Impact May 2017 by UTMB Health

UTMB NEWSLETTER â&#x20AC;˘ MAY 2017

Helping transplant recipients survive and thrive Advancing health through animal research UTMB maternal-fetal medicine specialist shares journey through infertility Spotlight on Dustin Thomas, Decision Support

Nurses, surgical technologists and physicians from the Division of Cardiovascular and Thoracic Surgery represented UTMB at the Marfan Foundation’s Walk for Victory in Houston on March 25. Marfan syndrome is a genetic disorder that affects the body’s connective tissue. Connective tissue holds all the body’s cells, organs and tissues together and also plays an important role in helping the body grow and develop properly. Marfan syndrome affects 1 in 5,000 people. UTMB is one of two designated Marfan Centers of Excellence in Texas. The UTMB group raised about $4,500 for the Marfan Foundation, which works to advance research, serves as a resource for families and health care providers, and raises public awareness. Joan Nichols, PhD, professor in Internal Medicine and Microbiology and Immunology, was named a 2017 Outstanding Woman of Texas by the Galveston Regional Chamber of Commerce. Nichols also is associate director of research and operations at the Galveston National Laboratory. The award was presented April 6 at the chamber’s 10th annual Celebrating Women: Mind, Body, Spirit conference. In 2016, Nichols, an expert in infectious diseases, was one of 10 professors in Texas to be selected by the Minnie Piper Foundation as a Piper Professor. Nichols and Dr. Joaquin Cortiella have successfully grown lungs in a laboratory in a project aimed at helping transplant patients and people with respiratory problems. Bonnie Webster, RN, assistant professor in UTMB’s School of Nursing, received this year’s SON DAISY Faculty Award. The award recognizes Webster for her integrity, compassion and commitment to nursing education. The DAISY Foundation, an organization that gives grants and awards to outstanding nurses, established the DAISY Faculty Award to provide colleges/schools of nursing a national recognition program that they may use to demonstrate appreciation to their nursing faculty for their commitment and inspirational influence on their students. UTMB’s Divisions of Infectious Diseases and Maternal Fetal Medicine joined forces to train midwives and physicians working in remote areas of the Cusco region in Peru. Drs. Miguel Cabada, Gayle Olson Koutrouvelis, Mauricio La Rosa and Camille Webb presented a two-day workshop titled “Obstetric Emergencies in Global Health.” The workshop was sponsored by the UTMB Collaborative Research Center in Cusco and was directed to midwives and general physicians working in health centers around the region. A total of 33 attendees from health centers as far as 20 hours away participated in training on pre-term labor prevention, pre-eclampsia and post-partum hemorrhage management, and bacterial and parasitic infections during pregnancy. Practical demonstrations followed the lectures including techniques to stop post-partum

hemorrhage in the field using readily available materials like condoms and intravenous lines. These activities were part of ongoing efforts to establish a research collaboration between UTMB faculty, the Collaborative Research Center and the Ministry of Health to improve maternal fetal outcomes in the region. Dennis Bente, DVM, PhD, associate professor in the Department of Microbiology and Immunology, received an Innovations in Health Science Education Award from the University of Texas System’s Kenneth Shine, MD, Academy of Health Science Education. Bente was honored for his development of the scenario-based Infectious Disease Outbreak Response course, an intensive three-day, one-hour elective course for students focused on applying theoretical knowledge of infectious diseases to real-life situations. The course addressed where the biomedical scientist “fits” in the public health issues and crisis situations that arise when there is an emerging virus or infectious disease epidemic. Bente developed the course after being inspired by the Scholars in Education program of the Academy of Master Teachers at UTMB. Jill Bryant-Bova, RN, senior quality management specialist, and David Marshall, JD, DNP, RN, chief nursing and patient care services officer, recently took part in emergency response training in Texas City as part of the U.S. Department of Health and Human Services’ National Disaster Medical System, or NDMS. There are more than 5,000 NDMS personnel nationwide who respond to large-scale natural and man-made disasters. Bryant-Bova and Marshall joined other local medical professionals for the March 11 training including physicians, nurses, EMTs, paramedics, firefighters and veterinarians. Team members set up a base of operations similar to a MASH unit and became more familiar with specific emergency medical equipment they would be provided during a response. NDMS members have been deployed to assist with emergency responses including Hurricanes Matthew and Sandy, and the earthquake in Haiti in 2010. Dr. Courtney Townsend, professor and Robertson-Poth Distinguished Chair in General Surgery in the Department of Surgery, received the Academy of Master Clinicians’ inaugural Lifetime Achievement Award. The award recognizes a clinician who has 20 or more years of contribution with most of that time at UTMB, and has provided outstanding clinical care over the years of their career. He was honored during the Academy of Master Clinicians guest lecture and new member induction ceremony on April 12. M AY 2 0 1 7

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From the President Welcome to the newest issue of Impact! This edition highlights another Best Care in Action showing how UTMB’s Rehabilitation Services team revamped a “boot camp” class for knee- and hip-replacement candidates that has improved the overall patient experience and outcomes.

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The class is yet another example of how each of you is contributing to our goal of providing Best Care and rising to the challenge to rank among the Top 20 academic medical centers in the Vizient Quality and Accountability Study by FY18. In fact, our recently released mid-year performance rankings show that, overall, we have improved from 76th place to 19th place of 102 reporting academic medical centers. While there is still work to be done, this remarkable achievement is a testament to the dedication and commitment from everyone throughout our organization.

UTMB maternal-fetal medicine specialist shares journey through infertility

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This month’s issue also seeks your input on Impact itself. The print edition of our monthly newsletter has been back on newsstands for nearly two years following its run as an online-only publication after Hurricane Ike. The Impact team is encouraging employees, faculty and students to take an online survey to share your thoughts about the publication. You can learn more about the survey at www.utmb.edu/iutmb/article9263.aspx and inside this issue, along with stories about our people. Among them:

Advancing health through animal research

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• A day in the life of Jeanene Trochesset, post-transplant coordinator in UTMB’s kidney and pancreas transplant programs • A profile of Dustin Thomas, vice president of Decision Support, who oversees financial forecasting, budgeting and operational analytics • How Dr. Shannon Clark, maternal-fetal medicine specialist, navigated her own journey through infertility on the way to motherhood • A closer look at a new website to inform employees and the public about the ways we’re advancing health through animal research • Defining the future of health care education with the groundbreaking of our new Health Education Center • A School of Nursing graduate fulfills lifelong dream of becoming a nurse • Numerous accomplishments and kudos in the Working Wonders column and throughout the newsletter

A day in the life of a post-transplant coordinator

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If you have ideas for future issues of the newsletter, please let the Impact team know. Thank you!

Spotlight on Dustin Thomas, Decision Support

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: As a post-transplant coordinator at UTMB, Jeanene Trochesset provides clinical management of hundreds of transplant patients from Lafayette, Louisiana, to McAllen, Texas, and helps them adjust to their new life after transplantation.

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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

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

B E S T CA RE IN AC TION

BY KIRSTIANN CLIFFORD

GETTING A KNEE OR HIP REPLACED IS A MAJOR SURGERY REQUIRING WEEKS—SOMETIMES MONTHS—OF RECOVERY. As you can imagine, most patients have numerous questions and concerns for their health care team leading up to the operation. A newly revamped “boot camp” class led by UTMB’s Rehabilitation Services department aims to educate and ease preoperative nerves so patients and their caregivers know exactly what to expect before, during and after a total joint replacement. “We fill in all the holes of the process from 30 days out to hospital discharge and beyond—it’s like an itinerary,” said Karen Chapman, DPT, director of Rehabilitation Services. “The patient truly becomes a member of the team and understands their role and responsibilities, along with all of ours, to make sure they have a really good outcome.” The free, hour-and-a-half class is held at each of UTMB’s three campuses at various times of the month and is specifically for individuals who have already seen their orthopedic surgeon and have scheduled a total hip or knee replacement surgery. A nurse and physical or occupational therapist lead the class, which covers everything, from packing for your hospital stay to managing pain and recovering at home. Patients are encouraged to bring a family member or caregiver with them.

“We start out each boot camp by having patients fill out a risk assessment prediction tool, which basically helps us preplan for a patient’s discharge by predicting whether an individual may need inpatient rehab or can be discharged home right after surgery,” said Chapman. “We also talk about the risks and signs of infection—and how to minimize the risk by things such as not shaving your legs a week before surgery to avoid nicks in the skin and showering with a special antiseptic the day before surgery.” Stephanie Custer, a total hip replacement patient, recently attended a boot camp at Jennie Sealy Hospital a few weeks before her scheduled surgery. Her son, Kevin Wood, attended the class with her and said the 90-minute session was well worth their time. “Before this class, my mom had about a thousand questions, but they pretty much answered them all today,” Wood said. Custer added, “I didn’t have to ask a question, they covered everything for me. I feel much more confident now and am ready to do this!”

Participants said they appreciated viewing “how-to” videos, which were recently added to the end of the class. The short clips show how to use various Boot camp leaders Cathy Elton (right) and Deatra Josiah (middle) show total assistive equipment, such as hip replacement patient Stephanie Custer and her son, Kevin Wood, how to use how to walk with a walker and assistive devices after surgery. how to get in and out of bed. Since patients are usually only The classes originally began about eight years ago as a collaboration between the Rehabilitation Services depart- in the hospital for about one to two days, Chapman said providing patients ment in the Health System and Orthopaedic Surgery and Rehabilitation in the with information on how to successfully recover at home is key. The class School of Medicine. The program underwent a transformation last October to add includes an opportunity for patients to schedule their outpatient physical therapy more structure to the class and ensure all patients receive the same information. appointments at UTMB if they haven’t done so already. “One of the main goals behind boot camp is to have a consistent message across the board,” said Chapman. “Whether a patient is having surgery at Jennie Sealy, League City Campus or Angleton Danbury, everyone is hearing the same things. So it was truly a collaborative effort because we had to meet with pre-op nurses, anesthesia nurses, surgeons, and inpatient and outpatient therapists to make sure all our efforts were aligned.”

In the future, Rehabilitation Services is looking to add boot camp sessions for patients who have not yet decided to undergo joint surgery, but would like to get more information about the process and hear from UTMB orthopedic surgeons.

“We continue looking for ways to improve the way we serve patients and I always ask participants if the boot camp was helpful,” said Cathy Elton, a physical therapist and boot camp leader. “So far, the feedback has been overwhelmingly In addition to providing consistent information and boosting patient satisfaction, positive. It makes us feel really good that we are moving in the right direction the classes aim to improve health outcomes by reducing infection rates and and providing Best Care before, during and after surgery.” hospital length of stay.

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Keeping hope

UTMB maternal-fetal medicine specialist shares her own journey through infertility

BY KIRSTIANN CLIFFORD

DR. SHANNON CLARK’S ENTIRE CAREER revolves around embryo transfer resulted in a pregnancy—with twins! As if her bringing new life into the world. So when the high-risk obstetri- journey thus far hadn’t been tough already, her pregnancy wasn’t cian found out she may not be able to conceive children of her exactly easy, either. own at the age of 40, it was tough news to swallow. “Being pregnant with twins is no joke,” said Clark. “I had “As a board-certified maternal-fetal medicine to be hospitalized and put on bedrest at only 22 weeks, specialist, I was medically trained to know which was way before the twins were viable. I the effects of age on a woman’s fertility, but was hospitalized on the same unit where I somehow felt it didn’t apply to me—I was work—Room 9 in Labor and Delivery—for healthy,” she said. “Turns out 40 is not the two months before I delivered. Having new 30 when it comes to your ovarian twins seems so glamorous and you see reserve and egg quality.” celebrities in magazines having twins, but the reality of the situation is that a twin Originally from Kentucky, Clark and her pregnancy is a high-risk pregnancy.” sister were the first in their family to graduate from high school and college. Highly motivated and focused on pursuing a career in obstetrics and gynecology, Clark’s undergraduate education was followed by more than 11 years of medical training, including a fellowship in maternal-fetal medicine at UTMB.

At 31 weeks, Clark had an emergency C-section and her son, Remy Vaughn, and daughter, Sydney Renee, were born in September 2016 at UTMB’s Galveston Campus. Although Clark and her husband live in Houston, they were adamant about delivering at UTMB.

PHOTO COURTESY OF ROBERTO GANOZA PHOTOGRAPHY For a long time, Clark thought it would be fine “We have a very special obstetrics department Dr. Shannon Clark and her husband, if she never experienced motherhood herself. here—we take care of a lot of high-risk patients René Harris, with their twins, Remy Her goals were career-oriented and not much from all over, and I knew that no one was Vaughn and Sydney Renee. spare time was left for finding a partner. But going to take better care of me than my own at 38-years-old, she met her husband—and everything changed. colleagues,” said Clark.

“My desire to have children became strong,” recalled Clark. “How- The twins spent more than a month in the neonatal intensive ever, I experienced a miscarriage shortly before my 40th birthday care unit (NICU) at UTMB, and are now healthy and happy and the panic really set in.” six-month-olds. Clark is grateful to have a happy ending to her journey, and added the whole experience was a “huge eye-opener” Clark and her husband, René Harris, decided to try in-vitro that has helped her empathize even more with patients. fertilization, an assisted reproductive technology. Commonly referred to as IVF, the process involves extracting eggs, retrieving a sperm sample and then manually combining the two in a laboratory dish. The embryo(s) are then transferred to the uterus. The couple went through five rounds of IVF in one year without success. It was emotionally, physically and financially taxing for Clark, but she always tried to put her own challenges aside and remain focused on her patients.

“I get it now. I have a whole new appreciation for women who have to be put on bedrest for extended periods of time and the anxiety and stress that comes with it,” said Clark. “And as a physician, I do urgent C-section deliveries all the time, but being on the other side of it, I have a whole new appreciation for that as well. And I understand what it’s like to be a NICU parent and how difficult it is to leave your babies every night.”

“As a high-risk obstetrician, I’ve spent years developing a tough Clark’s journey to motherhood is well-documented in her popskin, so I think I was pretty good at separating work from my ular blog, babiesafter35.com. She hopes it helps educate, inform personal life and compartmentalizing everything so it didn’t and inspire other women and men who are going through their affect my work,” said Clark. “But sometimes when I went home, own journeys. it would be hard. All physicians have gone through their own “As women, we are always told to get our Pap smears, our mamtraumatic events, whether it’s infertility or a death in the family, mograms and to do our well-woman exams, but no one really and at the end of the day, we are all still human and are not ever talks to us about our fertility,” she said. “My goal is to be immune to having it creep in sometimes.” transparent about it because infertility is a reality that a lot of Throughout it all, Clark and Harris didn’t give up hope. They couples face. I want them to know they aren’t alone—and to moved forward with using an egg donor, and Clark’s third never give up hope.” impact

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Advancing health New website aims to inform employees and public about animal research at UTMB BY KIRSTIANN CLIFFORD

When you take medication or get a vaccine or chemotherapy, chances are you’re able to do so because of animal research. In fact, most of the major medical advances in the last century were made possible through the help of laboratory animals. “Many people may not realize that almost every drug you take has been tested for efficacy and safety in an animal first,” said David Niesel, PhD, UTMB’s chief research officer and the senior vice president and dean of the Graduate School for Biomedical Sciences. Niesel, a microbiologist who has worked with animal models for more than 30 years, knows firsthand how important they are. “They are essential to understanding how to treat diseases and, ultimately, how new therapies, drugs and vaccines must be evaluated. Funding agencies and the FDA routinely require animal testing before a new drug or device can progress to human clinical trials. I don’t think any of us would want our loved ones to get a drug that had not been deemed safe for human use—that’s why animals are so important for medical progress.” As a major research university, UTMB uses research animals for some of its most important laboratory work. In just this decade, UTMB scientists have led worldwide efforts to combat the Ebola outbreak in West Africa, developed a vaccine for Chikungunya, created a quick test for the Zika virus and are working on growing lungs in a laboratory to help children whose lungs are diseased or not fully developed. But how are animals cared for and used in research, and what is the process for approving studies that use animals?

Accessible information A recently launched website, www.utmb.edu/animal-research, aims to educate and inform employees and the public on all aspects of animal research at UTMB—from the approval process for projects involving animals to the training required for their proper care and use. “The website is really important in that it defines for people what animal research is, why it is important and how it benefits health,” said Niesel. “It also highlights how careful we are in terms of using animals. The scientists I know who work with animals consider it a privilege. What we’d like is for the public to know that we do this very responsibly.”

As a guiding principle for the use of animals in research, UTMB adheres to what is known as the “3Rs” – Replace, Refine and Reduce. A scientist with a research question will consider all the available ways to answer that question. In some instances, there are ways to test a hypothesis without using animals—and these strategies are used whenever possible. This is the “replace” component. However, if it is determined animals are necessary, researchers turn their attention to the two other 3R components, “refine” and “reduce.” “Researchers work hard to refine their studies in order to minimize animal discomfort and pain,” said Niesel. “And, our scientists always look for ways to reduce the number of animals used while also making sure they have enough to get high-quality data that’s needed—so there’s a balance in that.” Niesel pointed to an example of the dangers of not fully testing medication before its use in people—the use of thalidomide in the mid-20th century. Thalidomide was widely taken to reduce anxiety and morning sickness in pregnant women. But the animal testing done before the drug came to market did not include studying its effects during pregnancy. Worldwide, more than 10,000 children whose mothers had taken the drug while pregnant were born with thalidomide-related disabilities.

Oversight roles and compassionate care The new website also contains easy-to-understand information on UTMB’s programs that oversee animal research—including the Animal Resource Center (ARC) and the Institutional Animal Care and Use Committee (IACUC). Every institution that receives federal funding for vertebrate animal-based research must have an IACUC in place to ensure compliance with all laws, regulations and policies—and to ensure research is conducted as compassionately as possible. “Before a scientist can ever do an experiment, they have to get approval from this committee, which includes a chairperson, veterinarians trained in laboratory animal science and medicine, practicing scientists, a non-scientist and an individual not affiliated with the institution,” said Toni D’Agostino, associate vice president for research administration. “Researchers fill out a very extensive document that makes them explain exactly what they are going to do and why, how many animals they are going to use, and more. Once the study is underway, IACUC inspects all research animal facilities regularly and, if needed, will investigate any concerns involving the care and use of animals.”

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RE SE A R CH

through animal research UTMB’s Animal Resource Center is a robust operation, providing hands-on care for all animals. Six veterinarians and about 65 staff members, including animal technicians, provide comprehensive veterinary and animal husbandry services 365 days of the year, 24 hours a day. ARC staff look at each individual animal— whether it’s a mouse, sheep or nonhuman primate—at least once a day. “I see our role as a pretty important one—to advocate for the animal, for science and for the institution,” said Doug Brining, DVM, ARC director and attending veterinarian. “We are in a position to really help. We have unique training and understand a lot of different aspects of research from an animal welfare perspective. For example, we review all scientific research that is proposed to help ensure the right animal model is used, the right nutrition is given and any animal discomfort is managed.”

“We want to be transparent with everything we do,” said Toby Boenig, JD, vice president and chief compliance officer, whose office handles all legal and regulatory matters related to animal care at UTMB. “If we have to notify a government agency because of our legal, regulatory and ethical obligations, then we are going to do it—and we will post that communication on the website so our community can see it.” D’Agostino acknowledged there have been newspaper articles and allegations by certain animal rights activist groups that portray animal research at UTMB in a negative light. She said the website is an opportunity to provide the public with the facts.

“The same standard of care and compassion shown to our patients by health care staff is applied to our animals by the research community,” said D’Agostino. “As in patient Learn more about UTMB Animals in Research at care, on rare occasions there www.utmb.edu/animal-research are unintended outcomes. Brining, who transitioned from a private veterinary practice to institutional research When an unintended outcome occurs, we look at the system and processes about 20 years ago, said most of his colleagues also have worked in the field for leading up to the outcome, and take appropriate steps to ensure it doesn’t happen again. All of that information, including the reporting of the event to our decades and care immensely about each animal. regulators, will be posted to the website. Additionally, we have developed an Animal “The caretakers who are there every day are connected to those animals and Safety Assurance System web form that allows any UTMB employee to report provide really great care—they even occasionally form strong emotional attachany concerns that they have regarding an incident they observed. Of course, we ments,” said Brining. “It’s hard for people outside our work to really visualize what would also like to hear about positive interactions as well using this same web animal research looks like, but once they see our facility and realize how clean form. The web form is available through the ARC and IACUC websites. I think that it is and how professionally it is done, it creates a different image in their mind. shows the amount of confidence we have in what we are doing.” “I really believe in what we do and the role we play in helping to develop vaccines UTMB leadership encourages employees, faculty and students to visit the new and surgical models, for example. To see something go from an idea, to being tested website and learn more about the groundbreaking research being done every day in an animal model, and then go into actual patient care is extremely rewarding.” and the important role animals play in advancing medicine for all.

Improving communication

In addition to the ARC and IACUC, several state and federal regulatory agencies provide oversight and comment or cite when they believe certain rules or protocols have not been followed. impact

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“We do this type of research because it is essential to our mission to improve health and improve lives,” said Niesel. “We want to push science forward—it’s going to lead to better care for you and me and our children and grandchildren.”

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BY KIRSTIANN CLIFFORD

Every day, Jeanene Trochesset sees how organ donation and transplant medicine provide recipients with a second chance at life. She’s spent the last 31 years working in nephrology-based positions at UTMB—from a pediatric dialysis nurse, to her current role as a post-transplant coordinator for UTMB’s kidney and pancreas transplant programs. A certified nephrology nurse, Trochesset provides clinical management of hundreds of transplant patients from Lafayette, Louisiana, to McAllen, Texas, and helps them adjust to their new life after transplantation.

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“It’s always exciting to see our patients thrive after a transplant and experience a better quality of life free from dialysis,” says Trochesset as I meet up with her on a Monday morning. “We have an entire team that cares for patients from the moment they are referred to us until after they are transplanted—and beyond. The team consists of intake coordinators, pre- and post-transplant coordinators, a waitlist coordinator, assistant coordinators, social workers, dieticians, transplant surgeons and a transplant nephrologist.”

kidney and pancreas transplant services to the greater Texas Gulf Coast and has completed more than 3,200 transplants to date. Trochesset introduces me to her counterpart, Janice Parson. Together, the two women, along with the help of four assistant coordinators and a part-time coordinator, monitor more than 800 kidney and pancreas post-transplant patients.

She’s getting ready to start a half-day post-transplant kidney “Once we have a patient, we have them for life,” says Trochesclinic, which is held twice a week at the Multispecialty Center set. “We really get to know each patient and their family. Taking and Stark Diabetes Clinic in League City. There are more than a prescribed medications, keeping up with lab work and regular dozen patients scheduled for post-transplant appointments—all clinic appointments are key to keeping their kidney safe. Each before noon. patient is different. I know patients who have had three kidney “This is a really busy clinic—it goes really fast and furious from transplants—and then I also know lots of other patients who have had only one transplant that when we start the clinic to lasted for 20-plus years and their when it ends. Coffee anyone?” transplant is still working fine.” she laughs and greets her colleagues, which include another Many patients get labs before post-transplant coordinator, arriving at the clinic to be seen by waitlist coordinator, physician one of the post-transplant coorand nutritionist. dinators and physicians. TypicalThey all sit in the “team room,” a small area in the middle of the clinic with computers lining the walls. Before clinic doors open at 8 a.m. is the only time the team will be seen together in one place—once things get started, Trochesset and her team quickly disperse into patient rooms, passing each other in the hall throughout the day.

ly, Trochesset sees patients twice a week for the first month following their transplant, then every two weeks, once a month, every three months, and so on. Two years out, she may see patients every six months to a year. It all depends on how smoothly the transplant surgery went and if there are any signs of organ rejection.

“We have two sets of patients,” says Trochesset. “The immediate post-op patients who have just received their transplant and need their surgical wound to be observed by the surgeon, and then the patients who are is not a cure, it’s a treatment.” all healed and may have received their transplant several years ago who will see the transplant nephrologist. In my role, I usually talk to the patient first and give In fact, last December saw the highest number of kidney trans- the doctor a heads up if anything urgent needs to be addressed.”

“We usually have one of our transplant surgeons here during the clinic, as well, but Dr. Kristene Gugliuzza just finished a kidney and pancreas transplant this morning in Galveston,” Trochesset says. “Donor organs can become available at any time, so “A transplant the team is always ready. The amount of transplants UTMB performs has really ramped up the last few years.”

plants within a month in the program’s 50-year history—14 transplants. Since 2014, the kidney transplant team has increased the transplant volume by 156 percent.

Her first patient of the day arrives carrying a large bag full of various medications, supplements and anti-rejection drugs. He had a kidney and pancreas transplant two years ago and will be on two anti-rejection drugs and other medications for the rest of his life.

UTMB has been a pioneering force in transplantation since 1967, when the first kidney transplant in Texas was performed on the “A transplant is not a cure, it’s a treatment,” says Trochesset. “The Galveston Campus. UTMB performed its first liver transplant in same thing that may have caused a kidney to fail the first time 1992, followed closely by heart transplant in 1993. Through a grant can cause it to fail again. If a recipient has diabetes, heart disfrom The Sealy and Smith Foundation in 2007, UTMB established ease or other comorbidities—and they do not keep all of them the Texas Transplant Center. Today, the center offers heart, liver, in control—the comorbidities could cause problems with their

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transplanted kidney. As a result, I spend a lot of time educating One of her last patients of the day had a transplant the previous patients about staying healthy and taking prescribed medications.” month and Trochesset immediately suspects he is having comSo far, the patient seems to be doing well post-transplant, and plications. In addition to a small infection at the surgical site, has gone back to work full-time. Trochesset knows the patient his symptoms and lab results point to signs of organ transplant well—she spends time asking about his family and how he has rejection. She changes the wound dressing and discusses her been feeling since she saw him last. When she finishes checking findings with the nephrologist, who comes in to assess the patient out his medications and refills, the nephrology physician pops for possible changes to the plan of care.

in to complete his assessment, review lab results and ask a few “When we look at lab results, the first thing we look at is the creatimore questions before scheduling the next appointment for six nine levels because that tells us the patient’s kidney function,” says months later. Trochesset. “Next, we check other labs such as their tacrolimus (an immunosuppressant used to prevent transplant rejection) I start noticing a pattern as each subsequent patient arrives holdlevels and urine analysis for any abnormalities. Any abnormal labs ing a large bag of medications. may signify a possible adverse event or rejection. I’m a stickler for “That’s one of the big things—making sure patients have all their detail, so I always review the patient’s labs with them and make medications, are taking them sure they understand what they when they are supposed to in need to do.” the correct doses, and are not The doctor asks Trochesset to out of anything,” says Trochesorder a biopsy for the patient set. “We literally go through and medication to help lower each patient’s medications onehis potassium levels, which is by-one and check it with our list. critical to the function of nerve There are a lot of medications and muscle cells. and it can be really intimidating, so I do everything I can to help “The patient has to take this patients become familiar with medication today because high them so it’s not as daunting.” potassium levels can be very dangerous, ” said Trochesset. “If One of her patients received a I order it from a pharmacy and kidney three weeks prior. It’s they don’t have it, I have to call the woman’s second kidney— around until I find it—I don’t and Trochesset had the honor want anything to fall through of informing the patient that a the cracks. We try really hard to kidney had been donated and take special care of our patients was available. and if they do have a problem, “I was on-call that night and got like they need a biopsy, it gets to call her in for the transplant,” first priority. There are ways to Trochesset says with tears formtreat transplant rejection, but we ing in her eyes. “To tell you the have to act quickly.” Trochesset with team members (L-R) Brenda Rush, truth, I still get choked up someDr. Muhammad Mujtaba, Trochesset and Janice Parson. It’s 1 p.m. by the time Trochesset times—it’s such a special, critical finishes up with the last patient moment. Patients are like, ‘Are and gets ready to drive back to the Rebecca Sealy building on the you kidding me?!’ They are always so excited and grateful.” Galveston Campus, where transplant offices are located. I learn Currently, there are more than 350 people on UTMB’s kidney she was born in Rebecca Sealy—then St. Mary’s Hospital—just a waitlist and 90,000 nationwide listed for kidney transplant. It floor below her current office. can take days, months or many years before a compatible match is found; however, Trochesset points out the process of living She’ll spend the rest of her day prepping for her next trip to donation can cut down wait time and improve the likelihood McAllen (she sees post-transplant patients there about once a of the transplant lasting longer. A person can live and function month) and answering patient emails and calls. normally with only one kidney, so it’s not uncommon for relatives, As we part ways, I reflect on how organ transplant saves many friends and others to serve as living kidney donors. lives each year. However, the procedure is only the beginning of a new life journey for the recipient—a journey that Trochesset Trochesset heads to the team room to get a quick sip of coffee and take a look at the white board listing all the patients who have is proud to be part of. arrived. The list gets longer and longer throughout the morning, “I really enjoy helping these patients get that second chance,” says and Trochesset goes from one room directly to the next. Trochesset. “It’s not just my job, it’s my passion.”

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E D UC ATIO N

Defining the future of health care education UTMB celebrates Health Education Center groundbreaking BY SIMONE PARKER

UTMB and UT System leaders joined elected officials, students and supporters to turn the first shovels of dirt marking the groundbreaking of the new Health Education Center (HEC).

A ceremonial groundbreaking on April 7 recognized the offi- Taylor presented a proclamation honoring the HEC groundbreaking on

cial start of construction on UTMB’s $90.4 million Health Education Center behalf of Gov. Greg Abbott. The event also featured a ceremonial first dig (HEC). A group of enthusiastic supporters, including faculty, staff, students, by UTMB leaders and guests and a check presentation, recognizing more alumni and donors, gathered for the event at the building site on UTMB’s than $800,000 in contributions received from students, faculty and staff in support of the $50 million Innovations Galveston Campus. in Mind fundraising initiative, which The ceremony was hosted by includes the HEC among its priorities. UTMB President Dr. David CalThe state-of-the-art landmark facility— lender, who said the center will the most significant addition to the Galadvance UTMB’s mission of veston Campus’ education infrastructure training tomorrow’s health care in about 40 years—will bring students workforce. from all four schools—Medicine, Nurs“The HEC will enable UTMB to ing, Health Professions and Graduate accommodate our increasing Biomedical Sciences—together to enrollments and train future gencollaborate through interprofessional erations of health care profespatient care scenarios, take part in active sionals using the most advanced learning strategies, and learn to work as technology in an interdisciplinary a health care team. The approximately environment,” said Callender. “We 160,000-square-foot HEC will feature consider the center an emblem of five floors of new space, including simUTMB’s continued service to Texas, particularly as the state faces critical ulation areas, learning studios, meeting spaces and a café. shortages of health care providers at a time when the number of patients “The Health Education Center is an important advancement not only for UTMB needing care continues to rise.” and for the UT System, but for all of Texas,” said Carruth. “The mission for Among the speakers were Leslie Carruth, associate vice chancellor for Health both UTMB and the UT System are centered on improving the lives of others.” Affairs with The University of Texas System; Dr. Danny Jacobs, executive vice president, provost and dean of UTMB’s School of Medicine; Texas Sen. The HEC is scheduled to open to students in 2019. For the latest Larry Taylor of Friendswood; and Alex M. Cranberg, former University of information on the facility, visit the Innovations In Mind website at https://innovationsinmind.utmb.edu. Texas System Regent.

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Switching careers

SON graduate fulfills lifelong dream of becoming a nurse

BY KURT KOOPMANN

FOR CHARMARIE RITCHIE REESE, the path to getting her nursing degree went down a long road that led her first through the criminal justice system. The 49-year-old mother of two and grandmother of two received her bachelor’s degree in nursing from UTMB’s School of Nursing on April 28 at the Moody Gardens Convention Center in Galveston, along with more than 400 fellow graduates. When Reese graduated from Ball High School in Galveston in 1985, she had the desire to become a nurse, but at the time, life took her in another direction and school was not in the immediate picture. When she decided to pursue a college degree in the early 1990s, the competition to get into a local community college program was intense. “I decided I needed to do something for my kids to make a better life for us, and to be a role model for them,” said Reese. “Unfortunately, there was a waiting list for the nursing program and I felt I did not have the time to wait around for a year or more before beginning my studies.” Reese happened to see a presentation on careers in criminal justice and decided that was something she could do. “It was still helping people, which was important to me,” she said. By 2003, Reese had earned a bachelor’s degree in criminal justice and a master’s degree in criminal justice management. She had a fulfilling and successful 13-year career in the field serving as a probation officer in Brazoria County. Back in the 1990s, she did not realize that UTMB had a nursing school. However, in early 2016, when nursing was once again calling her name, she knew about UTMB and knew that was where she wanted to pursue her dream of becoming a registered nurse.

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Reese said the hardest thing about going back to school was having to change her mindset, looking at things in a different way and using critical thinking skills. “In many college programs you simply brain dump, you memorize the information and pick the right answer and then move on,” said Reese. “In nursing, you have to retain all that knowledge because there may be four correct answers, depending on the case. You have to use your critical thinking skills to pick the best answer for the patient.” Since the beginning of her time at UTMB, Reese has known that it was the best choice and said the nursing faculty does a great job of preparing students for nursing’s high-pressure work environment. “I can tell you I will be graduating with the necessary skill sets to succeed in nursing as a result of UTMB’s program,” she added. According to Reese, her background in criminal justice also contributed to her success in working toward a nursing degree, as it provided her with the ability to assist and guide people in making autonomous decisions that can benefit their lives. “We all face difficult times in our lives,” said Reese. “During those times, we as professionals need to be there to guide, understand and show empathy to help individuals move forward.” Working with other, often much younger students, has been the most memorable experience of her 16-month journey. According to Reese, the students start out as individuals but quickly learn to work together to grow and succeed. “I am different from the traditional student but everybody in my class has been nice, helpful and supportive in any way they could. I never felt left out, which is a testimony to the acceptance of diversity in the school and from my classmates,” she said. When asked if she has plans for an advanced practice nursing degree, Reese said the option is always there.

L E A D ER S POTLIGHT

Spotlight on Dustin Thomas, vice president for Decision Support

Dustin Thomas joined UTMB in 2016 as the financial executive over forecasting, budgeting and operational analytics. He oversees compilation of UTMB’s annual budget, financial business planning, and the institution-wide strategy for the UTMB Discover data warehouse and suite of analytics applications. Most recently, Thomas worked at Scottsdale Healthcare in Arizona, where he established a clinical and business intelligence program and served as the central finance administrator supporting five hospitals, an employed physician group and a population health management division. Thomas holds a bachelor’s degree and master’s degree in business and health services administration from the University of Utah. He is a member of the Healthcare Financial Management Association and remains an active leader with the national Order of the Arrow leadership development program of the Boy Scouts of America.

What does Best Care mean to you and how do you contribute? Best Care means treating every patient the way we would hope to be treated if we were in their shoes. Providing the best evidence-based clinical care and extraordinary customer service to our patients and their families is so important, while also staying mindful that health care is very expensive so we must deliver great care in the most efficient ways possible. My team and I contribute to Best Care by providing data, metrics and financial information to our clinicians and leaders so they can continually improve UTMB’s quality, experience and cost of care.

What are the most challenging aspects of your job as VP of Decision Support? The most rewarding? UTMB has lots of very complex clinical, research, educational and financial data. When I come to work, I’m excited for the challenge of finding that data, connecting it and organizing it into actionable information that helps us grow, improve and better manage our business. It’s always rewarding to see the residents and students on campus, who remind us that in the midst of our world-class research and patient care, we are training the next generation of physicians, nurses and care providers.

You’ve been at UTMB for more than six months now. How do you like Texas so far? Coming most recently from the Arizona desert, I love living in Texas and next to the Gulf. In my role with UTMB’s budget, I’ve had the opportunity to visit the Legislature in Austin, which has given me a new appreciation for the magnitude of this state and the diversity of thought that exists in the different regions.

Dustin Thomas and his dog, Stoli, take in the views at Grand Canyon National Park.

swirling around in my head. A side benefit of that job was I sometimes got to be DJ for the cosmic bowling nights at the local bowling alley, which was a ton of fun.

What do you like to do outside of work? I love to travel. Las Vegas is my favorite—for no more than 48 hours at a time! Luckily my parents now live near there so I get to visit often. It’s such a great place to meet up with friends, watch sports, have a great meal, see a cool show (I like “O” by Cirque de Soleil at the Bellagio theater and “Le Rêve” at the Wynn because of the water), relax or gamble. I’m a numbers person, so I love playing Pai Gow poker at the Cromwell Casino because I get to organize cards into a variety of hands and it’s a social game so I can chit chat with the other players and dealers. A great perk of living in Galveston is being able to walk my dog, a yellow lab named Stoli, along the beach. I also like to ski and golf when I get the chance.

What’s something people would be surprised to know about you? Most people are surprised to learn I ride a motorcycle. Since moving here, my bike is rusting at a rate I never would have believed though, so I might have to trade it in for a boat!

What’s something you always wanted to do but have not done yet? I’ve always wanted to fly a plane! Getting a pilot’s license might be on my bucket list one day.

What was your first job?

If you could travel anywhere in the world, where would you go and why?

Before I started as an EKG (electrocardiogram) technician, I had a job working evening and weekend shifts at a used CD store called Disc-GoRound. As a result, I have all kinds of one-hit-wonders and music trivia

I haven’t yet been to Australia and would love to spend a couple of weeks exploring that part of the world. Everyone I’ve ever met from Down Under is happy, having fun and enjoying life.

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UTMB celebrates Earth Day BY SIMONE PARKER

If you’re looking for ways to go green, look no further than UTMB. This year’s winner was “Recycle Girl,” a.k.a. Cleo Glover, a patient The university is ranked No. 2 in paper recycling and No. 3 in card- care facilitator at UTMB-TDCJ Hospital Galveston. Glover board recycling among higher education institutions nationwide. designed her costume with a friend and colleague, Rachelle Jones-Lipscomb, a Angela McDowell health unit coordinaworks with Sustaintor with Hospital Galability Services and says veston. these accomplishments are part of an environmental movement and message that has spread throughout the institution. She is thankful to all employees for their efforts to reduce waste and adopt eco-friendly practices in their dayto-day work.

“I’m a Wonder Woman fan and that’s where we got the superhero idea for the outfit,” said Glover. “We designed a few accessories—a cape, boots, belt and wrist cuffs made from recycled medicine cups which are covered in foam and foil paper. I’m thrilled that we won.”

“We’re very excited about Recycle In Style fashion show winner Cleo Glover strikes a pose. the recycling programs that we have at UTMB and the impact they’re having,” said The annual festival was started by Ken Steblein, a UTMB employMcDowell, who recently joined UTMB as sustainability coordi- ee who lost his battle with cancer a year ago. Organizers say nator. “We’re working with each department to promote sustain- the event is more than just a one-day celebration, it is a call to ability initiatives, including the 3Rs—reduce, reuse and recycle.” action—to encourage people to keep our planet healthy while UTMB employees celebrated sustainability together at the uni- honoring the legacy of Steblein. versity’s 25th annual Earth Day Festival on April 21 on the Gal- The theme of this year’s celebration was “Elements of Education for veston Campus. Approximately 1,500 people attended the event, a Healthy Earth.” Mary Ellen Beaupre, a student life coordinator which featured live music, food trucks, kid-friendly activities, with the School of Health Professions, Office of Academic and pet adoptions, earth-friendly exhibits and the popular “Recycle Student Affairs, won first place in UTMB’s Earth Day art contest and her drawing was featured on this year’s Earth Day t-shirt. In Style” fashion show.

“Each year, UTMB employees showcase their outfits made from To see more pictures from this year’s event, visit recycled and reusable products like duct tape, film strips and com- UTMB’s Flickr account at www.flickr.com/photos/utmb/ pact discs,” said McDowell. “The fashion show is always a big hit.” albums/72157683459594755. The print edition of UTMB’s newsletter, Impact, has been back on newsstands for nearly two years. Impact began as a printed publication in 1977, but became online-only in 2009, following Hurricane Ike. UTMB’s Marketing and Communications office re-launched the print edition in 2015 in response to employee survey and focus group input and as part of a larger effort to strengthen internal communications. Now that we’ve published nearly two dozen print issues, it’s time to hear from you! Visit iUTMB for a link to the online survey, as well as a printable PDF version. This survey should take no more than 5 minutes, and your responses are completely confidential. Thank you for your time and feedback!

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Are you ready? Emergency prep made simple By Mike Mastrangelo, program director, Institutional Preparedness Hurricane season starts on June 1, but emergencies can come in many forms and in any location year-round—2016 floods and the John Sealy Hospital fire are just two reminders of that fact. Take the following actions now, before an emergency affects your work site or home, to ensure you are prepared. • Know your role. Become familiar with your department’s emergency plan and your UTMB role before, during and after an emergency. • Complete the Emergency Classification and Acknowledgment Form by June 30, available in a new online format at https://utmb.us/84 (login required). • Ask questions now. Consult your supervisor or faculty advisor if you have any questions about your responsibilities or reporting to work/school during an emergency. • Become familiar with UTMB’s Institutional Emergency Operations Plan, available at www.utmb.edu/emergency_plan. • Enroll in Direct Deposit to ensure your paycheck can get to your bank account even if UTMB is unable to issue paper checks. • Update your UTMB Alerts emergency notification system information. Go to iUTMB and click on the internal directory tab. Search your own name, and in the resulting entry, click the “Edit My Alert Info” button. To ensure you can be reached in the event of an emergency, enter at least two contact methods, including your cell phone number, personal email, text message or home phone. • Update your general UTMB Directory information. Log in to Peoplesoft HCM and navigate to Self-Service/Personal Information/

UTMB Directory Self-Service. Updating your work location (L-code) and departmental mail routing number will support institutional efforts to update location data, and could improve the accuracy of targeted emergency-related messages in the future. • Keep computer security in mind. Never reveal your UTMB login information to anyone, and be suspicious of emails asking you to enter your login information. • WEAR your ID badge every day at all UTMB locations, so emergency responders will know you belong. If classified “Essential,” locate orange placards and cards for parking to regain entry. If you are an E-1 employee, the orange card ensures entry for authorized personnel to UTMB parking areas during emergency status and may help facilitate passage through mainland/island checkpoints for re-entry immediately after a storm. • Develop personal, family emergency plans. Talk with family and make plans based on your assigned role. Make a plan for your dependents, including children, seniors and pets. Notify your supervisor ahead of time if your personal situation changes. • Sign up for MyChart to ensure ongoing access to your UTMB medical records and prescription information. Visit www.utmb.edu/emergency_plan to view materials from the annual UTMB Emergency Preparedness Meeting, preparedness checklists, related forms and emergency-related policies. You can also learn more about the business continuity planning process for ensuring our ability to fulfill our mission, no matter the challenge.

PARTING SHOT

Keep calm and pet a therapy dog School of Nursing students were greeted by Pet Partners therapy dogs in April as they entered the UTMB Testing Center to take their exams. The furry friends offered students a much-needed opportunity to relax and take a break from preparing for final exams—and the dogs seemed to enjoy the attention, too! The event was hosted by the SON and the SON Alumni Association.

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