial tangible impact on quality of life, economic which formed to speed the procontributions to emerging development and welfare of society. “UTMB cess for creating vaccines and infectious disease is extremely proud that Dr. Weaver has much-needed diagnostic tools for been recognized by the National Academy research.” these viruses, as well as to advoof Inventors,” said Dr. Danny Jacobs, UTMB cate for research efforts. Weaver

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RESEARCH

Vaccine research and development will expand at UTMB with the creation of the Sealy Institute for Vaccine Sciences.

less than 50 vaccines for human disease in the world, but the threat from and the spread of emerging diseases continues to grow.

The institute, supported by The Sealy & Smith Foundation and approved

by The University of Texas System, will help fund and further guide the development of preventive and therapeutic vaccines at UTMB.

“The addition of just one vaccine will be a tremendous success story,” Barrett said.

The institute will expand the successful, nationally and internationally recognized Sealy Center for Vaccine Development, which was established at UTMB in 2001.

To expedite the work on vaccine candidates, the institute plans to provide robust financial support over the next five years to UTMB researchers as part of a university-wide competition. The institute will review vaccine candidate proposals submitted by researchers, and the most promising candidate will secure funding and receive guidance to get a vaccine candidate ready for clinical trials.

UTMB is one of only seven World Health Organization vaccine centers in the world and one of only two in the United States. It is also home to a designated center of excellence regarding vaccines for emerging diseases, “It’s a difficult, time-consuming and expensive process including Ebola and Zika. UTMB has an established, highly to develop a new vaccine, but here at UTMB and at the successful vaccine clinical trials program that has supInstitute we are committed to developing a new vaccine ported numerous clinical trials sponsored by the National in the next decade,” Barrett said.

Institutes of Health and industry. Most recently, UTMB Dr. Alan Barrett Along with the increase in funding for research, plans and the Sealy Center for Vaccine Development partnered also include increased opportunities for students interwith Nature Publishing Group to launch a new leading vaccine journal. ested in focusing on vaccine research at UTMB as well as expansion of “We’ve had a lot of success but there is a need for more funding and more research and development of vaccines that will benefit people all over the world,” said Dr. Alan Barrett, the director of the institute and the first holder of the John Sealy Distinguished University Chair in Vaccinology. “The objective of the Sealy Institute for Vaccine Sciences is to further enhance the international reputation of vaccine sciences at UTMB and create an environment where scientists can take their idea from discovery to phase I clinical trials.”

Advancing a vaccine candidate beyond basic research and into clinical trials will be one of the Institute’s main goals, Barrett said. There are

executive vice president and provost, and dean of the School of Medicine.

“As leader of an internationally recognized research program, Dr. Weaver has developed innovative vaccine technologies that will likely improve our ability to fight the spread of dangerous viruses such as chikungunya.”

New research looks at inducing labor, cesarean delivery risk UTMB is a part of the network presenting late-breaking research data showing that inducing labor when a woman is in the 39th week of a lowrisk pregnancy results in better outcomes for both the mother and the baby. The data suggest that inducing labor could lead to fewer cesarean section births. The presentation was at the 38th annual meeting of the Society for Maternal Fetal Medicine on Feb. 1 in Dallas. In the study, lowrisk pregnant women from 41 hospitals across the U.S. nearing the end of their first pregnancy were divided into two groups—3,062 women had

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vaccinology internship activities and the clinical trials program.

“We are extremely proud of the vaccine work Dr. Barrett and others have done at UTMB and expect that more great work benefiting our country and the world will come from the Sealy Institute for Vaccine Sciences,” said Dr. Danny Jacobs, executive vice president and provost and dean of the School of Medicine. “Vaccines already prevent the deaths of millions of people around the globe and more could someday benefit from the efforts made by institute members under Dr. Barrett’s leadership and by the outstanding support of The Sealy & Smith Foundation.” n

their labor induced in their 39th week and 3,044 women were allowed to go into labor when their bodies began the process naturally. The women in the induced labor group were significantly less likely to need a cesarean section and were significantly less likely to develop preeclampsia/gestational hypertension. The babies born to women in that group also were significantly less likely to need respiratory support. “This is the first large and geographically diverse study to test induction of labor in low-risk women,” said UTMB’s Dr. George Saade, division chief of obstetrics and maternal-fetal medicine. “The results clearly show that if we are looking for an approach to decrease cesarean birth, induction of labor at 39 weeks is that approach. This is also the first intervention to show such a significant reduction in pregnancy-related hypertension, a condition that can result in significant morbidity for both mother and baby.” n

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BY KIRSTIANN CLIFFORD

For Jeimmy Banegas and Darion Alexander, working as patient transporters means much more than just taking patients from point A to point B. It’s about providing excellent customer service, supporting patients when they need it most—and always greeting everyone who comes through the door with a smile.

“I have a sunny disposition—that’s the way I prefer to be,” says Alexander as he arrives to UTMB’s Galveston Campus on a morning that is anything but sunny.

In fact, the December day I meet up with Banegas and Alexander is downright miserable, with freezing rain and high winds. Dressed in warm clothes and rain jackets, the pair doesn’t let the wintry conditions dampen their mood as they prepare for the day ahead.

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BY KIRSTIANN CLIFFORD

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For the past two years, they have have worked as a team for Hospital Transportation Services, stationed next to the parking garage behind UTMB Health Clinics, commonly referred to as “UHC.” From there, they stand ready to assist anyone who needs help getting to or from their outpatient clinic appointment. On average, the two help transport about 60 to 70 patients a day by wheelchair to the clinics—which cover a variety of specialties such as dermatology, cancer care and endoscopy.

Banegas and Alexander take turns saying “Good morning!” to UTMB employees who are making their way from the parking garage to the main building. Even serious-looking passersby can’t help but crack a smile when they see the duo intently wiping down wheelchairs and lining them up in preparation for patient arrivals.

“It can get really busy, so we try to have a dozen or so wheelchairs cleaned and ready to go,” explains Banegas.

“That way we don’t have to leave patients waiting while we go round the wheelchairs up later.”

Just before the outpatient clinics open at 8 a.m., vehicles dropping off patients begin arriving at the parking garage.

Some patients are accompanied by family members, others come alone.

“Many times, people may be worried, confused or in pain— because either themselves or a family member are sick or hurt,” says Alexander. “So always expressing kindness and a simple smile can go a long way.”

Banegas approaches one woman who is on her own and is unable to walk very far without stopping to sit. She grabs a wheelchair and gently helps the woman into it—and the two immediately strike up a conversation in Spanish. She asks for the woman’s name and appointment info, which she writes down into a log book. Then they’re off—up a ramp and into the much warmer UHC building.

“Don’t forget your parking garage ticket if you have one,” Banegas says in Spanish after tucking a blanket around the patient’s legs.

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Banegas doesn’t leave the patient once they get to the designated clinic—instead, she helps the woman check in for her appointment and asks if she would like any water while she waits. Once the patient is settled, Banegas reassures her that she will be back after the appointment to wheel her back to her car.

“We have a cell phone that the clinic will call when patients have finished up their office visits and are ready to be transported back to the parking garage or to another appointment,” she says.

In the meantime, Banegas heads back down to the patient drop-off area to see if there are any more people who need help. As we get off the elevator into the main lobby, Alexander waves as he approaches, pushing another patient. It’s impressive to watch the team of two in action—they treat each person with individualized care, interacting in a way they feel is most helpful and supportive.

“I like to meet new people all the time—it keeps things interesting, and you never know who you may meet or what kind of difference you may make,” says Alexander. “A lot of times, we become attached to our ‘regulars’ who are here a lot.

It’s fun because they look forward to seeing us.”

It’s obvious Alexander and Banegas are a favorite among patients and employees. They humbly admit to receiving positive comments and fan mail on a regular basis. Some patients make special requests to be transported by Alexander or Banegas to the clinics—or even all around John or Jennie Sealy hospitals. LaTayna Hill, a patient service specialist in the endoscopy clinic, now counts the two patient transporters among her close friends.

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“I wouldn’t trade them for anyone,” says Hill. “It’s about putting patients first and that’s what they do—and patients love them. When I worked in radiation oncology, I had a patient who wouldn’t let anyone besides Jeimmy or Darion take her to and from appointments. I guess everyone has their favorites—and they are a lot of people’s favorites!”

By 1 p.m., I’ve lost count of the number of patients Banegas and Alexander have greeted or wheeled to an appointment.

In addition to monitoring patients coming to and from the parking garage next to the UHC, the two take turns checking to see if any cars, taxis or shuttles pull up in an adjacent garage next to the ED. And if a patient is done with their appointment and is waiting to be picked up, Alexander and Banegas try to make them as comfortable as possible.

Hill adds that Alexander and Banegas have a patient demeanor and are always willing to go the extra mile for anyone. The two have many patient stories—some heartwarming, some adrenaline-provoking. In addition to having the occasional stroke, heart attack or laboring patient who needs to be run to the Emergency Department, Alexander recalls one regular patient who is terribly afraid of elevators. Instead, he helps the patient walk up and down the five flights of stairs whenever they come to the UHC for an Alexander (left) and Banegas (right) with LaTayna Hill, a patient appointment.

“I definitely get my exercise doing this job,” he says smiling.

service specialist in the endoscopy clinic.

“Sometimes patients may wait several hours for their transportation to pick them up,” says Alexander. “We’ll call their shuttle or taxi service to get a guestimate of when they will get here to help relieve any stress or anxiety the patient is feeling. In the meantime, we try to provide them with good company, water and snacks.”

It’s not a glamorous job and it can be tough at times, but he and Banegas enjoy every day that they are able to help a patient and keep the Health System running efficiently.

Alexander takes one more “It’s about putting patients first and that’s person to an appointment before breaking for a quick what they do—and patients love them.” lunch. The patient, who has Another common dilemma seen either Alexander or is when patients forget Banegas every day for the last three weeks of his radiation therapy, where they parked. lights up when he describes the impact they’ve had on him.

“Sometimes you’ll see us going around and around with a wheelchair all over the parking garage to find someone’s car,” laughs Banegas.

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“They take great care of me,” he says. “They are just as good as gold.” n

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LEA D E R S POT L I GH T

Dr. Vicki Freeman, interim dean and professor, School of Health Professions Dr. Vicki Freeman currently serves as interim dean for the School of Health Professions, which is celebrating its 50th anniversary this year. She first joined UTMB in 1996 as chair of the school’s clinical laboratory sciences department and is responsible for leading the program into becoming one of the largest and most dynamic in the country. In 2016, she established the Doctorate in Clinical Laboratory Sciences degree program, the second of its kind in the nation. She also has served as associate dean for faculty development within SHP since 2014.

Freeman began her academic career at the University of Nebraska Medical Center after earning a PhD in community and human resources and a master’s degree in adult and continuing education from the University of Nebraska-Lincoln. She earned bachelor’s degrees in biochemistry and medical technology from the University of Texas at Austin.

We recently celebrated UTMB’s tremendous success with Best Care. What are your thoughts on how UTMB can maintain its fivestar performance long-term?

In order for UTMB to maintain its five-star performance, we must involve the entire health care team in the management of our patients—each profession brings expertise to the table. When we all are able to value each other’s knowledge, then we can provide better care to the patient. Initiatives such as the diagnostic management teams introduced by Dr. Michael Laposata, chair of the Department of Pathology, will be important, as they bring experts from different disciplines together to discuss the best diagnostic testing for critical patients.

What are your goals as interim dean of SHP? My goal is to build trust in the school through open communication and dialogue, as well as transparency in processes. I am committed to increasing innovative, progressive, faculty-led programs of research across departments; to look at faculty and staff retention and salary benchmarks; and to expand competency-based and interprofessional education. Also, as this year marks SHP’s 50th anniversary, my hope is to have a big celebration at UTMB’s 2018 Homecoming that brings together faculty, staff, students and alumni.

You’ve won numerous teaching awards and served as the Academy of Master Teachers director from 2010-2014. What has contributed most to your success as a teacher?

I believe that my success comes from putting myself into the shoes of my students and seeing each one as an individual. Since we all learn in different ways, I try to provide educational experiences to students in a variety of settings and delivery methods. I have had many great mentors along the way, each who have contributed to my success and helped to guide me as I developed as an educator. In several ways, my background is similar to many of our students. I am a first-generation college graduate who went from a small rural high school to a large urban university. I began my teaching career during my first year in college, when I served as an informal tutor for students who were having difficulties in general chemistry and microbiology. I enjoyed working with students and found it rewarding when they “saw the light” in terms of understanding the material. Even now, my most rewarding teaching experiences are when the students finally “get it” as they apply what they have learned.

Describe yourself in three words.

Focused, flexible and fearless What has been your greatest achievement?

I believe that my greatest success is not what I have personally accomplished, but it is seeing the accomplishments of those individuals who I have guided 12

and mentored. It is rewarding to see a variety of individuals—including my daughters, Girl Scouts, students, faculty and other people I have worked with over the years—find success both personally and professionally in their chosen vocation. Both of my daughters completed their Girl Scout Gold Awards and obtained college degrees in fields in which they are professionally successful. Faculty in the Department of Clinical Laboratory Sciences have been able to easily transition into new roles and responsibilities as I moved into the interim dean position. I’ve traveled to Maua Hospital in Kenya regularly since 2005 to help laboratorians assess and update laboratory quality systems, and professionals there are able to provide better care to patients because they are working together more as a team. These are just a few examples of where I think I have had some impact.

What energizes you?

Family, travel and enabling others to grow. I especially like it when I can put all these together. I love to be with my family, especially traveling with them to new places and introducing them to new cultures. I find that we learn so much about other cultures when we actually visit their country. Some people think that I never take a vacation because many of my trips are “working” trips, i.e. mission trips or cultural trips where I get to know the people of the land, not just go to the tourist sites. A few years ago, I took my 19-year-old granddaughter to Kenya, where she worked with the local missionaries at Maua Methodist Hospital. It was a great experience to introduce her to the African culture.

What book are you currently reading?

I like to read mystery novels as well as books on leadership. I have been reading a series by Louise Penny, the latest being “Glass Houses.” This series is about leadership in the Sûreté du Québec—the provincial police force for the Canadian province of Québec. Not only does it include the mystery element, but it also shows how you can be a compassionate leader even in the face of adversity. Chief Inspector Armand Gamache, as head of homicide, demonstrates his compassion with those under his command and how he has to stand up for what he believes is right.

What’s something people would be surprised to learn about you?

Many people know that I am a Girl Scout, but not many know that I lived in England for a time and was a Girl Guide Ranger Guider (leader to girls ages 14-16). Girl-guiding is the UK’s largest youth organization for girls. With the rangers, I was qualified to take groups of girls on camping trips in the Forest of Dean and Wales. Working with girls in Hawaii, Texas, Nebraska and Europe also led to developing craft skills in candle making, macramé and cross-stitch—although ballroom dancing has replaced those pursuits in my free time. n FEBRUARY 2018

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IN M EM ORI AM

A lasting legacy UTMB Police Chief Tom Engells remembered as brilliant, humble leader

BY KIRSTIANN CLIFFORD

As the University of Texas System community continues to mourn the sudden loss of UTMB Police Chief Tom Engells, those who knew him are remembering his charismatic personality and the legacy he built.

“He was a wonderful man, a marvelous leader— and he had a wicked wit,” said UTMB President David Callender. “Oftentimes, during a meeting, while we were talking about something serious, he would know exactly the right comment to lighten the mood and help us think more clearly.”

Engells, who led the UTMB Police Department since 2010, passed away unexpectedly at his home on Jan. 21. A proud veteran of the United States Marine Corps, Engells was part of the UT System family for more than 34 years, rising in the ranks from police officer to police chief.

Under his leadership, UTMB became the first UT System police department to achieve national accreditation for excellence from the Commission on Accreditation for Law Enforcement Agencies (CALEA). He was named the inaugural UT System Police Chief of the Year in 2011 and earned the honor again in 2014. He also was named “Law Enforcement Administrator of the Year” by the Texas Association of College and University Police Administrators. More recently, Engells achieved international recognition for his expertise in biosecurity.

Although Engells’ accomplishments and contributions were many, he always attributed his success to the men and women officers he led.

As he told the Impact newsletter for a recent article, “These men and women do amazing work so regularly here that it has become a routine expectation. From life-saving events to significant charitable campaigns for the community, my folks accomplish a lot without fanfare or publicity. My success is attributed to their hard work on a daily basis.”

Outside of work, Engells was known as a devoted family man who made holiday fudge every year and enjoyed tending to his “monster” 20-foot fig tree in his garden. He is survived by his wife, Peggy, and daughter, Laura, whose accomplishments were the source of his joy and admiration.

Dr. Callender invited the entire UTMB community and police department colleagues for a memorial tribute celebrating the life of Chief Engells on Feb. 23 at Levin Hall Main Auditorium on the Galveston Campus.

“Chief Engells will have a powerful, lasting impact on all who knew him. His influence here went beyond just policing and into every aspect of what we do at UTMB,” Callender said. “We will surely miss him.” n The Galveston County Daily News contributed to this story.

Ruben Puente to serve as interim police chief Ruben Puente, assistant director of the UT System Police Department, has been appointed to serve as interim chief of police for UTMB, as of Jan. 30.

During his career, Puente has served in the Arlington, Texas, Police Department and held a command position with the Dallas Area Rapid Transit Police. As senior manager of corporate security with Frito Lay North America, he oversaw security operations for 52,000 employees in 18 regional offices, 10 manufacturing plants and 200 distribution centers throughout the U.S. He also oversaw corporate security operations for Major League Baseball, including planning sporting event security throughout North America and in numerous international venues. He joined the UT System Police Department in 2012.

“Looking ahead, we will work with the UT System Director of Police, Interim Chief Puente and the UTMB Police Department to initiate the process for hiring a permanent chief of police for the institution. We will keep the university community updated on our progress in the search,” said UTMB President David Callender in a message to employees. “In the meantime, please join me in welcoming Interim Chief Puente to the UTMB community and in supporting our entire police department in its continuing work to ensure our university remains a safe and secure environment in which to work, study and seek care.” n

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E D UC AT I O N

Interprofessional from the start Since the beginning of his teaching career, Dr. José Rojas has emphasized a team approach

BY STEPHEN HADLEY

Throughout his teaching career, Dr. José D. Rojas has stressed the importance of interprofessional education in better preparing his respiratory care students for careers in the medical field.

Rojas, associate professor and chair of UTMB’s Department of Respiratory Care in the School of Health Professions, saw firsthand the value of students working in interdisciplinary teams when he taught at Midland College in the late 1980s.

“At the time, we didn’t think our approach was groundbreaking. We were just looking for a better way to teach students,” Rojas remembered. “We had a lab that connected the nursing students with the respiratory care students and we understood that the best way for them to learn was by working together, by mirroring the approach they would take in the workplace.”

Over the years, as Rojas’ career took him across the country as a respiratory therapist and finally to a position teaching physiology to medical students on the Caribbean island of Dominica, he continued to promote interprofessional education as the cornerstone of preparing the health care workforce of the future.

But it was a personal tragedy that brought him back to Texas to teach respiratory care at UTMB—and to convey a deep understanding of why interprofessional education and practice are so vital.

“Interprofessional education is vitally important.

Employers are looking for graduates who have the soft skills—the people skills—to be able to interact with one another and be part of a team.”

for graduates who have the soft skills—the people skills—to be able to interact with one another and be a part of team.

His youngest son, Josh, who was serving as a crew chief on an A-10 Warthog “If all we do is teach them a skillset or share our knowledge about a particular for the U.S. Air Force in Fairbanks, Alaska, died in 2004 after he was misdi- disease, I think we’re missing out on an opportunity. It’s been shown again agnosed with pneumonia. His death, just shy of his 21st birthday, was caused and again that the outcomes for patients are better when we approach care in an interdisciplinary way.” by a pulmonary embolism.

“Thinking about and confronting what the experience had been like with Josh Rojas said UTMB’s new Health Education Center, which is under construction during his hospitalization made me realize I needed to get back to teaching on the Galveston Campus and set to open in 2019, is going to improve the respiratory care,” Rojas said. “I knew I could make a difference by looking at institution’s approach to providing an education that is focused on team skills. the dynamic of people who worked with Josh, examining the team effort and how I could contribute to that.”

“Having the HEC is going to facilitate grouping learners with similar skillsets so they can work together,” he said. “We can actually work with a nursing student Rojas said at UTMB his focus is on helping students learn to work in teams to to simulate the role of a nurse. The same goes for a therapist or a medical student or a physician assistant. I really believe that being able to simulate these provide the best care possible to patients. interprofessional teams is going to be a great opportunity for us to enhance “Interprofessional education is vitally important,” he said. “Employers are looking the education of all of our students.”

The HEC, which represents the first significant addition to UTMB’s educational infrastructure in four decades, will feature three core areas of focus: simulation, where students can learn in high-realism, low-risk settings; interdisciplinary training, where students from our four schools will work and learn together; and active learning, where students will tackle challenging cases in small group settings.

The next challenge, Rojas said, will be to connect interprofessional education initiatives with clinicians who are already in practice at UTMB. “We’re all working to bridge the gap that exists between the academic environment and the real-world practicing environment and we will find ways to make that happen,” Rojas said.

Dr. José Rojas works with students during a simulation.

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“The HEC is the first step, a place where we can bring everyone together to learn, but we are continuing to find ways to improve what we offer our students, our communities and, ultimately, patients.” n

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impact

CON STRUCTI ON

Facilities construction continues across UTMB, including the new Health Education Center on the Galveston Campus and expansion on the League City Campus. Here’s a closer look at the construction projects ongoing at UTMB:

GALVESTON CAMPUS

LEAGUE CITY CAMPUS

Health Education Center

League City Campus Hospital

The Health Education Center, which will allow UTMB to increase student enrollments to meet the growing need for a well-trained health care/health sciences workforce and provide faculty and students with the most advanced educational technologies, is scheduled to become operational by Spring 2019.

Current status: Structure “top out” completed in January

The Phase 2 expansion of the League City Campus Hospital, which will include construction of a South Tower featuring five levels with 60 patient beds, is scheduled to be operational by May 2020.

John Sealy Hospital The project to modernize and expand patient rooms and technologies in the John Sealy Hospital is set for completion in Spring 2020.

Current status: Plans to UT System Board of Regents for final approval this month; construction set to begin in March

Current status: Brick removal and steel inset installation in progress on the building’s façade; demolition in progress on AB Wing Levels 4 & 5; final, redesigned room mockups set for completion this month

Parking Garage

Building 17E Expansion

Current status: Underway with plans to be operational on July 2

The expansion of Building 17E is nearing completion—set to partially open in April and be completely finished by December—will provide vital support space for UTMB’s research enterprise

MD Anderson Cancer Center (MDACC) Outpatient Center

Current status: Levels 1-4 operational by April as commissioning of mechanical, electrical and plumbing in progress; Level 5 will remain shelled space; Level 6 and Sky Bridge will be operational in December

Jennie Sealy Hospital Level 6 Construction is underway on the sixth floor of Jennie Sealy Hospital, where invasive cardiology services—including Cath Labs, Electrophysiology Labs and a Post Anesthesia Care Unit—will be located.

The new parking garage currently under construction on the League City Campus will be seven levels with an attached 33,000-square-foot multi-use building and connecting sky bridge.

MD Anderson, which is leasing property on UTMB’s League City Campus, is constructing a $110 million, 190,000-square-foot full-service outpatient cancer center. This collaborative effort will allow both institutions to expand access to advanced health care services by taking advantage of MD Anderson’s internationally recognized expertise in cancer care and clinical research; the investments UTMB has made in its League City Campus and surrounding clinics; and UTMB’s extensive network of primary and specialty care providers throughout the region.

Current status: Operational this summer

Current status: Operational in October

MDACC UTMB Clinic on Level 2 District heating and cooling system The recently completed West Plant, which became operational in December, added 15 megawatts of power-generating capacity to the campus, further hardening UTMB’s capabilities to provide its own source of electrical power. impact

FEBRUARY 2018

UTMB will open a 9,100-square-foot multi-purpose clinic on the second level of the new MDACC Outpatient Center. The facility will include 12 exams rooms and two treatment rooms.

Current status: Operational in September

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Nutrition tips for a healthy heart

By Blair H. Brown, registered dietitian nutritionist, UTMB Health Texas Transplant Center February is American Heart Month. Cardiovascular disease—including stroke and heart disease—claims more lives in the U.S. than any other illness. Making healthy diet choices is one of the easiest and most effective ways to reduce your risk of heart disease. The following tips will help you eat your way to a happier, healthier heart: • Shake your salt habit. Though your body needs sodium to work properly, too much sodium can cause your body to retain excess fluid. This puts an extra burden on your heart and blood vessels. The American Heart Association recommends no more than 2,300 milligrams of sodium a day and an ideal limit of no more than 1,500 mg per day for most adults. However, the average American eats about 3,400 mg of sodium! Even cutting back to 2,400 mg a day can significantly improve blood pressure and heart health. Keep an eye out for the “salty six” foods, including bread, cold cuts and cured meats, pizza, poultry, soup and sandwiches.

• Cut back on packaged, processed foods. More than 75 percent of the sodium Americans eat comes from processed, prepackaged or restaurant foods—not from the salt shaker. Familiarize yourself with food labels, as you may be surprised by hidden sodium, sugars and fats in foods you considered healthy.

• Reduce added sugar. Too much added sugar significantly increases the risk of cardiovascular disease and contributes to obesity, high blood pressure and high cholesterol. Some major sources of added sugars include soft drinks, candy, cakes, fruit drinks and dairy products. Two simple tips: Consider cutting back on

the amount of sugar added to things you drink regularly such as coffee or tea and buy fresh fruit instead of fruit canned in syrup.

• Remember not all fats are created equal. While it’s important to avoid eating saturated and trans fats, monounsaturated and polyunsaturated fats can actually be good for you in moderation because they do not raise the “bad” LDL cholesterol in your body and may actually help raise your “good” HDL cholesterol.

Eating fish such as salmon, trout and tuna are an excellent source of healthy fat, along with vegetable oils, avocados, olives and various types of nuts.

• Add more color to your plate. Aim for five or more servings of colorful fruits (such as berries, oranges, and apples) and veggies (bell peppers, spinach, broccoli and carrots) each day.

• Look for healthy key words. When ordering food at a restaurant, look for menu items prepared using a low-fat method, such as “steamed,” “broiled,” “grilled,” “roasted,” “poached” or “in its own juice.” Key words that indicate foods contain saturated fat or cholesterol include “creamed,” “au gratin,” “marinated,” “fried” or “sautéed.”

• Drink alcohol in moderation. Drinking an average of more than one drink a day for women or more than two drinks a day for men can raise the levels of some fats in the blood and can lead to other serious problems such as heart failure and stroke.

• Cook meals at home. When you prepare and cook your meals at home, you have better control over the nutritional content and the overall healthfulness of the foods you eat. Plus, you can save money, too! n

UTMB TRIVIA This heart was preserved by an individual who was a pioneering cardiology researcher and past UTMB president using the “injection-and-corrosion” method.

This method involved injecting a colored plastic material into the heart. After the injection, the heart was then submerged in concentrated hydrochloric acid. The corrosion would take anywhere from one to three days depending on the size of the heart. The hearts were cleaned and dried, then covered with a clear plastic spray to preserve them and enhance the colors before being mounted for study. Can you name the individual who preserved this heart and was a world-renowned cardiovascular pathologist?

Send your answer to impact.newsletter@utmb.edu and be entered into a drawing to win a UTMB swag bag. Good luck!

Answer to the January trivia question: Dr. Herman Barnett Congrats to Earl McAfee, patient access specialist at the UTMB Access Center, who won the Jan. drawing!