UAMS MEDICAL CENTER MAGAZINE • A Publication of the University of Arkansas for Medical Sciences
Fall 2011
UAMS Center for Primary Care Keeping Patients Healthy
welcome
Welcome back. It’s been a busy six months since the last issue of this publication, and we’re gearing up for even more activity as we expand our operations once again in early 2012. We plan to open the ninth floor of our hospital early next year, and we will be opening a new West Little Rock clinic for internal medicine and ob/gyn patients in January. This new clinic is part of our new Center for Primary Care, the topic of this issue’s cover story. People often think of UAMS as the place for very specialized or trauma care when there’s nowhere else to go. As Eleanor Karam and Betsy Parkinson can attest, UAMS is certainly the right place for those patients. But our hospital and clinics are so much more. Lisa Gandy is an example of the other type of care we provide – routine health care and screenings to ensure you stay healthy – and access to the latest research and top-notch specialists when something is wrong. Whether your visit to UAMS is for a check-up, a minor illness or something major, you can be assured that you will be cared for by some of the finest health care professionals and staff in Arkansas. We pride ourselves not only on expert medical care but also the amenities we provide for family, visitors and caregivers. Your support of the Medical Center ensures that we can provide lifesaving care for our patients and life-sustaining support and resources for family caregivers. We hope you enjoy the UAMS Medical Center Magazine. You can find an enhanced on-line version at uamshealth.com/mcmag. If you’d like to learn more about one of our articles or featured programs, just click the underlined text.
Richard A. Pierson Executive Director, UAMS Medical Center Vice Chancellor for Clinical Programs
2
UAMS Medical Center Magazine
UAMS Medical Center Magazine Fall 2011 Kate Franks editor
Laurie Shell
creative director
Angi McDaniel
creative services director
Lauren Farabough Nate Hinkel Jon Parham David Robinson writers
Johnpaul Jones photographer
Dr. Daniel W. Rahn
chancellor University of Arkansas for Medical Sciences
Richard A. Pierson
executive director UAMS Medical Center
Melissa Fontaine
chief operating officer UAMS Medical Center
The UAMS Medical Center Magazine is published twice a year by the UAMS Office of Communications & Marketing, 4301 West Markham Street, #890, Little Rock, AR 72205-7199. We’d like to hear what you have to say about this magazine and patient care at UAMS Medical Center. Call us at 501.603.1452, or e-mail us at reddie@uams.edu UAMS Medical Center Magazine is available online at uamshealth.com/mcmag.
UAMSHEALTH.COM
contents Fall 2011
17 Et Cetera
4
Keeping Patients Safe
An innovative risk-assessment tool which dramatically reduced the number of patient falls and injuries at UAMS is now used in hospitals across the country.
6 Just a Phone Call Away
The Physician Call Center at UAMS provides resources and support for doctors across Arkansas. Appointments with specialists, patient transfers and consultations are all just a phone call away.
8
Husband Honored with Patient Room
Eleanor Karam of Little Rock chose to honor her late husband by funding a patient room at the UAMS hospital. He was treated at UAMS for routine care and a rare condition diagnosed after extensive research.
10 Back Together and Back to Normal
Betsy Parkinson suffered multiple injuries, including 27 fractures in her skull, in a car accident in June 2010. More than a year later, her life is nearly back to normal.
Top-tier ratings from U.S. News & World Report and The Joint Commission, new patient amenities including more outdoor sitting areas, license plates that support UAMS students, new leadership of UAMS clinics and volunteer opportunities are among the news highlights at UAMS Medical Center.
20 Keeping the Faith
Patients of all faiths find emotional and spiritual support from the chaplains at UAMS.
22 Always Searching Never satisfied that there’s not a better way, researchers and those in patient care are always looking for cures and better methods of care.
24 Behind the Scenes
Often the last person patients see when they leave the hospital, Greg Willis makes sure they leave on a positive note. UAMS MEDICAL CENTER MAGAZINE • A Publication of the University of Arkansas for Medical Sciences
Fall 2011
14 Cover Story: Staying Healthy
The Center for Primary Care at UAMS helps ensure patients get routine health screenings, preventive care and access to specialists when needed.
UAMS Center for Primary Care Keeping Patients Healthy
Center for Primary Care patient Lisa Gandy Photo by Johnpaul Jones UAMSHEALTH.COM
UAMS Medical Center Magazine
3
Melinda Barbee, RN, is one of the trained staff members at UAMS who assess patients for fall risk and then implement appropriate measures to ensure they don’t fall while at the hospital.
Safety In Numbers
Implementing Evidence-Based Practice Helps Reduce Falls By Kate Franks
4
UAMS Medical Center Magazine
UAMSHEALTH.COM
Falling became part of American pop culture communication or sensory deficits and behavioral humor in the early 1990s with the line “I’ve fallen and issues. Based on the score, patients are identified as a fall I can’t get up!” from a TV commercial for a medical risk or not, and, if so, are categorized as high, medium alarm company. or low risk. Falls are no laughing matter at UAMS Medical Center Once the scale is completed and the patient care – or any hospital – where the average additional cost of staff knows whether the patient is at risk for falling, an injury sustained from a fall is nearly $25,000. appropriate intervention measures can be put into place, With the stakes so high, most hospitals have protocols, individualizing nursing care for the patient. policies and measures in place to prevent falls. Yet, they “The reason this program has been so successful is happen every day at hospitals around the world. because of our nursing staff’s commitment to quality For decades, UAMS was like most other hospitals, care and because we live a culture of safety at UAMS,” taking precautions, offering staff training and monitoring Hester said. falls. The numbers varied a little month-by-month, but “We’ve learned through use of the Hester-Davis Scale nothing was really working to dramatically decrease the that it’s really important why the patient is at risk for falling,” number of patients who fell while in the hospital. said Davis. “What works to help one patient may not work That is, until January 2010 when Clinical Services for another. For example, patients who are impulsive are Manager Amy Hester, R.N., and typically not going to respond to bed Advanced Practice Partner Dees Davis, alarms that signal our nursing staff when We presented the patient gets out of bed. They usually R.N., implemented the research project they had been working on for nearly a the results of our just ignore it and continue on. What year and a half. Their research resulted in often works best for these patients is to pilot project at a the Hester-Davis Scale, a risk-assessment encourage family members to stay in the tool that identifies patients most likely to room as much as possible, engage patients national safety fall, and, more specifically, the reason for daily activities and encourage them to conference last in the fall risk and appropriate interventions express their feelings.” fall, and it just for the nurse to implement. The success of the Hester-Davis Scale Use of the Hester-Davis scale resulted in an in-patient setting using paper forms went viral.” in a 20 percent decrease in the number of has motivated Hester and Davis to want falls across the hospital and a 40 percent to make additional improvements and decrease in injuries in six months beginning in March expand application of the tool to other settings. “Our next 2011. “These results are phenomenal in the world of step is to test and validate our results in an environment patient quality statistics,” said Dr. Nicholas Lang, medical with electronic records rather than the paper forms we’ve director for UAMS Medical Center. “Amy and Dees are used so far,” explained Hester. “Then, the possibilities are great examples of our constant work to improve patient limitless. Just think of what this approach could mean in safety, and their research has had a positive impact not an outpatient setting. only on patients at UAMS but at other hospitals around “Clinic staff can complete the form with the help of an the country.” elderly patient’s family and caregivers to identify behaviors, “We presented the results of our pilot project at a medications and other factors that can increase a patient’s national safety conference last fall, and it just went viral,” fall risk. With this information and an assessment of the said Hester. “It spread so fast we couldn’t keep track of patient’s fall risk, we can provide strategies and resources all the facilities using it. We know of organizations in 20 for the family to prevent falls at home.” states who’ve made inquiries directly from us, and there “And, it’s not just limited to falls,” adds Davis. “This are others who’ve adopted it based on the experiences of same approach can be used for lots of other health care these facilities without contacting us.” issues like allergy triggers or diabetes management.” The Hester-Davis Scale has nine sections and takes “We started this because we wanted to help our patients,” about a minute to complete. The sections include age, said Hester. “And, based on the feedback we’ve received, last known fall date, mobility, medications, mental status we know we’ve done the right thing. The possibility of and awareness, toileting needs, nutritional needs, helping even more patients is very exciting.”
“
UAMSHEALTH.COM
UAMS Medical Center Magazine
5
Here When You
Need Us Doctors Across Arkansas Get Support from UAMS By David Robinson When Dr. Bruce Burton needs specialized care for a patient, he often reaches for his phone rather than his prescription pad. Whether he needs to schedule an appointment or talk to one of the many specialists at UAMS, Burton knows help is just a phone call away. Although it’s been 30 years since he completed his internal medicine residency at UAMS, Burton has developed new The doctors contacts, thanks to the efforts of at UAMS UAMS doctors. are generous This year, for Dr. David with their time example, Rutlen, Director when I call.” of Cardiovascular Medicine at UAMS, met with Burton and other doctors in Malvern and set up a satellite cardiology clinic there. “I’ve really enjoyed working with him and have sent him several patients over the last couple of months,” Burton said. “Familiarity helps.” Physicians often depend on UAMS because, as the state’s only academic medical center, it offers
“
6
UAMS Medical Center Magazine
treatments not available anywhere else in the state. With this in mind, UAMS has staff dedicated to providing resources and access for doctors and their patients across Arkansas. Melanie Meyer, director of physician relations in the UAMS College of Medicine, said good communication is key to the good relationships UAMS enjoys with its referring physicians. For example, the UAMS Physician Call Center provides a toll-free number that gives doctors across Arkansas access to a one-stop shop for appointments, patient transfers and routine and urgent consults with UAMS specialists.
Essential Link “The doctors at UAMS are generous with their time when I call,” Burton said. “And when patients are sent home, they faithfully send me copies of the discharge summaries, lab tests and everything I need. “It’s a great system for me and my patients.” While Burton uses his phone and fax machine to communicate
with UAMS, others prefer on-line tools. MD-Link is a UAMS Webbased program used by nearly 2,500 Arkansas doctors to view their patients’ medical records. This on-line service is available only with the patient’s permission. “When a patient returns home from UAMS, it’s important for their primary care doctor to have access to their patient care records because it translates to better continuity of care,” Meyer said. “Our referring physicians expect us to not only take care of their patients while they’re here, but to help their patients transition back to their care.”
Doctors’ Advice UAMS taps into the needs of referring physicians through its Referring Physicians Advisory Board, which is made up of 23 physicians from across the state. Additionally, representatives of the UAMS Physician Relations Department travel the state and meet with more than 700 doctors every year. Recommendations of the advisory board have led to the recent development of a faster system of sending outpatient information to referring physicians and the establishment of the UAMS Physician Call Center, which has improved telephone access to UAMS physicians. One component of UAMS’ commitment to Arkansas doctors is keeping them abreast of the latest treatments offered at UAMS and new specialists who join the UAMS team through the UAMS Consult, a bi-monthly publication for referring physicians which highlights UAMS physicians and clinical news. UAMSHEALTH.COM
Director of Physician Relations Melanie Meyer talks with Donna Williams, RN, nurse manager of the UAMS Physician Call Center.
Grateful Patient Gives Back By Brandi Stafford
Having stayed by her husband’s side for days at a time, Eleanor Karam knew what a difference larger, brighter patient rooms would make for patients and family members at UAMS. She was eager to support the new hospital during its construction in 2008 and donated funds for a patient room in memory of her husband, Jimmy Karam. “The new rooms are just lovely,” she said. “I was there day and night when my husband was sick, so I can appreciate a well-designed hospital room. The new rooms are very family-friendly, and it’s wonderful 8
UAMS Medical Center Magazine
that families can now stay with their loved ones in private rooms.” Karam has had a long-standing relationship with UAMS that started more than a decade ago when she and her late husband became UAMS patients. She has been a Chancellor’s Circle member since 1987 and has also supported the Donald W. Reynolds Institute on Aging, the Winthrop P. Rockefeller Cancer Institute, the Jackson T. Stephens Spine and Neurosciences Institute and other priority development initiatives at UAMS. UAMSHEALTH.COM
Eleanor Karam made a donation for a hospital patient room in memory of her late husband, Jimmy Karam, in appreciation of the care he received at UAMS.
“Prior to 1997, we traveled to Mayo each year for our annual physicals,” she said. “We just thought that was the best place at the time. But, when Jimmy’s health situation became more complicated, I knew we had to find a doctor closer to home.” Karam reached out to her good friend Ginger Wilson, wife of former UAMS Chancellor I. Dodd Wilson, who was then dean of the College of Medicine. Wilson referred them to the Institute on Aging at UAMS. From that point on, they started receiving all of UAMSHEALTH.COM
their routine care at UAMS, and they relied on UAMS when her husband became seriously ill. Jimmy Karam had a very rare condition, and, at first, doctors weren’t sure what was wrong. It wasn’t until a young resident took an interest in his condition and did extensive research that a diagnosis of malignant hyperthermia was made. “That shows you why UAMS is so important to this state,” said Karam. “This is a medical center that encourages an inquisitive young health professional to explore and learn the answers to a puzzling medical condition like that. It really is a great teaching institution. You wouldn’t find that at any other hospital in the state for sure.” Jimmy Karam passed away in 2000 at age 88, but his wife says she still remembers some of the nurses who cared for him and keeps in touch with many of them. As for her own care, Karam says she’s been seen in just about every clinic on campus, and she’s probably had an appointment with every doctor at the Jones Eye Institute. She is particularly appreciative of the Institute on Aging, but she credits Dr. Richard Evans, a former UAMS orthopedist, with saving her life. “I became acquainted with Dr. Evans while I was recovering from hip surgery some years ago. We had become friends, and he and his wife invited me to dinner one Sunday evening,” she said. “I told him I couldn’t go because I had the worst headache ever. I was seeing red and blue lights flashing. He told me to stay put and said ‘we’re on our way.’” Karam was experiencing signs of a stroke, but thanks to Dr. Evans, the UAMS emergency medical team was prepped and waiting for her when she arrived. They treated her immediately, and she made a full recovery. “I am grateful for the close proximity of UAMS and the impeccable speed and skill of the emergency medical team – undeniably the key to my recovery,” she said. “My life has been enriched by my experiences with the medical team at UAMS. I’ve had some wonderful care other places, but I never developed the personal relationships with those physicians quite like I have with my physicians and nurses at UAMS.” “I am so thankful that UAMS was here for us over the years, and especially when we needed it most,” said Karam. “It is for these and many more reasons that I continue to give back and support UAMS. It is perhaps the best kept secret in Arkansas.” UAMS Medical Center Magazine
9
Putting the Pieces Back Together UAMS Restores Patient’s Life By Kate Franks
10
UAMS Medical Center Magazine
UAMSHEALTH.COM
Joyce Randof, RN, reunites with Betsy Parkinson, a patient she helped care for in July 2010. Parkinson doesn’t remember her four-week hospital stay but heard from her family all the things Randof had taken care of and was excited to meet her.
Betsy Parkinson of Little Rock had 27 fractures in her skull when she came to the UAMS Emergency Department on June 29, 2010. “All the king’s horses and all the king’s men” weren’t available to put her back together, but, thankfully, the staff at UAMS was. “Dr. Gruenwald, Dr. Moody, Dr. Westfall, and the amazing emergency room doctors and nurses pretty much ‘Humpty-Dumptied’ me back together again,” said Parkinson. “I smashed my collar bone, broke two bones in my arm, had a collapsed lung, and the right side of my head was crushed.” She was driving alone on North Lookout Street in Little Rock, when, according to police investigators, she apparently swerved to miss an oncoming car and went up the embankment of the steep, windy road. Her Considering car then flipped several how serious times as it rolled down hill, landing back my injuries the on the road. were, my life A neighbor heard crash and called is completely the 9-1-1. Because of the normal now.” severity of her injuries, Parkinson was taken immediately to the UAMS Emergency Department, where she was admitted as a Jane Doe. “A close family friend was one of the ER docs, and he didn’t even recognize me,” said Parkinson. “He didn’t know it was me until he saw his parents in the waiting room and asked them why they were there.” “We weren’t even sure Betsy was going to make it for the first 48 hours,” said her father, Bill Parkinson, who was out of the country when the accident happened. “To see her today is just amazing. We are so
“
12
UAMS Medical Center Magazine
grateful for the care she received at UAMS – from the emergency room doctors who first treated her to the ophthalmologists, plastic surgeons, therapists and orthopedists who have helped her return to her life – they’re all incredible. We are so blessed that these people were all there for Betsy.” Betsy Parkinson says she feels not only blessed to be alive and able to do everything she did before the accident, but also blessed to not remember anything from the four weeks she spent in the hospital. “Apparently, a large head trauma can make you pretty grouchy,” she said. “I don’t remember anything, but I’ve been told stories about things I said and did. My brothers were all here with me, and they’ve had a great time teasing me about all these things I don’t remember. I guess I told people they were fired or that they were grounded. That’s so not me . . .” “Immediately after the accident, Betsy was sedated so she wasn’t talking, and we weren’t sure how much brain damage there was,” said Bill Parkinson. “They had to put a bolt in her head to release pressure, and she was on a vent, so there was very little communication and we had no idea what she’d be like when she woke up. “You can only imagine our joy when they asked her four questions to test her cognitive ability and she aced them all,” he said. “She not only knew her social security number, but also went on to explain that she knew it so well because of her student ID number at Baylor. The doctors were a little surprised by a head trauma patient whose mental abilities came back so quickly. “In fact,” he said, “Betsy heard the doctors and nurses explain her
condition and quiz residents so often that she’d answer the questions herself or correct them if they missed a detail or left something out.” “I don’t remember my hospital stay, but I do remember tons of followup visits,” said Betsy Parkinson. “And, I remember lots of questions from students and residents. I guess I was very interesting because of all my injuries. But I think a hospital teaching that way is amazing. “I can tell they’ll be great doctors, ones I would choose to be my doctor in the future” she said. “They were asking really good questions and were intent on learning new things. It’s wonderful – for that I’ll answer 15 people all day. I could tell they were thinking ‘Look at this girl. Can you believe she’s still alive?’ and not only is that humbling, it doesn’t bother me at all.” The most amazing part of Parkinson’s recovery – besides the fact that she’s alive – is how she looks. “Half of my head was crushed from what I understand,” she said. “They had to rebuild my nose and my eye socket, and now I have this brilliant prosthetic eye. Because of the amazing work of Dr. (Christopher) Westfall in rebuilding the base and attaching all the muscles, my false eye even tracks with my real one. “Initially, when they weren’t sure I’d even make it, they just left my mangled eyeball in the socket until they could get permission to remove it,” said Parkinson. “They were concerned that the damaged eye might impact the vision in my good eye. My brother had to give them permission to remove it. I cannot imagine having to make that decision for one of my brothers – he is a very strong and wise man. Once I was out UAMSHEALTH.COM
of critical care, one of the first surgeries they did within that first week was to attach an artificial base to the muscles before they started to atrophy.” “We are incredibly blessed that Dr. Westfall was there for Betsy,” said Bill Parkinson. “He’s one of the best doctors in the country for this type of delicate surgery, and thanks to his work most people would never suspect that both of those eyes aren’t Betsy’s.” Dr. Marcus Moody rebuilt Parkinson’s face, including her nose and eye socket, using titanium mesh, and her eyelid was stitched shut during the healing process. When the bones and muscles had healed enough, Dan Eaton, a Little Rock ocularist, fitted her with her first prosthetic eye. She’s now on her third or fourth eye. “Who knew?” she said. “You kind of have to keep adjusting these things. They really are trying to make it perfect.” Dr. J. Michael Gruenwald is the orthopedic surgeon who fixed all the broken bones below the neck. “I’ve got screws and plates all over,” said Parkinson. “They’re in my left collar bone and my right arm. When Dr. UAMSHEALTH.COM
Gruenwald put my arm back together there was a piece of bone that was missing – just nothing there. It was amazing to watch it grow back on the x-rays. “First, there was just this giant black gap, then it turned gray, and now it’s finally white where the bone regrew.” Parkinson travels around the world as part of her job with Dillard’s. “Nothing happens at security,” she said. “I fly at least two times a month, and even with all the plates and screws in me, I’ve never set off any alarms. “The first time I went through security, they didn’t say anything, and I stopped and looked back at the security staff, waiting for them to call me back. One of them just looked at me and said ‘Can I help you?’ I smiled and said ‘no’ and kept walking.” “Considering how serious my injuries were, my life is completely normal now,” she said. “My depth perception is a little skewed and I run into doors occasionally, but I still run, I go to a sculpting class, and I travel to Asia and Europe. My life is insanely, amazingly normal. It’s a miracle. “I believe the reason I’m alive today is that God isn’t finished with what
he has for me to do for him yet,” said Parkinson. “The good Lord worked through the doctors and nurses at UAMS to save me, and I’m forever grateful for all they did for me and my family. “I wish I remembered more and could thank them all, but all I remember is being home and being humbly thankful,” she said. “I know there were a lot of incredible doctors and residents who worked on me, and I know that Joyce Randof is one of the people who was always there making sure everything was OK – she was like a little angel for our family. “My life today is directly attributable to the staff at UAMS – God working through them,” she said. “What’s so strange is that I know all this second hand – I’m grateful I don’t remember. “I love UAMS. You know, I should put that on a t-shirt,” said Parkinson, a fashion designer. “‘I heart UAMS’ with a big sparkly heart . . .” UAMS Medical Center Magazine
13
A
Lifetime of Good Health Preventive Care Through the UAMS Center for Primary Care By Kate Franks
As her primary care physician, Dr. Charles Smith ensures Lisa Gandy gets routine health screenings.
14
UAMS Medical Center Magazine
UAMSHEALTH.COM
The new Center for Primary Care at UAMS is a little different than most programs at the Medical Center. It supports the overall mission of UAMS to improve the health and health care of Arkansans, but the focus is on keeping patients healthy rather than merely treating them when something’s wrong. “People usually think of going to see their doctor only when they’re sick, but we’re learning more and more about the value of regular check-ups and preventive care,” said Carol Graham, chief ambulatory officer at UAMS. “The Center for Primary Care is focused on establishing long-term relationships with our patients and working with them to identify warning signs of potentially larger issues and then treat those before they affect the patient’s well-being.” Lisa Gandy is a perfect example of the way the Center for Primary Care works. She’s 53 years old and has been coming to UAMS for regular check-ups for about 25 years. She’s been a patient of Dr. Charles Smith at the UAMS Family Medicine Clinic for the past 13 years. “I see him for my routine health care needs, my annual checkup and anything else that comes up,” said Gandy. “I haven’t really had to see anyone else. We have a good patient/physician relationship. “Instead of telling me what to do, Charlie will come in and discuss treatment options with me and together we determine a course of action,” she said. “I have hypothyroidism, and he checks this on an annual basis. He’s very good about recommending preventive measures for someone my age – such as bone densitometry tests, mammograms and a colonoscopy. He has all my records, he’s easy to talk to and patientfriendly. In fact, over the years I’d say we’ve developed not only a physician/patient relationship but also a friendship.” Preventive care and long-term relationships like Gandy’s relationship with Smith are just two of the many benefits of the Center for Primary Care. “One of the best kept secrets around is the health maintenance care offered at our primary care clinics,” said Graham. “In addition to treating the trauma, cancer and high-risk pregnancy patients that UAMS is so well-known for, we’re here to keep patients well and out of the hospital. “Through the Center for Primary Care, we further enhance the team approach to medicine that UAMS has always been known for,” she said. “In addition to our UAMSHEALTH.COM
doctors and nurses, we have dietitians, social workers, pharmacists, therapists and other patient resources. Patients also have ready access to all our specialty facilities through their primary care doctor. No one else around Because we’re has the whole gamut we have a teaching hospital, here at UAMS.” This access to specialists patients are always is another reason Gandy is pleased with her care at UAMS. ensured the most “One time I was having acid up-to-date care.” reflux issues that I mentioned to Charlie during an annual visit,” she said. “Getting a referral was easy, and within a matter of days I was seeing Dr. Suen, a world-renown otolaryngologist. “Maybe everyone else knows this and it isn’t anything special, but who would’ve thought Boniva® can be a contributor to acid reflux?” she said. “I hadn’t heard that and didn’t realize it could be what was causing my problem, but Dr. Suen knew within a matter of minutes what the problem was. “I think at UAMS the doctors are more in tune with research and the latest information than doctors in private practice often are,” she said. Graham agrees that many patients benefit from the academic environment at UAMS. “Because we’re a teaching hospital, patients are always ensured the most up-to-date care,” she said. “Our physicians know what is being taught today, not just what they learned 20 years ago.” The Center for Primary Care includes the Family Medicine Clinic, a stand-alone facility with street level parking on the east side of the main UAMS campus, along with geriatric care for patients age 50 and older at the UAMS Donald W. Reynolds Institute on Aging and three Internal Medicine clinics. Internal Medicine North and Internal Medicine South, which were previously named the Medicine Clinic and University Physicians Medical Group (UPMG), respectively, are both located on the second floor of the Outpatient Center on the main campus. Internal Medicine West will open in January 2012 in a new UAMS facility just west of the I-630 and I-430 interchange in Little Rock. (See story on next page.) “Lisa is a perfect example of the goal of our primary care program,” said Smith, who also serves as executive»
“
UAMS Medical Center Magazine
15
associate dean for clinical affairs at UAMS. “She’s a very active, physically fit woman, and at age 53 she could very well be at her middle-age – with another 53 good years to go. With life expectancies growing as they are, it’s more important than ever that people establish a relationship with a primary care doctor, take preventive measures and do screening tests throughout their lives. “For example, like with Lisa, early detection and treatment of osteoporosis can mean the difference between a physically and mentally active 80 or 90-yearold and someone who’s confined to a wheelchair.” “I believe there’s a role for a primary care doctor in all phases of a person’s life,” said Gandy. “You have different needs when you’re young, at middle age, and when you get older. I was in my early ‘30s when I started with the
family clinic at UAMS, and as my needs have changed my care has changed with me. “I guess someday I’ll go to the Institute on Aging,” she said, “but for now, I think of that as for my parents’ generation. No matter what your age, there really is value to someone who sees you on a regular basis – someone who knows your history and can recognize when something needs to be taken care of.” “The reason behind the Center for Primary Care really just goes back to the UAMS mission,” said Graham. “It’s all about improving the health of Arkansans. “Let’s face it – the Razorbacks are a lot more enjoyable when you feel good. It’s our job to help patients share the big games not only with their grandchildren, but also with great-grandkids and great-great-ones too.”
UAMS to Open West Little Rock Clinic in 2012
The broad umbrella of the Center for Primary Care covers not only internal medicine, geriatric care and family medicine at the main campus, but also a new West Little Rock facility that offers primary care services. UAMS will open a new office near the intersection of I-630 and I-430 in early 2012 with an Internal Medicine Clinic, an Obstetrics/Gynecology Clinic and a sleep lab. Construction is now under way to convert existing office space into medical clinics. “We expect to open and see our first patients in the new clinic early next year,” said Carol Graham, chief ambulatory officer at UAMS. “These clinics, which will be staffed full-time by UAMS faculty physicians, will be available to both new and existing patients. We’re already scheduling patients for these clinics. If you’d like to make an appointment in 2012, call 16
UAMS Medical Center Magazine
501-686-5545 for Internal Medicine or 501-526-7425 to schedule an ob/gyn appointment.” “We chose the Pyramid Place site at 11300 Financial Center Parkway because of its easy interstate access and proximity to residents west, southwest and northwest of Little Rock,” said Graham. “The new clinics are part of an expanded focus on primary care and the desire to meet the needs of a large patient population in a changing health care environment. They are in addition to the outpatient clinics at the main UAMS campus and do not replace any existing clinics.” The UAMS Financial Center Parkway Clinic will house two full-time internal medicine physicians and four ob/gyn doctors. The sleep lab will have six beds and will be used by patients of UAMS neurologists who refer them for observation in the lab. The longer-term plan for UAMS expansion into West Little Rock includes building a facility on land purchased in 2010 at the intersection of Cantrell Road and Rodney Parham. “We plan to build at that site in the next five or so years,” said Graham. “Market demand will dictate what services will be provided there. With the growing need for more primary care physicians, it too may be part of the Center for Primary Care. We’ll just have to wait and see.”
UAMSHEALTH.COM
Etc.
UAMS License Plate Now Available
U.S. News & World Report Gives UAMS Top Ranking UAMS Medical Center received the number one ranking out of 23 hospitals in the Little Rock metropolitan area in U.S.News & World Report’s 2011-12 Best Hospital rankings. This ranking is based on the 2011-201 Medical Center’s recognition 2 as “high performing” in the four specialty areas of cancer, obstetrics/ gynecology, ear/nose/ throat (ENT) and nephrology (kidney). “This recognition represents a lot of hard work by all of our physicians and staff to provide our patients with the kind of world-class care they need,” said Dick Pierson, executive director of the medical center. “We are pleased to have been recognized on the best hospital list for central Arkansas and are committed to continue delivering on our mission of improving health in the entire state of Arkansas.”
U.S. N & World Rews eport’s
BEST HOS PITALS
Thanks to a suggestion from a second-year medical student from Fayetteville, Arkansas drivers can now support UAMS with a specialty license plate that provides $25 in scholarships for each plate purchased. “I had seen specialty plates for other universities and organizations in the state and was surprised that UAMS didn’t have one,” said Diego Espinoza. He had his younger brother design a prototype of a UAMS plate and asked his classmates what they thought of the idea. With encouragement from his fellow students, he took the idea to the UAMS marketing department, and they worked with the state Department of Finance and Administration to develop the plate. Espinoza, who received one of the first plates issued, said he’s happy students, employees, patients and other Arkansans have a new way to show their support for UAMS. “That the license plate purchases will provide scholarship funds is icing on the cake for me,” he said. For more information, visit www.uams.edu/ licenseplate.
New Hospital Garden Opens
In early September, hospital employees
celebrated the opening of a rooftop garden outside the hospital lobby on the top level of Parking 1. The landscaped area includes a water feature with clear globes covered in running water along a river rock-lined bed, plantings and seating areas. When funded, the next phase of the garden will include additional landscaped beds, tables and chairs and additional lighting.
UAMSHEALTH.COM
UAMS Medical Center Magazine
17
Additional Volunteer Opportunities Available at UAMS Hospital
If you’ve got a caring heart and some extra time,
you may want to consider volunteering at UAMS. The Medical Center is recruiting new volunteers to serve in a variety of roles.
First Floor of Cancer Institute Offers Patient Amenities
The completely remodeled first floor of the Winthrop P. Rockefeller Cancer Institute’s original Walker Tower reopened in mid-June, bringing patients and families resources and support in a bright, open and convenient environment of comfort. A focal point of the new space is the Ford Patient Support Pavilion, named in honor of long-time UAMS supporters Joe and Jo Ellen Ford, where patients can find educational materials and support services. The Cancer Institute Auxiliary offers a free wig to every patient, and the pavilion’s wig shop provides a private area for patients to try on a variety of wigs and hats. Patients, caregivers and visitors also can pick up educational materials, use the pavilion’s computers, copier and fax machine, or attend classes on topics relevant to cancer patient health and well-being. Also new to the first floor is The Gathering Place Café, the Cancer Institute’s first-ever eating establishment. “When we were planning this area, it was very important for us to provide healthy food choices for our patients, visitors and employees,” said Cancer Institute Administrator Shirley Gray. “We wanted to create an area where patients and their caregivers could relax and enjoy a meal together, as well as a centralized location for patient education and volunteer services.” The new café is open from 7 a.m. to 6 p.m. Monday through Friday and from 8 a.m. to 1 p.m. Saturday and Sunday. The newly opened area is also home to the Auxiliary-run gift shop, the Department of Volunteer Services, a chapel, and consultation areas for clinical support services. There is also a direct connection to Parking 3, Infusion Clinic 1, the Outpatient Center and Jones Eye Institute.
18
UAMS Medical Center Magazine
If you like a calm environment and can’t do a lot
of walking, rocking babies or reading to them in the nursery may the job for you. If you have a well-trained dog, the SPOT animal therapy program might be of more interest.
If you like interacting with people, the Emergency
Department waiting area might be a good place for you to help out. If you’ve got more of a librarian personality and like to find information and answer questions, the Family Resource Center can always use more volunteers.
If you’re looking to get in shape or stay in shape by doing a little “mall walking,” and can give directions, wayfinding may be your calling. If retail’s your area of interest, there’s the hospital Gift Shop, which is run by the Medical Center Auxiliary.
“The Medical Center is
huge, and there are always lots of opportunities for volunteers,” said Erin Gray, director of volunteer services. “We have several new programs and are expanding others, so now is a great time to join our volunteer team.” For more information, visit www.uamshealth.com/volunteer or call 501-686-5656.
UAMSHEALTH.COM
Chief Ambulatory Officer Carol Graham, left, and Trenda Ray, ambulatory operations officer and director of ambulatory nursing.
New Leadership Team Named for Outpatient Clinics Carol Graham joined UAMS in April 2011 as chief ambulatory officer with responsibility for managing all the outpatient clinics. There are more than 400,000 patient visits to these clinics every year. Graham was previously part of the leadership team at Arkansas Children’s Hospital where she was responsible for their ambulatory operations. “The entire management team and I are looking forward to working with the clinic staff to fulfill the mission of UAMS to improve the health and health care of Arkansans by making it easier for patients to make appointments, easier for physicians to refer patients to UAMS, and easier for our health care professionals to deliver care,” said Graham. “I am committed to improving patient outcomes, patient satisfaction and employee and physician satisfaction,” she said. “The first step in this process is developing an effective structure for implementing change, and I am confident that our new leadership team is up to handling the challenges ahead.” Trenda Ray, PhD, APN, joined UAMS as ambulatory operations officer and director of ambulatory nursing. She is responsible for the Access Center, surgical, cancer, medicine, eye, longevity and women’s health clinics along with the new satellite clinic in West Little Rock, which is scheduled to open in early 2012. UAMSHEALTH.COM
UAMS Named
Top Performer for Quality
Earlier this fall, UAMS Medical Center was
named one of the nation’s top performers on key quality measures by The Joint Commission, the nation’s leading accreditor of health care organizations. The Medical Center was recognized by The Joint Commission based on data reported in 2010 about clinical processes that are shown to improve care for certain conditions, including heart attack and heart failure.
UAMS is one of only 405 U.S. hospitals
earning honors from The Joint Commission. This represents about 14 percent of all Joint Commission-accredited hospitals in the country.
“We understand that what matters most to
patients is safe, effective care. That’s why UAMS is committed to accreditation and positive patient outcomes. We are proud to be named to this list of top performers.” said Dick Pierson, executive director of the medical center.
UAMS Medical Center Magazine
19
Staff Chaplain Susan McDougal says she wants patients to know that she cares and she will be there as long as they need her.
Being
telling their stories that allows them to navigate their hospitalization,” Hankins-Hull said. “We play a supportive role to help the patient call upon their own faith or philosophy of life as a source of comfort,” said George Buck, Ph.D., a chaplain and instructor in the UAMS clinical pastoral education program. UAMS chaplains honor each patient’s individual religious traditions and needs. A patient’s own pastor and other representatives of their faith community are welcome to visit patients at any time, and they are often contacted by UAMS chaplains on behalf of patients. UAMS chaplains make rounds throughout the hospital every day, and they are also on call at all times. Patients and family members may page a chaplain or call the UAMS operator to request a chaplain visit. The pastoral care team also conducts a nondenominational service every Sunday at 10 a.m. in the hospital’s Walton Chapel. The chapel is open at all other times to accommodate patients, families and those simply seeking a space apart. The chaplains see patients in the hospital, the Winthrop P. Rockefeller Cancer Institute, the Myeloma Institute for Research and Therapy and other programs such as the palliative care service, which provides compassionate care for patients living with a severe illness or when the goal of care becomes comfort. McDougal, a Quaker, is the newest full-time chaplain at the Medical Center, joining the team in June 2011 after completing the UAMS Clinical Pastoral Education program. Her interest in becoming a chaplain was kindled by 18 months spent in prison for refusing to answer grand jury questions related to the Whitewater investigation of then-President Bill Clinton. “I was frightened in jail,” said McDougal. “These were women at the worst time in their lives, yet they embraced me and cared about me. “It changed me and made me want to live up to that by offering a personal connection, comfort and caring to those who are in a time of trauma.”
There
UAMS Chaplains Offer Comforting Presence for Patients, Families By Jon Parham
A Code Blue alert for a patient in cardiac distress at UAMS Medical Center quickly brings medical help – and a chaplain While health professionals tend to the patient’s medical needs, the chaplain offers pastoral support for family members, friends, other patients or employees. In this sometimes emotional situation, a UAMS chaplain may serve as a liaison for the patient and family with physicians, nurses and other caregivers. Perhaps more importantly, they are simply there. “I want to let them know – whether it’s a patient or a family member – that I care and that I am there for them,” said Susan McDougal, UAMS Medical Center staff chaplain. “I will stay with them as long as they need me.” This personal connection is key for a chaplain, who is a minister serving in a specialized setting, usually a hospital, prison or the military. At UAMS, chaplains are available for pastoral support 24-hours-a-day. “Chaplains at UAMS do not proselytize,” said George Hankins-Hull, director of pastoral care and clinical pastoral education training programs at UAMS. “And we’re not here to replace a patient’s own pastor. We’re present to provide emotional and pastoral support during a time of crisis or hospitalization.” Pastoral care at UAMS is primarily about relationships and the stories people tell about illness. “The least known role of the clinical chaplain is as interpreter of the metaphors and the connections people make while 20
UAMS Medical Center Magazine
UAMSHEALTH.COM
Teaching the Art of Caring While UAMS is widely known for its academic programs in medicine, nursing, pharmacy and other health professions, a lesser-known but strong pastoral education training program is also offered. About 18 ministers or lay people are chaplains-intraining through the program at any given time. Training can be completed on a full or part-time basis, or over the course of a summer. Pastoral care trainees present clinical case studies on their pastoral interventions and attend seminars while serving as chaplaincy interns or residents. They serve as chaplains for different areas of the hospital, which allows them an opportunity to experience the full range of care settings in a modern medical facility. Graduates of the program may go on to become boardcertified clinical chaplains through the College of Pastoral UAMSHEALTH.COM
Supervision & Psychotherapy, the national organization that accredits the training programs at UAMS. George Hankins-Hull, director of pastoral care and clinical pastoral education at UAMS, has led the program since 2005 and says it attracts people from all faith backgrounds. That was the case with him, a Methodist pastor in Northern Ireland who was drawn to the clinical model of pastoral training as the best means of caring for others. George Buck, Ph.D., a chaplain and instructor in the UAMS clinical pastoral education program, who led the program prior to Hankins-Hull, is retired from working as a full-time chaplain, but still enjoys teaching in the program. “It is a privilege to supervise people through their spiritual growth and development,� said Buck. UAMS Medical Center Magazine
21
Inquiring Minds
Clinical Innovation Benefits Patients at UAMS By Nate Hinkel
It’s imperative that health care providers caring for patients with head injuries or other neurological problems have the ability to regulate drainage of spinal fluid when necessary. There’s a standard practice for accomplishing this, but is there a better, more efficient way of monitoring fluid levels? Is there a way to do so that keeps patients more comfortable? A way that might help patients heal faster? At UAMS Medical Center, curious and innovative health care professionals are continually asking those questions. And patients are benefitting. “We are constantly promoting what we like to refer to as a ‘culture of inquiry,’” said Tammy Jones, Ph.D., R.N., associate chief nursing officer and director of the UAMS Center for Nursing Excellence. “We want everyone to consider the latest evidence and ask questions like, ‘Is there a way to do this better?’ ‘Is there a way this can be done that will make this patient’s life a little easier right now?’ ‘Is there a more efficient and effective way this could be done?’” 22
UAMS Medical Center Magazine
Culture of Inquiry It’s one thing to ask those questions, Jones said, but it’s quite another to have dedication like at UAMS to actually find the answers. “Opportunities for improved health care can easily be found. Having the commitment it takes to turn those opportunities into reality is what sets UAMS apart. This academic, research-intensive health care environment stimulates innovative thinking and problem solving,” she said. “In nursing we’ve done a lot of recent work creating structures and processes that promote evidencebased practices and models to support finding answers to clinical questions that can then be translated to the bedside. “That’s a very big deal for us,” said Jones. “There are a limited number of original evidence-based practice models in existence. We are proud to have one out there that originated at UAMS. “Patients here benefit directly from this culture of inquiry, and this work helps cement those processes.”
Fluid Motion As for those patients with neurological conditions, answers to a few simple questions have proven to provide big benefits. A traditional lumbar drain relies on gravity to regulate the patient’s spinal fluid. But for that to work, patients have to be positioned at a certain angle, which can be uncomfortable, or nearly impossible, depending on their condition. UAMS professionals asked the question, “What can we do to make these patients more comfortable and keep them safer?” As a result of an evidence-based practice project, an intravenous pump is now attached to the drain so gravity is taken out of the equation. A small pilot study conducted at UAMS on the new pump-regulated drains yielded good outcomes. In response to the findings, UAMS nurses have developed a larger research protocol to generate more evidence and knowledge. This is just one of the ways the culture of inquiry at UAMS is benefitting patients. Another example is a UAMSHEALTH.COM
fall prevention program which also produced dramatic results at UAMS. (See article on page 4.) Jones said other projects currently underway are wide in scope. They include finding ways to enhance patient- and familycentered care through bedside shift report, decreasing noise in patient care areas and promoting mobility of patients who are in the hospital.
Dr. Thomas Kieber-Emmons, professor of pathology, is testing a breast cancer vaccine that he describes as the “the culmination of my life’s work.” His research has been federally funded for more than 17 years, signifying the lengthy process involved in developing something as complex as a cancer vaccine. Dr. Laura Hutchins, director of the UAMS Division of Hematology and Oncology, is also working on the trial. Try and Find With the breast cancer vaccine, the goal is to trigger Doctors, scientists and other health care professionals an immune response to the carbohydrates covering the at UAMS consistently conduct medical research to find surface of the cancer cells, thus destroying the cells and new and better ways to fight diseases, treat patients leaving the healthy tissue alone. effectively, and ultimately prevent devastating diseases. A clinical trial is also underway for an HPV vaccine for Only large research and educational centers like UAMS those already infected with the virus. offer clinical trials, allowing patients to benefit from the HPV is passed through sexual contact. In about 90 latest, state-of-the-art therapies. percent of cases the virus clears itself from the body Perhaps the hallmark of this research at UAMS lies naturally. But the remaining 10 percent are at the most risk within the Myeloma Institute for Research and Therapy, for having precancerous cervical lesions that lead to cervical which has become the world’s foremost research and cancer, which is the second-most common cancer among treatment center for multiple myeloma, women. a cancer of the blood’s plasma. For more We are constantly Being conducted by Dr. Mayumi than 20 years the program has developed Nakagawa, associate professor of research and innovations that have promoting what we pathology in the UAMS College of earned its reputation as a world leader for like to refer to as a Medicine, a research project is trying those with multiple myeloma. to determine if there is a way to put a ‘culture of inquiry.’” Clinical trials within the UAMS sizable dent in the more than 12,200 myeloma program have had a significant impact on new cases of invasive cervical cancer in the United States patients. A National Cancer Institute study done between each year. 1995 and 2001 showed that only 34 percent of newly “I think it is possible to do this, and we’re getting much diagnosed multiple myeloma patients lived at least five closer to making it happen,” Nakagawa said. “The ultimate years, compared to 57 percent of patients at UAMS. The goal would be the prevention of cervical cancer in those rate has since improved at UAMS – today more than 65 who are most likely to develop it.” percent of these patients live at least five years. Multiple myeloma clinical trials are ongoing, such Educated Advantage as a first-of-its-kind treatment that uses supercharged The advantages to patients being treated at the state’s immune cells known as “natural killer cells” that attack only educational research hospital are vast. With seven institutes and dozens of centers dedicated to research, cancer cells. “This is an entirely different approach to treating the shared goal of quickly moving those practices from multiple myeloma, which until now has been treated laboratories to hospital rooms is changing lives. mainly by chemotherapy,” said Dr. Bijay Nair, assistant “The goal is to provide high-quality care that is patientprofessor of medicine in the UAMS College of Medicine, and-family centered in the most efficient way possible,” Jones said. “Asking questions about improving care and who is leading the trial. providing a system to put the answers to work for patients Vaccine Dreams is what it’s all about. Patients and families at UAMS can Patients with other forms of cancer also are benefitting rest assured knowing that we are committed to offering from clinical trials and research at UAMS. Two ongoing the most up-to-date, evidence-based treatment options projects include developing vaccinations for the human and care possible.” papillomavirus (HPV) and even breast cancer.
“
UAMSHEALTH.COM
UAMS Medical Center Magazine
23
Nonprofit Organization U.S. Postage
MEDICAL CENTER
PAID
Permit No. 1973 Little Rock, AR
UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES
4301 W. Markham St., #890 Little Rock, AR 72205
behind the scenes A Lasting Impression Getting Patients Home Safely By Lauren Farabough
A last impression can be a lasting impression. When patients leave the hospital at UAMS, Greg Willis makes sure the last impression is a good one. Willis works in patient discharge, and his is often the last face patients and family members see when they leave the hospital. Even though he has had other careers, including time in the Air Force, Willis says he finds the most satisfaction in his current position. He came to UAMS in 2008 and first worked as a transporter. He then moved I always to the hospitality team and have something became the “discharge guy.” Citing his grandmother’s positive to say.” quote that the best thing a person can do is serve others, Willis said, “That fits with me. I get to fulfill what she always told me. It’s the best job I never thought I’d have.” Day after day, Willis enjoys hearing testimonies
“
from patients and their families of how UAMS has helped them or even saved their lives. He likes to have a conversation with each patient and their family member as he helps them into their vehicles. “I try to treat them as I would my mom or dad. I show interest in them. I always have something positive to say,” he said. And, patients notice. One family member wrote a letter to hospital administration to express his appreciation for Willis’ help in getting his wife into their car and described him as “an especially caring and distinctive person.” Willis is always on the lookout for ways to improve the patient experience. Noticing that patients and families had no place to sit outside near the discharge area, he asked for – and got – benches so patients can enjoy fresh air while waiting for pick-up. He now considers these benches his office, providing a convenient, comfortable spot for patients and their families to share their stories.