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We have 10 HOSPITALS and 300 CARE SITES supported by

MedStar is advancing health by leveraging the collective capabilities of a research institute, an innovation institute, and an academic partnership with Georgetown University.

31,000 ASSOCIATES and 6,500 AFFILIATED PHYSICIANS.

As the largest healthcare

With more than 200,000

MedStar Health has one of

Our 31,000 associates and

and Washington, DC region,

million outpatient visits and

education programs in the

support the MedStar Health

provider in the metropolitan MedStar’s 10 hospitals, 20

diversified healthcare entities and 300 service locations are recognized regionally and

nationally for excellence in medical care.

inpatient admissions and 4

nearly 300,000 home health visits annually, we care for a socio-economically diverse

population in urban, suburban and rural settings.

the largest graduate medical country, training more than 1,000 medical residents annually.

6,500 affiliated physicians all patient-first philosophy,

delivering a combination of

care, compassion and clinical

excellence with an emphasis on customer service.


Our position in both clinical and academic environments allows us to catalyze innovation and apply the latest findings in medicine into the care we provide.

Our commitment to

advancing health is built on integration of

three imperatives...


Discover. Innovate. Learn. DISCOVER

INNOVATE

LEARN

09 On the Front Lines

21 Finding New Answers

33 A Culture of Learning

10 World Class Outcomes

22 Doctor at Your Door

37 A Strong Foundation

14 P  athway to Health

24 Better Data; Better Outcomes

38 Residents Raise the Bar

16 S  peaking up for Safety

26 Outside In & Inside Out

40 Learners to Leaders


DISCOVER. O N THE FRONT L I NES WO RL D CL ASS OUTCO M E S

PATHWAY TO HE ALT H

SP E AKI NG U P F O R SAF E TY


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DISCOVER. MedStar is utilizing the research capability and scope of the system to advance health throughout the communities we serve.


One of our greatest assets is an incredibly large and diverse patient population. This also necessitates that

we do all we can to help our

communities stay healthy. By

providing access to cutting-edge and experimental treatments

we are actively helping those who battle illness in their everyday lives. .

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On the Front Lines Deploying research directly to the community MedStar’s position at the crossroads of clinical and academic environments allows us to catalyze innovation and provide the latest advances to our patients. As a distributed healthcare delivery network, our research programs are advancing our vision by applying research insights directly into the community fabric of Baltimore and Washington, DC, area residents.

CONNECTING DIABETES RESEARCH TO THE COMMUNITY MedStar is providing community access to several national diabetes prevention clinical trials through our MedStar Community Clinical Research Center (MCCRC). Our researchers at MCCRC are part of the Vitamin D and type 2 Diabetes (D2d) study, sponsored by Tufts Medical Center in collaboration with the National Institutes of Health’s National Institute of Diabetes and Digestive and Kidney Diseases (NIH NIDDK). The purpose

of the study is to determine whether vitamin D supplementation is safe and effective in delaying the onset of type 2 diabetes in people at risk for the disease and to gain a better understanding of how vitamin D affects glucose metabolism. In addition, we are one of 25 clinical sites across the nation that are studying the long-term benefits of diabetes prevention with lifestyle intervention or metformin, as part

of the Diabetes Prevention Program (DPP)/DPP Outcomes Study (DPPOS). MedStar continues to be a top patient enroller in the Glycemia Reduction Approaches in Diabetes: A Comparative Effectiveness (GRADE) study, a long-term study funded by the NIH NIDDK. Today, more than 3,000 participants have been randomized into GRADE, at 45 clinical sites in the United States.

TREATING PATIENTS WITH THE HEPATITIS C VIRUS With new therapeutics, the Hepatitis C viral infection (HCV) can be cured with eight to 24 weeks of antiviral therapy, greatly reducing the possibility of end-stage liver disease when treated early in the disease process. MedStar is determined to identify patients with HCV across the disease spectrum and has been

awarded several grants to address gaps throughout the cascade of care for HCV. One grant funded the testing of baby boomer patients (born between 1946 and 1964) who had been seen in the primary care clinic at MedStar Washington Hospital

Center. In another study, we are screening baby boomers across MedStar Health as well as identifying and re-engaging HCV patients who have fallen out of care. The goal is to get HCV patients into care, and cure them with new antiviral therapies, reducing their risk of morbidity and mortality in the future.

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World Class Outcomes Community access to national specialists and researchers At MedStar Health, our patients have access to the latest diagnostic tests, treatments, clinical trials and support that come from a welcoming community environment.

NEW TECHNOLOGIES TO TREAT HEART DISEASE By harnessing the latest advancements in medical technology and research, our cardiovascular surgeons at MedStar Union Memorial Hospital in Baltimore, MD, have been able provide cutting-edge treatments to patients suffering from advanced

heart failure. At the hospital, we are restoring normal lifestyles for elderly patients with transaortic valve replacement (TAVR), a procedure tested at the hospital with positive patient results. For patients who are too ill to undergo open heart valve replacement,

TAVR is a much safer option with a significantly shorter recovery period. MedStar Union Memorial Hospital is also the first and only location in Maryland to offer to our communities the fully dissolvable cardiac stent for patients fighting coronary artery disease.

partners with medical and industry partners across the country, further increasing our access to the most progressive clinical trials.

advancing immunotherapy research by:

PERSONALIZED MEDICINE The Harry and Jeanette Weinberg Cancer Institute at MedStar Franklin Square Medical Center serves Baltimore area residents in their own neighborhood, providing access to the latest diagnostic tests and treatments, clinical trials, and support that comes from a welcoming community environment. The Weinberg Cancer Institute has a robust, well- established clinical trials program. As a member of the MedStar-Georgetown Oncology Network as well as several National Cancer Institute cooperative groups, the Cancer Institute closely

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• Participating in early studies with ipilimumab (the first The Weinberg Cancer Institute immunotherapy approved for As traditional chemotherapy fails to currently haswith thirty open clinical melanoma) 51 patients provide long-term benefit for many enrolled inin trials. patients, recent studies indicate thattrials, primarily the areas of breast, immunotherapy holds the potential lung melanoma cancers. • and Serving as a top enroller on to be a breakthrough treatment an industry- sponsored study for cancer, especially for those with for patients with Stage IV advanced disease. Immunotherapy non-small cell lung cancer uses the body’s own natural opening studies comparing ,pembrolizumab vs. for system to fight disease and cancer chemotherapy. researchers are increasingly cancer patients with a specific genetic studying it to bring remission mutation identified by world molecular • Being the first site in the and even cure to cancer patients. to enroll a patient on on a study for all The Weinberg Cancer Institute is profiling that is done almost

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We remain on the cutting edge of personalized medicine

advanced cases.


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A TRADITION OF EXCELLENCE As one of the most advanced hand trauma centers in the world, the Curtis National Hand Center at MedStar Union Memorial Hospital is a hub for discovery, innovation and education. This groundbreaking work is supported by 14 surgeons, a prominent fellowship program, a complete research department and association with the largest hand rehabilitation center in the nation.

In working with MedStar Inventor Services, MedStar’s technology and commercialization arm with Cleveland Clinic Innovations a fellowship alumnus from the Curtis National Hand Center developed a unique device that allows surgeons to reattach tendons without sutures. This new approach allows patients with hand tendon injuries to move their fingers during recovery, helping them regain a better range of motion.

In partnership with MedStar Georgetown University Hospital surgeons, the researchers at the Curtis National Hand Center coauthored one of the largest longterm, follow-up studies of its kind, published in the online journal Hand. The study supported their work on endoscopic carpal tunnel release as a better option than traditional carpal tunnel surgery, as it is associated with a faster recovery and return to activities for patients.

As one of the most advanced hand trauma centers in the world, the Curtis National Hand Center at MedStar Union Memorial Hospital is

a hub for discovery, innovation, and education. A D V A N C I N G H E A LT H : D I S C O V E R

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Pathway to Health Making an impact on diabetes prevention, management and education EDUCATIONAL PATHWAYS The MedStar Diabetes Pathway, a technology-enabled “Boot Camp” project, serves patients with uncontrolled diabetes being cared for by MedStar Health providers. Patients receive 12 weeks of intensive survival skills, self-management education, and frequent medication adjustments guided by real-time blood glucose monitoring, largely delivered via ‘virtual visits’ (telephone call or text messaging) to save our patient’s

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time by reducing visits to the doctor’s office. Patients successfully completing the Boot Camp have a marked improvement in blood glucose control and significant reduction in risk for emergency department visits and hospital admissions. This Boot Camp program is now being rolled out at additional sites within MedStar Medical Group’s large primary care practice network so that it can reach other patients needing support in

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taking care of their diabetes. “Diabetes to Go,” funded by the National Institutes of Health is examining how hospital nursing unit staff can best deliver concise survival skills diabetes selfmanagement at the bedside in the hospital setting as part of the process of caring for our patients. Many patients with diabetes never receive basic education needed to live well with diabetes, leading


The National Institutes of Health saw promise in our expert diabetes management research and awarded the organization a grant to study the feasibility of integrating the “Diabetes to Go” program into the inpatient hospital workflow to improve diabetes self-care and outcomes.

to hospital admissions. The hospital setting offers an opportunity to deliver diabetes “survival skills” education to inpatients. We believe that providing education during patient ‘down-time’

during the hospital stay will help to improve diabetes self-care and outcomes following discharge home from the hospital.

WELLROOTED—DELIVERY FOOD & DIABETES EDUCATION TO YOUR DOORSTEP What happens when you apply diverse next-generation talent, innovation and distinctive learning experiences to tackling America’s most pressing healthcare challenges? Our Health for America (HFA) fellowship, the first program of its kind, immerses four young professionals in distinctive learning experiences centered on health, design, entrepreneurship, and leadership and challenges them to create an innovative solution to a chronic disease. The 2015-2016 class of fellows

tackled type 2 diabetes treatment and management by shadowing the type 2 diabetes treatment and experience and spent months shadowing practitioners at the MedStar Diabetes Institute and DuPont Nemours Children’s Hospital, in Wilmington, DE, along with learning from experts nationwide. The result was the development of WellRooted, a nutrition education tool that delivers ingredients, recipes, and education content to the doorways of individuals newly diagnosed with type 2 diabetes. WellRooted allows diabetes

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Speaking up for Safety Improving patient safety beyond the walls of MedStar hospitals As one of just 13 healthcare organizations in the ACTION III research network (Accelerating Change and Transformation in Organizations and Networks), MedStar has won several high profile awards to improve how healthcare systems approach patient quality and safety across the nation. Research suggests that while there have been significant advancements in hospital-based patient and family involvement in patient safety, the role of patient and family engagement in primary care-based settings lags behind. Under the ACTION III network, funded by Agency for Healthcare Research and Quality (AHRQ), a team of our experienced researchers is leading a 38-month contract to design, develop, pilot, and disseminate a guide for improving patient safety in primary care settings by engaging patients and families in their care. The project incorporates the strengths of a diverse research and safety team and leverages network partners, including CVS Health, Prince George’s County Health

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Department, the Clinical Directors Network practice-based research network, Georgetown University, Consumers Advancing Patient Safety and dissemination partners Iowa Healthcare Collaborative and Telligen, Inc. This work successfully builds on another national program led by MedStar and funded by AHRQ called CANDOR – short for Communication and Optimal Resolution. CANDOR is a patientcentered approach to care delivery that emphasizes disclosing immediately to the patient when a serious, unanticipated outcome occurs, conducting a thorough event review to discover and eliminate the risk, and reaching fair resolution with the patient and family. The CANDOR process helps our healthcare team make care safer by fostering a culture of safety and increasing the reporting of possible adverse events. This facilitates a learning environment built on trust and transparency.

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As part of the

CANDOR project, we have

successfully led 14 hospitals

from three healthcare systems nationwide in a 24-month implementation process,

bringing our care for our community to the national stage.


MedStar has the infrastructure and funding to provide its researchers with institutional support, most notably through the Georgetown-Howard Universities Center for Clinical and Translational Science (GUHCCTS), funded through the Clinical and Translational Science Awards (CTSA) program. Its mission is to increase the number and quality of clinical investigators by offering a broad range of research resources and educational opportunities to trainees, faculty, and staff at MedStar Health, Georgetown, and Howard University. A D V A N C I N G H E A LT H : D I S C O V E R

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INNOVATE. F IN D I NG NE W ANSW E RS

D OCTOR AT YOU R D OOR

BE TTE R DATA; BETTE R O U TCO M E S OU TSI D E I N & I NSI D E O U T


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INNOVATE. MedStar is creating a vibrant innovation ecosystem that is transforming care and advancing health.


Can...

eye movements

...following the of experienced physicians enhance training of residents?

social networks

...clinicians’ be used to identify primary influencers to lead safety initiatives?

advanced visualizations

... of patient safety events show us how to prevent them? 18

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At MedStar’s National Center for W E

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Finding New Answers HOME TO THE LARGEST HUMAN FACTORS EXPERTS IN HEALTHCARE Fully embedded in the diverse MedStar Health system, our researchers and clinicians in the National Center for Human Factors in Healthcare work collaboratively to understand the needs of our clinicians and patients, and develop more effective and safe technology and processes to meet these needs. Central to our research is the notion that we can’t eliminate human error, but we can engineer solutions so inevitable errors do not result in patient harm. You cannot redesign people, but you can redesign the systems in which people wok to optimize for how people think and perform. Our research agenda is to conduct applied research, grounded in theory, to advance

we find practical solutions that help to improve the overall safety and quality of healthcare.

safety, efficiency, and quality for our clinicians and patients. Our work has been sponsored by the Agency for Healthcare Research and Quality, NIH, the Office of the National Coordinator, and several foundations. The Usability division of the National Center for Human Factors in Healthcare advises medical device and health information technology companies on creating safe and effective products for the global market. Our Usability experts are human factors engineers, industrial systems engineers, and clinicians who perform formative and summative testing for preand post-market activities—saving time and money in obtaining

IMPROVING THE ELECTRONIC HEALTH RECORD (EHR) Electronic health record (EHR) systems seek to optimizecare and provide a real-time, patientcentered record that makes

Human Factors in Healthcare,

information available instantly and securely to authorized users that also helps to automate and streamline provider workflow.

regulatory approval—to quickly translate scientific findings into improved care, efficiency, reliability and safety for patients. In addition, the Usability team provides consultation for MedStar entities on product purchase decisions, placing a premium on safety and user efficiency.

LOOKING WHERE YOU WANT TO GO At the National Center for Human Factors in Healthcare, we are using mobile eye tracking technology to better understand how practitioners interact with patients, patient tools and other providers in given circumstances. This innovative research is providing insight into cognitive processing to forge improvements in practice and use of equipment. However, the design and implementation has inadvertently introduced new types of patient

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Doctor at Your Door Innovation in Care Delivery Medstar is thinking differently about caring for patients.

TOTAL ELDER CARE

Frail elders with chronic health needs are especially vulnerable. Limited mobility and cognitive impairment make it very difficult – mentally and physicially -- to access consistent primary care in a doctor’s office. This can lead to further deteriorations or acute episodes and result in preventable, stressful, and expensive emergency room visits or hospital admissions. The seed for MedStar Total Elder Care was planted 17 years ago in 1999. The idea was to meet these patients where they already were – in the home – requiring no doctor’s ofices while providing the highest quality care keading t9o strong patient and family satisfaction while reducing costs. . A study published in the Journal of the American Geriatrics Society in 2014, outlines the effectiveness of the MedStar Total Elder Care model and shows 17 percent savings in total

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Medicare costs for this population. Most recently, the program received recognition from the Centers for Medicare & Medicaid Services Independence at Home demonstration program, where a 20 percent reduction in cost resulted in more than $1 million in shared savings provided to MedStar to reinvest in innovation. MedStar Total Elder Care will continue to expand its footprint, providing the highest level of service to eligible patients throughout the region.

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PALLIATIVE CARE + TELEHEALTH Using advancements in telemedicine technology and pilot funding from the Verizon Foundation, MedStar created the PaTCH2 Program, short for Palliative Telehealth: Connecting Hospital to Home. The main goal of the program was to improve access to palliative care for patients with advanced congestive heart failure (CHF) and chronic obstructive pulmonary disease (COPD), beginning at MedStar Union Memorial Hospital. In addition, the aim was to provide more effective medication management, and education to ensureimproved patient selfefficacy and quality of life.

MedStar Total Elder

Care currently cares for

60 patients in

Washington, DC, and has recently expanded to Baltimore, using an

integrated team of doctors, nurse practitioners, social workers and operational staff.

Seventy-two patients with CHF or COPD were enrolled in a randomized, controlled trial to evaluatefollow up by telephone compared toh follow up via the use of mobile tablet computers which were given to each patient at discharge to support remote management and follow up with the palliative care team. The ability to connect digitally allowed patients access to accurate and updated medication information, education resources and realtime videoconferencing and messaging capabilities. Compared with the usual approach of telephonebased follow-up, the value of videoconferencing for “face time� between patient and provider was validated by the results of the pilot. Readmission rates were reduced for all patients in the program and 45 patient safety events were prevented. Of those, 76 percent would have affected patient outcomes. Based on the resultant patient outcomes of the PaTCH2 Program, the model was expanded and adopted at three additional MedStar hospitals to facilitate improved communication between our patients and our providers.

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Better Data; Better Outcomes Leveraging predictive analytics to generate knowledge and insight Data is critical to making effective decisions and we are presented with new and unprecedented amounts of data, both across populations and at the individual level. Properly harnessed, this information allows for earlier interventions allowing us to turn data into improved quality of life. Using predictive analytics and insights from the EHR, we are: • Saving a million hearts MedStar became the first healthcare system to join with Million Hearts®, a national public-private initiative dedicated to preventing 1 million heart attacks and strokes over a 5-year period. Using the EHR as a virtual care team member, we have exceeded all national targets and are enhancing EHR algorithms to detect undiagnosed and uncontrolled hypertensive patients.

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• Improving screening and prevention of diabetes With funding from a KL2 PostDoctoral Scholarship, MedStar’s outpatient EHR is improving provider screening for type 2 diabetes in the primary care setting. This tool also aids in the identification of those who may be dealing with the potentially devastating complications of this condition and, once a diagnosis of prediabetes has been made, provides prompts that alert the provider to the need for annual testing and education. • Patient Safety Event Reporting Reports of patient safety events can range from near misses to serious errors. MedStar’s National Center for Human Factors in Healthcare has developed an enhanced tool to analyze tens of thousands of patient safety event reports to distill the information needed by hospital staff to improve identification of hazards to patient safety.

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Our success in using vast amounts of structured and unstructured data to generate knowledge and reach deeper insights is critical to our journey to improve patient outcomes.

ACCELERATING INNOVATION THROUGH CLOUD COMPUTING MedStar’s Center for Digital Health and Data Science is developing innovative methods, tools and processes to transform data into knowledge, providing a foundation for measurable action. By using natural language processing algorithms and prescriptive and predictive modeling techniques, we and our community partners are scrutinizing raw clinical data and using open-source biomedical ontologies to identify drugs, symptoms and procedures to predict emerging patient safety issues and trends. In radiology, we and our partners at the Georgetown University Department of Computer Science are creating machine learning algorithms to identify critical results among unstructured radiology data. These algorithms, which will classify radiology data according to custom radiology terms, will help alert healthcare practitioners to patients who require immediate clinical attention. MedStar is also harnessing medical data from multiple sources and collaborating with industry partners, discovering and applying new models of care and efficiencies to obtain better patient outcomes. Patients and associates armed with knowledge and tools acquired from this data are equipped to continue forward in our journey toward advancing health.

In collaboration with Booz Allen Hamilton, we are using data science to increase understanding of emerging patient safety issues, finding missed diagnoses and unsuccessful treatments, and identifying gaps in care among patient populations.

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Outside In & Inside Out Partnering with the most progressive and innovative companies inside and outside healthcare

If we talk only to ourselves, we stay where we are. If we talk only to others in healthcare, we move with the pack. If we talk to people and seek ideas from outside of healthcare,

we can leap boundaries. — Mark S. Smith, MD, Chief Innovation Officer, Director MI2

By encouraging our inventors and partnering with innovative startup companies and alliances, we have created a vibrant ecosystem for innovation that is transforming care and advancing health.

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STARTING UP CHANGE MedStar Health is one of only four founding partners in the global startup incubator and venture fund, 1776. This strategic partnership is part of MedStar’s quest to find new, better and faster responses to the challenges facing the nation’s hospitals and lead to the transformation of the U.S. healthcare system. In support of this quest, 1776 helps identify the most promising startups in healthcare and related fields and helps engineer their success. As 1776’s primary healthcare partner, MedStar acts as an advisor to the incubator’s new health-related companies, helping refine prototypes into practical, real-life applications that better

patient care. MedStar also participates in the annual 1776 Global Challenge Cup, which sources the best startups from 54 cities worldwide, culminating in a week-long, 8,000-person event in the nation’s capital. Currently, MedStar is working with start-ups on remote monitoring systems, informatics, telemedicine and other digital health solutions that could radically change healthcare delivery. In exchange, we gain first access to approaches and technologies from the latest startup companies, putting us on the leading edge of patient care technology.

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PARTNERING OUTSIDE THE BOX Health care is undergoing transformational change and the public is asking for smart solutions that meet its needs. • We became the first health system in the world to partner with Uber in an effort to increase patient access to services. • ZocDoc allows direct booking and scheduling of doctors’ visits 24/7 via web and mobile technology, to MedStar to make scheduling appointments easier. • CVS so that patients can receive coordinated care services, including medication counseling, chronic disease monitoring and wellness programs at CVS pharmacy stores and MinuteClinics. • AARP’s Project Catalyst to inform health-tech products and services so that they can improve the quality of life for the fast growing population of people over age 50. • Mytonomy Patient Education Center to empowers patients with the information they need through bite-sized video content developed by the MedStar Institute for Innovation. With this technology, patients can access content at home before and after their visit.

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• Rebel Desk, a treadmill desk designed by a local 1776 startup to promote a movement and wellness among associates at scores of MedStar office locations. • Babyscripts approach to prenatal care, developed by a local 1776 startup company to extend prenatal care beyond the office visit by monitoring pregnant women’s weight gain and blood pressure. The program is being tested at four clinical obstetric sites throughout the region. • Health for America is bringing a fresh set of eyes to the healthcare innovation sphere by supporting young professionals in creating new solutions to chronic health care issues. • Global Healthcare Innovation Alliance, Global Healthcare Innovation Alliance, now eight institutions as well as the 75-person team at the Cleveland Clinical Innovations.

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MedStar is seizing opportunities to evolve the traditional

healthcare system into one that is widely

accessible, coordinated and focused on wellness and prevention.

ENGINEERING HEALTH What do the following have in common? • The Brain FORCE mTBI Screening Tool, a portable test for mild cognitive impairment (concussion) that can be deployed on the battlefront or sidelines. • Use f probiotics to treat and prevent urinary tract infections (UTI) in paralyzed spinal cord patients • Face2Face™ an iPad® application now available on iTunes that assists patients suffering from facial nerve damage, which often results in mild-to-severe physical disfigurement, in performing the facial exercises that will help them recover more quickly. Each represents an idea from a MedStar Health National Rehabilitation Network associate submitted to MedStar Inventor Services. In partnership with the Cleveland Clinic, MedStar Inventor Services works hand-in-hand with our associates to transform their innovations and discoveries into commercial products and services that advance health and improve the patient and family experience.

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LEARN.

A CU LTU RE O F LE ARNI NG

A STRO NG FO U NDATI ON

RE SI D E NTS RAI SE TH E BAR

A LI FETI ME AT MED STAR H E A LTH


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LEARN. MedStar provides a robust learning environment to advance health through new knowledge, simulation, and skills development.


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A Culture of Learning Where everyone identifies as a learner Opportunities for learning are everywhere at MedStar. From the first educational efforts of our undergraduate medical students to the perfecting of medical education by our most-seasoned faculty members, we aim to offer ample opportunities to learn.

LEARNING THROUGH SCHOLARSHIP

The MedStar-Georgetown academic enterprise is ever-expanding to support more student and faculty learning opportunities. Medical students from the Georgetown University School of Medicine (GUSOM) rotate through our hospitals for their electives in clinical education and are offered first choice on careershaping mentorship opportunities in research, innovation and clinical practice. As a result, many GUSOM students choose to go right across the street from their college campus to complete residency training at MedStar Georgetown University Hospital.

TRAINING TOMORROW’S PROVIDERS We operate one of the largest Graduate Medical Education programs in the county, training more than 1,000 medical residents and fellows annually. The resources we offer as a 10-hospital health system, coupled with our academic partnership with Georgetown University, make MedStar a unique place for residency. With more than 60 Graduate Medical Education (GME) training programs, ranging from neonatology to a spine injury fellowship, our GME experience offers something for everyone. Similarly, we have a robust Nurse Residency Training Program that incorporates research-based evidence linked to practice outcomes and individual development plans for Nurse Resident’s new clinical role.

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LEARNING THROUGH DOING Multiple Continuing Medical Education opportunities take place each week at our various clinical sites. These courses, lectures and conferences are aimed at enhancing the expertise of our clinicians, as well as sharing our own experts’ knowledge within the system and beyond. The next phase of learning at MedStar is to broaden the focus from continuing medical education to inter-professional education, planned by and for the entire healthcare system.

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This shift expands our educational offerings to serve more than just our physicians, creating new learning opportunities for our nurses, pharmacy technicians, quality improvement professionals, educators and stakeholders.

LEARNING ENVIRONMENT We aim to improve performance of our workforce by deploying a blended model of interactive online and face-to-face training,

3-D virtual simulation and handson, high-fidelity simulations, as well as performance support tools that can be used during the delivery of patient care. High-fidelity simulation centers in Washington, DC; Baltimore; and across the region in a mobile simulation lab ensure that our Simulation Training and Education Lab provides learning management for all 31,000 associates across MedStar Health.


TAKING SIMULATION FOR A SPIN Our vision is to make simulationbased learning accessible across our growing network of hospitals, ambulatory care centers, and physician offices. The MedStar Simulation Training and Education Labs use a fully equipped, 40-foot truck-based simulation laboratory with two simulation bays that can hold up to six learners each, two control

rooms, and a group debriefing space where learners can replay videos of their performance and discuss lessons learned. In its first year of operation the mobile lab was used to train more than 2,500 MedStar associates in quality, safety, teamwork, and communication skills.

When the mission is patient first, you don’t try first on patients™

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A Strong Foundation Patient Safety First for First-Year Residents

We believe our

Studies cite hospitals as dangerous places to be, with hospitalization leading as one of the top three causes of death in the United States. For new doctors, these statistics are especially frightening as many step out of medical school and onto hospital floors where the numbers are real people, families and situations.

Blackman, who died from a medical error. Helen led residents in smalland large-group discussions on rapid response, family-andpatient openness and overcoming report breakdowns in care. New resident orientation also covers universal precautions to avoid error, managing fatigue, high reliability and human factors in healthcare.

We saw an opportunity to address the anxiety and fear that surrounds the intern year of residency by having a pre-training experience for residents that orients them to our culture of patient safety. To drive home this message, we invited national patient safety advocate, Helen Haskell, to join MedStar at its inaugural system orientation and share the tragic story of her 15-year-old son, Lewis

In addition to the important patient-safety training MedStar provides its newest physicians, we also aim to give our residents a warm welcome with some fun social elements. Coined “Welcome Week,� we bring the residents from across our system to meet, network and make friends prior to the start of their training. Through this experience, we hope to provide a meaningful and memorable start to residency.

safety-first approach ensures our

residents feel equipped and confident prior to ever

seeing patients in a MedStar hospital or clinic.

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Raising the Bar Seeing and solving breakdowns in care With seven teaching hospitals at MedStar Health, residents and fellows care for close to 80 percent of our patients. From routine surgeries scheduled Monday mornings to emergency procedures in the middle of the night, it’s more than likely there is a resident present, not just observing but actively taking part in the scene. Quality improvement projects are a required component of most all of our residency and fellowship programs, compelling our physician trainees to actively engage in improving care delivery across our system.

IMPROVING THE TRANSPORT OF THE REGION’S TINIEST BABIES

For her Quality Improvement project, a third-year neonatalperinatal fellow at MedStar Georgetown University Hospital used her extensive experience on transport to improve assessments and interventions at the initial pickup of the smallest and sickest babies in the region.

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Identifying a need to improve the documentation used upon pickup, she developed a new checklist for the transport team. worked with a multidisciplinary team to train the entire neonatal transport group regarding stabilization for infants during neonatal transport, which led to a decrease in incidence of unintentional hypothermia and hypoglycemia during transport as well as improvements in the documentation of interventions related to these conditions.

TAKING A HARD LOOK AT MISTAKES THAT HAPPEN IN THE OPERATING ROOM

A fourth-year general surgery resident at MedStar Washington Hospital Center took a unique approach to the QI requirement, seeking to empower residents as agents of change by forming a Resident Process Improvement Committee to routinely run a root-cause analysis of near misses and medical errors that occur in the operating room. Serving as “eyes on the ground,” the Committee provides

detailed recommendations to the hospital’s General Surgery Practice Committee on steps that need to be taken to prevent such occurrences in the future. In instances where a resident is involved, the Committee recommends enhancements to education delivery, such as through new learning tools, extended instruction periods, and/or quality and safety training.


As first-hand witnesses to the everyday workings of our

hospitals, we empower residents to identify

and rectify any opportunities

for quality improvement.

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Learners to Leaders It’s always an honor when our trainees decide to begin their professional careers with us and they often bring with them a passion to mentor the next generation, same as they were mentored during residency. Eager to take the reins as leaders and give back to the body of knowledge that shaped their experiences, the cycle is an ever-spinning wheel of seeking to advance health. The Researcher: Dr. Jeffery W. Shupp

Research from the Ground-up When he was a resident in the MedStar Washington Hospital Center general surgery program, Jeffrey W. Shupp, MD, could not have imagined the amount of research the Burn Center would produce today. There was a paucity of funded research projects when he began his residency, until his mentor, Marion H. Jordan, MD, found some funding to provide Dr. Shupp a research coordinator. Now, 85 percent of people who walk in the Burn Center are eligible to participate in a research trial, whether it’s for a onetime blood draw or to receive regenerated skin. “Adding the research portfolio to the Center has really completed the multidisciplinary team we have here,” said Dr. Shupp, now Director of the Burn Center. “When I completed residency and people asked me why I wanted to stay, the reason was simple: having a robust research environment near where I practice clinically was 100 percent essential to my success academically.” By building the burn center research portfolio from the ground-up, Dr. Shupp has given back to the source of his own inspiration as a resident, and is able to serve the research interest of today’s trainees, all while advancing health of burn patients and beyond.

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Dr. Edmund Tori

Doctor’s Orders and the Power of Influence Edmund A. Tori, D.O., FACP, CH, was a Medical Director of the Cardiovascular Step-Down Unit at MedStar Union Memorial Hospital in Baltimore, MD, where he was responsible for running perioperative cardiac services. In that role, he listened carefully to what patients were saying – not just about their illness but about what mattered to them. He observed their actions – the adoring eyes of a man looking at his wife and then the man’s eyes casting down when the discussion turned to his smoking habit. By meeting his patients “where they were,” he was able to convince all but one to quit smoking. Now he is director over MedStar’s new Center for Health Influence and Engagement. The Center focuses oninfluence as a primary function of healthcare and howchanges in words, body language and other nonverbal communication can be used to effect positive changes in behavior. Influence is a learnable skill that involves applying proven principles and techniques to generate positive behavior, create stronger relationships, improve communication, and produce feelings of satisfaction and engagement. It is foundational to everything we do, from clinical care, patient engagement, performance transformation, professional leadership, research and education.

Dr. Princy Kumar

From One Generation to the Next The moment Dr. Princy Kumar arrived at Georgetown University in 1988 for an Infectious Disease Fellowship, she knew she found a special place, she says. Upon completion of her fellowship training, Dr. Kumar stayed on to become faculty and eventually became the Program Director, a decision she says helped her get to where she is today—recognized as the first woman in Georgetown University’s 100-year history to be inducted into the Golden Orchard, an honor shared by faculty whose dedication to teaching has earned them three or more Golden Apple Awards. Now, as Chief of the Division of Infectious Diseases and Travel Medicine as well as Senior Associate Dean for Student Affairs at the Georgetown School of Medicine, engaged in teaching, research, and clinical practice. Dr Kumar has been looked to as a role model because she has been able to succeed in the three pillars of an academic career – research, academics, and clinical practice. Professional accolades aside, a special moment in Dr. Kumar’s career was when her daughter, a Georgetown University School of Medicine graduate, found out she’d been matched into Medstar Georgetown University Hospital residency program. From one generation to the next, Dr. Kumar says she’s proud to A D V A N C I N G H E A LT H : L E A R N

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Resident Voices There is a tremendous amount of support for resident education, particularly the availability of attending physicians from all different specialties and their excitement to teach with a focus on evidencebased medicine. David A. Engorn, MD | Podiatry Surgery, PGY-3 MedStar Washington Hospital Center

I really love the exposure to world-renowned specialists in all fields – it’s a part of the daily routine at Georgetown and the Internal Medicine program’s affiliated clinical sites. Jason M. Redman, MD | Internal Medicine Resident, PGY-3 MedStar Georgetown University Hospital

I love that our program has a good balance of clinical and academic duties and the great cultural diversity that my colleagues add to my every day work. Elie Al Kazzi | PGY-1, Internal Medicine MedStar Union Memorial Hospital

I am attracted to the sheer breadth and depth of surgical experiences across a huge hospital system. As surgical, we receive a lot of hands-on experience, arguably the most of any residency program in the country. We are trusted early on for our clinical assessments and treatment. Manas Nigam | PGY-1, Plastic Surgery MedStar Georgetown University Hospital

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Leadership

“ MedStar Health’s vision is to be the trusted leader in caring for people and advancing health. We are fueled by a commitment to, and passion for research, education, innovation and safety.” Steve Evans, MD, Executive Vice President, Medical Affairs, and Chief Medical Officer

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“ Innovation is a fundamentally optimistic stance about the future: There is always a better way” Mark Smith, MD, Chief Innovation Officer, Director, MedStar Institute for Innovation

“ MedStar represents the crossroads between academics and real world medicine, where we advance medical knowledge and help people get better.”

Neil Weissman, MD, President, MedStar Health Research Institute

“Our mission is to support a transparent


Infrastructure

The MedStar Institute for Innovation (MI2) is unique among innovation centers that are embedded in health systems. MI2’s approach is to create an innovation ecosystem across MedStar Health that fosters the vast creative talent and energy of its 31,000 associates and 6,500 physicians. MI2 itself has developed deep technical expertise in human factors engineering, health influence and engagement, innovative learning and simulation, and digital health and data science. MI2 also serves as the portal for engaging outside startups and entrepreneurial collaborators to apply new ideas and innovative approaches to care for people and advance health.

“ The commitment to teaching and nurturing our next generation is critical to the success of our health system and to our mission of advancing health.” Jamie Padmore, Vice President of Academic Affairs

MedStar Health Research Institute (MHRI) provides scientific, administrative, and regulatory support for research funded by local, state, and federal government; private foundations; and private industry. The transformational nature of MHRI’s research – from bench to bedside to community – complements the key clinical services and teaching programs in MedStar’s hospitals and in the diverse communities MedStar serves. In the last year, more than 1,000 active studies resulted in more than 800 peerreviewed publications. MHRI is in the top 20% of U.S. institutions receiving funds from the National Institutes of Health and other federal agencies, with approximately 60% of its studies being federally funded. MedStar Health Academic Affairs has one of the largest graduate medical education programs in the country, training more than 1,000 medical residents and fellows annually. As the medical education and clinical partner of the Georgetown University School of Medicine, MedStar is committed to the culture of cura personalis, or “caring for the whole person,” and that extends to the whole community. Our vision is to continue our established culture of lifelong learning, where every member of our community identifies as a learner.

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An Investment Worth Making MedStar strives to improve the quality of medical care and the quality of life in the communities it serves. Our research, innovation and education advances are driven by the patients we serve. As doctors treat patients and see opportunities for advancing patient health, they work together with researchers, innovators and academics across the system to develop new and improved tools, methods, and treatment protocols. And because our extensive facilities and resources are embedded into the community fabric of Maryland and Washington, DC, we can bring proven discoveries and innovations quickly to the patients and share this knowledge with the next generation of doctors and nurses. MedStar continues to seek new ways to channel the creative energy that flows through our healthcare system into an infrastructure that best serves our patients, our associates and our community. We have amassed great minds, and with philanthropic partnership to invest in the vision now, the discoveries, innovation and learning will only happen sooner and with a larger global impact.

HELP MAKE OUR COMMUNITIES BETTER TOMORROW THAN THEY ARE TODAY.

Join us as we ADVANCE HEALTH.

www.medstarhealth.org


W E

A R E

Discover. Innovate. Learn.

1,000 research studies

Medical, education & clinical partner of GEORGETOWN UNIVERSITY

A D V A N C I N G

We have

10 HOSPITALS

and 300 CARE SITES supported by GME training programs in specialties

30,000 ASSOCIATES and 6,000

AFFILIATED

60+

1,000

peer-reviewed publications annually

$30 million research revenuie

PHYSICIANS

1,100 residents & fellows

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MedStar Health: Advancing Health  

MedStar Health: Advancing Health  

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