R E S E A R C H . I N N O VA T I O N . K N O W L E D G E . The power of enhancing clinical care.
TABLE OF CONTENTS 4
• ABOUT US
• SPECIAL FEATURE: MONROE CAMPUS
• SPECIAL FEATURE: MORAVIAN COLLEGE
24 • QUALITY
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President & CEO Richard A. Anderson Vice President, Marketing & Public Relations Ken Szydlow Editor-in-Chief Dorrit Trate Editorial Director Stephen Andrews Art Director Jen Rimonneau Research Contributors Tracy Butryn Stanislaw Stawicki Jill Stoltzfus Contributing Photographers Anne Kemp Anita Sergent Betsy Toole Contributing Writers & Designers St. Luke’s Marketing & Public Relations Department
MESSAGE FROM SENIOR LEADERSHIP ENHANCING CLINICAL CARE This is our mission and our imperative. At St. Luke’s, the daily work we do is powered by three things: research, innovation and knowledge. Research is the scholarly pursuit of new information, discovery or creative activity in any particular discipline with the goal of advancing that discipline’s frontiers or boundaries. As physicians, scientists and investigators in a university health network, we have research at our core, in fact, in our very DNA. Collectively, our faculty leads the region in clinical research, backed by millions of dollars in funding.
Jeffrey Jahre, MD
Innovation is the transformative application of better solutions that meet new requirements or unmet needs. Our physicians are early adopters of the latest promising technologies. They blaze new trails in the operating room. They trial new devices, medications and techniques. “First in the region, state, country and world” are not foreign concepts at St. Luke’s. Knowledge is the product of research and innovation… it is the understanding required to turn theory into practice. It is knowledge gained through research and innovation that allows us to enhance clinical care throughout our Network and beyond.
Jeffrey Jahre, MD Senior Vice President Medical & Academic Affairs
Stanislaw Stawicki, MD
Stanislaw Stawicki, MD Chair & Network Medical Director, Department of Research & Innovation
Research. Innovation. Knowledge. This is the essence of St. Luke’s and the power of enhancing clinical care.
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ABOUT US St. Luke’s University Health Network (SLUHN) is a nonprofit, regional, fully integrated, nationally recognized Network providing services at seven hospitals and more than 250 sites, primarily in Lehigh, Northampton, Carbon, Schuylkill, Bucks, Montgomery, Berks and Monroe counties in Pennsylvania and in Warren County, New Jersey. EASY. ACCESS. NOW. St. Luke’s University Health Network makes it as EASY as possible for you to access our health care services 24-hours-a-day, 7-days-a-week from the comfort of your home or the convenience of your neighborhood. No matter where you are in the Lehigh Valley, no matter when you need us... St. Luke’s will be there!
PRICE Anticipate your health care costs
Learn more about St. Luke’s Research & Innovation at research.sluhn.org. 4 • RESEARCH. INNOVATION. KNOWLEDGE. • RESEARCH.SLUHN.ORG
St. Luke’s University Hospital – Bethlehem
St. Luke’s University Health Network was named one of the nation’s 100 Top Hospitals® by Truven Health Analytics™, a leading provider of data-driven analytics and solutions to improve the cost and quality of health care.
BY THE NUMBERS
St. Luke’s Allentown Campus
St. Luke’s Anderson Campus
St. Luke’s Miners Campus
St. Luke’s Quakertown Campus w ! No en p O
St. Luke’s Warren Campus
St. Luke’s Monroe Campus
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RESEARCH “Research is creating new knowledge.” – Neil Armstrong
St. Luke’s University Health Network values research and clinical trials and is able to effectively provide therapies to its patients through experienced physicians as well as the centralized Department of Research & Innovation. RESEARCH INSTITUTE In September 1992, the Research Institute was founded in order to nourish the academic environment required by the accrediting body that certifies graduate medical education programs. Currently, the Research Institute serves as an internal resource to assist St. Luke’s University Health Network medical students; residents; fellows; attending physicians; nurses; and other administrative, clinical and managerial staff with their research-related needs, including: • Planning, designing and implementing research projects • Statistically analyzing data and summarizing results • Writing and editing abstracts, manuscripts and other documents • Providing lectures and workshops on various research topics • Assisting with grant writing CLINICAL TRIALS OFFICE The St. Luke’s University Health Network Clinical Trials Office is the clinical and administrative shared resource for the conduct and management of sponsored clinical research across SLUHN. This infrastructure ensures that both the clinical and administrative operations involved in clinical research are compliant and that the workflow between sponsors, physicians, clinical support staff and other ancillary departments is streamlined and efficient, thus leading to several notable achievements.
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Trial Categories include: • Critical Care • Emergency Medicine • Endocrinology • Heart and Vascular • Nephrology • Neuroscience • Oncology • Orthopaedics • Radiology • Trauma • Wound Care
“What’s most important is getting information to patients so they are educated enough to make a well-informed decision and most importantly, get the best care.” — Lee Riley, MD, PhD, FACS CLINICAL TRAILS
POST-DOCTORAL RESEARCH PROGRAM
Oncology Clinical Trial Now at St. Luke’s: Breakthrough Immunotherapy Study for Triple-Negative Breast Cancer
In 2015, SLUHN implemented a post-doctoral research program for doctoral-level applicants (e.g., DO, MD, PhD) to provide them with experience in designing and conducting research in a large health care system. During the first year of the program, two post-doctoral researchers were selected from a competitive pool of applicants: Thomas Wojda, MD and Kristine Cornejo, MD, MPH. Dr. Wojda’s and Dr. Cornejo’s accomplishments include publication in peer-reviewed journals, coordinating multiple externally sponsored clinical trials, giving keynote presentations at medical conferences and serving on Research Faculty Council subcommittees.
Among the trials we offer is the WO29522 metastatic triple-negative breast cancer study. St. Luke’s Cancer Center is one of only two sites in Pennsylvania selected by Genentech, a member of the Roche Group, to participate in this clinical trial to determine the efficacy and safety in using MPDL3280A (an Anti-PDL-1 antibody) in combination with nab-paclitaxel to treat patients with untreated triple negative breast cancer. Neuroscience Clinical Trial St. Luke’s University Health Network (SLUHN) was the only research site in Pennsylvania to participate in a pivotal neuromodulation clinical trial of an investigational neurostimulation system using Tonic and Burst Stimulation, which ultimately led to FDA approval in October 2016. This new, FDA-approved device was designed to reduce pain, improve patient satisfaction and allow reduced paresthesia (a tingling sensation associated with stimulation). It will also give patients access to a new technology as an alternative therapy method for chronic conditions such as back pain. This is a testament to how clinical trials conducted at SLUHN contribute to advancing health care by investigating and bringing new medicines, practices and technologies to the public. This is the type of cutting-edge research led by the SLUHN Clinical Trials Office and one of many contributions SLUHN has made to advancing medicine.
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RESEARCH cont. INDIVIDUAL HIGHLIGHTS Neil Belman, DO Neil Belman, DO, is a board-certified hematologist oncologist for St. Luke’s University Health Network. His clinical interests include hematology (anemia, thrombocytopenia), brain and nervous system tumors, lung cancer, lymphomas and leukemias. Dr. Belman also serves as an associate professor at the Temple/St. Luke’s School of Medicine. Instrumental in the development of the Lung Cancer Program and the Brain Tumor Working Group for St. Luke’s, Dr. Belman collaborates with thoracic surgeons, neurosurgeons and radiation oncologists. He believes a multidisciplinary team approach helps ensure patients get the most appropriate, state-of-the-art cancer care. Dr. Belman has an active interest in clinical research studies and heads many oncology clinical trials as the principal investigator. He is involved in several second-generation clinical trials with breakthrough immunotherapies that are promising better disease control and better tolerance for patients with small cell and non-small cell lung cancers, from early stage to advanced disease. The studies include stand-alone immunotherapy treatments, immunotherapies used in combination with chemotherapies or other targeted agents, maintenance immunotherapy for those patients already treated with chemotherapy and second-line targeted treatments for patients diagnosed with acquired mutation for advanced non-small cell lung cancer. These clinical investigations will provide insight into determining which patients will benefit most and also how new treatments may best be integrated with already existing protocols to extend life and improve quality of life. Bankim Bhatt, MD Bankim Bhatt, MD, serves as the chief of endocrinology and metabolism for St. Luke’s University Health Network. Board certified in internal medicine and endocrinology, Dr. Bhatt earned his medical degree from Eastern Virginia Medical School in Norfolk, VA. Dr. Bhatt completed his residency at the Washington Hospital Center in Washington, D.C. and a three-year endocrinology fellowship at the University of Pittsburgh School of Medicine. He is a clinical assistant professor of medicine at Temple University’s School of Medicine and is particularly interested in treating patients with diabetes. Dr. Bhatt has investigated the role of inflammation in the development of diabetes while conducting basic science research at
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Neil Belman, DO
Bankim Bhatt, MD
Stephen Kareha, DPT
Sudip Nanda, MD
the University of Pittsburgh. He has presented his findings at national meetings of the American Diabetes Association. Currently, he is involved in clinical research and actively pursues poster presentations at national meetings, the last being at the most recent AACE conference in Orlando, Florida. He is a fellow of the American Association of Clinical Endocrinologists (AACE) and a member of both the American Diabetes Association (ADA) and The Endocrine Society. Dr. Bhatt participates in several network committees such as the Inpatient Diabetes Performance Improvement Committee, Patient Safety Committee and the EPIC Documentation Integrity Team. Stephen Kareha, DPT Stephen Kareha, DPT, serves as the director of the orthopaedic physical therapy residency for St. Luke’s University Health Network. Dr. Kareha is committed to bringing the most promising studies to the Lehigh Valley. In addition, he is adjunct professor of physical therapy at Arcadia University and has been an invited speaker at multiple universities. Dr. Kareha has published a variety of diagnostic and therapeutic approaches to shoulder pain, most notably on scapular dyskinesis. Additionally, he has led efforts in the research of improving care for people with low back pain and chronic pain. Dr. Kareha serves as key member of the Shoulder Pain Module development committee for the National Orthopaedic Physical Therapy Outcomes Database, a national database developed by the Orthopaedic Section of the American Physical Therapy Association aimed at assessing and improving patient outcomes. Sudip Nanda, MD Sudip Nanda, MD, is a clinical cardiac eletrophysiologist with St. Luke’s University Health Network. In addition to clinical cardiac electrophysiology, he is board certified in cardiovascular medicine, nuclear cardiology, echocardiography and internal medicine.
In September 2016, he was the first physician in northeastern Pennsylvania to implant the Medtronic Micra Transcatheter Pacing System, the first FDA-approved leadless pacemaker. Dr. Nanda also performs ablations for atrial fibrilation, ventricular tachycardia and supra ventricular tachycardias. Dr. Nanda is also active in research, and is currently involved in a study searching for the pathogenesis of acute stress-related cardiomyopathy. Since 2008, he authored or co-authored more than 60 articles and abstracts in national and international journals. He serves on the editorial board of the International Journal of Academic Medicine and the Indian Journal of Medical Specialities. He has co-authored chapters of three books and has made more than 30 national and international presentations. Resident Bios Ronnie Mubang is a fourth year surgical resident at St. Luke’s University Health Network, who hails from Reading, England. He is currently the president of the resident organization at St. Luke’s. He has over 20 publications and is striving for more collaboration among various peer and hospital networks. He has presented both nationally and locally at various meetings including AAST, PACOT and will be presenting at the American College of Surgeons this year. Dr. Mubang has been linked to multiple online media for patient care advancement. Dr. Mubang believes the key to success stems from the passion to treat every patient with the upmost of care and most importantly like a family member. Julia C. Tolentino is a general surgery resident at St. Luke’s University Health Network and a graduate of the Temple/ St. Luke’s Medical School. Her project “Lung Cancer Screening in the Community Setting” was presented at the 2015 American College of Surgeon’s Clinical Congress. She was the winner of the 2016 St. Luke’s University Health Network Annual Research Symposium with “ComorbidityPolypharmacy Score: an Alternative Measurement of Frailty across Medical-Surgical Patients.” Dr. Tolentino will be presenting a project on the comorbidity-polypharmacy score in this upcoming ACS Clinical Congress.
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RESEARCH cont. DEPARTMENT HIGHLIGHTS Neuroscience St. Luke’s Brings Advanced Treatment Options to the Lehigh Valley St. Luke’s Center for Neuroscience continues to push the boundaries of what is possible to improve the quality of life for patients with neurological conditions. Under the leadership of Jonathan Hosey, MD, FAAN, chief of neurology and network chairman, Department of Neurosciences, St. Luke’s neurologists and neurosurgeons have brought cutting-edge procedures to the Lehigh Valley. Dr. Hosey conducts several research and clinical studies relating to stroke diagnosis, treatment and management. Dr. Daniel Ackerman, director of stroke and Jessica Heckenberger, MSN, RN, stroke program coordinator have established clinical trials in stroke care in addition to establishing Telestroke capabilities at all seven St. Luke’s University Health Network hospitals cutting the critical time for acute stroke consultation to minutes. Dr. Falowski was the first surgeon In addition, six St. Luke’s hospitals are Primary Stroke in the world to implant Medtronic’s Center-certified with the same protocols in place for our new St. Luke’s Monroe Campus. St. Luke’s has a team of full-body, MRI-compatible paddle four epileptologists and a cognitive neuropsychologist electrode leads for the Restore® that offer the highest level of epilepsy evaluation and neurostimulator system. treatment with the Epilepsy Monitoring Unit at St. Luke’s Bethlehem Campus. Steven Falowski, MD, chief of St. Luke’s functional neurosurgery is a nationally recognized leader in research, advancing functional neurosurgery to treat movement disorders and control pain. He was selected by global medical device company St. Jude to participate in SUNBURST (Success Using Neuromodulation With Burst), a clinical study of the Prodigy neurostimulator to evaluate whether burst stimulation technology can be more effective in managing chronic pain than traditional treatments. St. Luke’s is one of only 20 hospitals throughout the nation chosen to participate in the study. Hugh Moulding, MD, PhD, is the director of the St. Luke’s Brain and Spine Tumor Center. A multidisciplinary team of neurosurgeons, radiation oncologists and medical oncologists meet with each patient and together provide a comprehensive treatment plan that may include a combination of innovative surgical, medical and radiation oncology treatments.
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Oncology St. Luke’s is Aggressively Pursuing a Cure for Cancer As the local leader in cancer clinical trials, St. Luke’s offers patients access to the very latest in cancer care — testing breakthrough treatments that are giving patients new hope in their fight against cancer, while giving clinical cancer experts the opportunity to study their effectiveness. Immunotherapy is at the forefront of cancer treatment, harnessing the power of the immune system to fight cancer. Because of St. Luke’s extensive experience with immunotherapies, St. Luke’s knows how to best manage potential symptoms and side effects of immunotherapy treatments, as well as the expected rate of response. Looking forward, immunotherapies may replace some standard regimens of chemotherapy as they tend to be more effective, less toxic and better tolerated, often causing fewer and less severe side effects. Some immunotherapies work in conjunction with chemotherapies. St. Luke’s is often first, both regionally and nationally, to offer leading immunotherapies for many types of cancer. Working with numerous drug companies throughout the world, St. Luke’s carefully selects which trials to offer and can have a study open to patients at our cancer centers within 80 days of the trial becoming
available. The decision to participate is made by St. Luke’s team of cancer specialists. After a careful evaluation, St. Luke’s chooses only the most promising studies that offer the best response, opportunity for compliance and the fewest side effects. Trials are then awarded based on a visit from the sponsoring company and a thorough review and approval by the St. Luke’s Institutional Review Board (IRB).
Watch St. Luke’s cancer experts discuss how to access the latest and greatest cancer clinical trials with a focus on personalized cancer care and targeted therapies. Visit cancer.sluhn.org.
Learn more about St. Luke’s Research & Innovation at research.sluhn.org. THE POWER OF ENHANCING CLINICAL CARE • 11
RESEARCH cont. Community Health St. Luke’s is Building Healthier Communities Community Health Needs Assessment (CHNA) St. Luke’s conducted a Community Health Needs Assessment (CHNA) for the network, examining needs, especially among our vulnerable population. Additionally, St. Luke’s Cancer Center conducted a CHNA for Commission on Cancer accreditation. Our community intergrated process has been highlighted at the national, state and regional levels. St. Luke’s Adolescent Career Mentoring Initiatives In 1996, the Bethlehem Area School District conducted a district internal evaluation that concluded that the English as a Second Language (ESL) students not following an “academic track” were more likely to engage in high risk behaviors such as truancy, delinquency, unintended pregnancies and low academic achievement. As a result of this evaluation, St. Luke’s and the Bethlehem Area School District developed a partnership called the “School–to-Work Program.” Of the students who participated in the program, 95 percent went on to graduate high school. Employee Wellness Through its Caring Starts with You Employee Wellness/Population Health program, St. Luke’s is committed to health education, programming, policies and environment designed to encourage employees, patients and community about healthy living, disease prevention and supporting healthy behaviors in their lives. Employees can take advantage of advice and support for nutrition, Community Supported Agriculture (CSA) programs, fitness center discounts, reduced cost weight management programs,free tobacco cessation counseling and pharmacotherapy, stress management and one-on-one health coaching. AIDS Services Center The AIDS Services Center (ASC) at St. Luke’s delivers nationally recognized quality care through two clinic locations. The program has been featured twice in the National Quality Center’s newsletter, and won the St. Luke’s 2015 President’s Award for Quality Improvement for its Viral Load Suppression project. ASC offers HIV prevention programs, comprehensive clinical care and case management. It serves more than 270 clinical patients, almost 300 case-managed clients and tens of thousands of people with its prevention services and public education. ASC works closely with Temple Medical School and University faculty, medical students and residents.
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“Identifying areas that need to be improved and together implementing evidence-based programs is the key to positively impact the health and welfare of our citizens and future generations.” — Bonnie Coyle, MD Educational Partnerships The Health, Education and Resources Temple St. Luke’s (HEARTS) clinic was created by St. Luke’s Temple Medical School students as a way to increase access to care and help reduce health disparities in our community with a free clinic for the uninsured and underserved in Bethlehem. Lehigh University students work in partnership with Temple medical students and St. Luke’s physicians as coordinators for the health care team to identify barriers to care.
Hall of Fame pitcher, Steve Carlton hits the trail in support of the St. Luke’s Get Your Tail on the Trail Community Health program. This program is aimed at getting people off the couch and active. Participants are rewarded for hitting the trails and walking, biking or hiking. Traveled miles are recorded on the Tail on the Trail website and once certain milestones are reached, prizes are redeemed. The community-based program partners with the Delaware and Lehigh National Heritage Corridor and has been recognized at the national level as an innovative health and wellness program. For more information on this program visit tailonthetrail.org.
Adopt-A-School Model In an effort to continue to provide comprehensive service and coordinate care to improve student learning and overall health, St. Luke’s has created an Adopt-ASchool Model. This initiative with local school districts focuses on medical, dental and vision services. Through various partnerships, St. Luke’s also provides mental health services, healthy living initiatives, literacy programs and youth development.
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SPECIAL FEATURE: MONROE CAMPUS ST. LUKE’S MONROE CAMPUS St. Luke’s University Health Network has opened its newest hospital in Monroe County. This state-of-the-art facility, the first new hospital in Monroe County in 100 years, will provide patients with all-private rooms, cutting-edge technology and an expert staff. For area residents, the new location means access to the advantages of a large, university hospital-led network with the accessibility, convenience and compassionate care of a small community hospital. The four-story building features private spacious patient rooms, 12 beds for critical care, a 33-bed emergency room, a helipad, state-of-the-art operating rooms, a cardiac catheterization lab and advanced diagnostic technology like the GE Healthcare, wide-bore high-field MRI with Silent Scan. This system ensures excellent image quality, a larger opening and significantly less noise than traditional machines, making for a more comfortable MRI experience. As the region’s largest health care network, St. Luke’s strives to bring better health care to the community. The construction of the Monroe Campus fulfills that commitment. In designing the new hospital, St. Luke’s borrowed from the same architectural design as the Anderson Campus, which opened Fall 2011.
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“Together, we will provide exceptional care with the profound belief that the health and wellness of a community is integral to its growth and success.” — Don Seiple, President, St. Luke’s Monroe Campus Nestled in a beautiful, natural setting on 45 acres of land, St. Luke’s Monroe visitors, guests and employees will also be able to enjoy our walking paths in our natural setting. The creation of the walking paths demonstrates St. Luke’s commitment to providing care for the whole person: body, mind and spirit.
BY THE NUMBERS
“We have assembled a first-rate team of employees at this extraordinary facility,” said Don Seiple, president of St. Luke’s Monroe Campus.
Learn more about St. Luke’s Research & Innovation at research.sluhn.org. THE POWER OF ENHANCING CLINICAL CARE • 15
INNOVATION “Never before in history has innovation offered promise of so much to so many in so short a time.” – Bill Gates
From its founding in 1872, St. Luke’s has been at the forefront of innovation. From the first modern era surgeries to today’s most advanced hybrid operating rooms, St. Luke’s is committed to providing patients with unequaled technology, techniques and patient care. FIRST TO INTRODUCE NEW LASER PROCEDURE FOR BRAIN TUMORS St. Luke’s University Health Network is the first in the region to offer a new laser procedure that uses minimally invasive MRI-guided laser technology to target and destroy cancerous brain tumors. Visualase®, an MRI-guided laser ablation system by Medtronic, enables neurosurgeons to deliver laser energy through a hole with a diameter approximately the size of a coffee stirrer. The precision of the technology, also known as laser interstitial thermal therapy (LITT), allows the laser to destroy the tumor while minimizing harm to surrounding tissue. “This is an exciting breakthrough in the treatment of brain cancer,” says Hugh Moulding, MD, PhD, chief of St. Luke’s department of neurosurgery and clinical director of the St. Luke’s Brain and Spine Tumor Center. “We are now able to treat tumors previously considered inoperable because the accuracy of laser technology allows us to reach lesions deep into the brain and even near sensitive areas.” Dr. Moulding is the only physician in the Lehigh Valley and surrounding areas performing the procedure. Due to its minimally invasive nature, patients are discharged within a day of their procedure — much sooner than patients who have had traditional, open surgery. In addition, laser ablation patients report experiencing fewer side effects than those receiving open surgery.
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BRINGING THE WORLD’S SMALLEST PACEMAKER TO THE REGION St. Luke’s University Health Network is the first in northeastern Pennsylvania to install the world’s smallest pacemaker. This revolutionary technology is the first FDA-approved leadless pacemaker. Comparable in size to a large vitamin, the Micra can be placed via a minimally invasively procedure through a catheter and can pace the heart for up to 12 years. The cardiac electrophysiologists at St. Luke’s University Health Network are dedicated to delivering the most state-of-the-art treatments available for heart rhythm disturbances.
St. Luke’s has been named a GE Healthcare National Show Site for Women’s Imaging, one of only seven in the nation.
NATIONALLY RECOGNIZED BREAST SCREENING PROGRAM St. Luke’s offers low-dose 3D mammography (tomosynthesis) with SensorySuite® that allows women to have a calming, interactive experience during their mammogram. Women also may benefit from automated breast ultrasound (ABUS) technology that produces a clear, accurate evaluation of dense breast tissue without radiation. Nationally recognized for his leadership role in the women’s imaging movement is Joseph Russo, MD, section chief of women’s imaging. Under his guidance, St. Luke’s created an individualized breast screening protocol that is based on family history, age and health. Effectively using breast screening tools based on a patient’s unique needs can lead to a significant increase in cancer detection rate while reducing the need for a return visit or an unnecessary breast biopsy. Interestingly, St. Luke’s has reported breast cancer detection rates that are higher than the national average.
The Micra device provides the unique capacity to pace a heart, and not interfere with veins of either arm, which could cause serious complications in post–mastectomy patients. Another benefit of the Micra TPS is patients may receive full-body magnetic resonance imaging (MRI) scans, which is not possible for individuals with many traditional pacemakers. Should the Micra ever need to be removed, the Micra design incorporates a retrieval feature, but it may also be left in the body. For patients who need more than one device, the miniaturized Micra TPS has a unique feature that enables it to be permanently turned off. As a result, it can remain in the body and a new device can be implanted without risk of electrical interaction.
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INNOVATION cont. MEETING THE UNIQUE CHALLENGES OF OLDER ADULTS St. Luke’s University Health Network provides a positive aging experience for older adults in the community through specialized services and care designed especially for seniors. Recognizing that with age comes unique needs and challenges, St. Luke’s is committed to helping seniors and caregivers get the most out of life by offering programs, classes and tools designed by geriatric specialists.
ACE Consults – Inpatient, Trauma, Virtual The Acute Care of the Elderly (ACE) is a specialized program that addresses the needs of hospitalized older adults. The multidisciplinary team approach prevents functional and cognitive decline, while improving outcome and satisfaction. The ACE program identifies older adults at risk and creates an individualized care plan to reduce hospital complications, length of stay, delirium rate and unnecessary medication use. Geriatric Outcome Database Clinical pathways implementation is one of the key elements to improve quality in skilled nursing facilities. The evidence-based and medically driven pathways reduced the length of stay by 50 percent in skilled nursing facilities in St. Luke’s service area. NCQA St. Luke’s University Health Network is the region’s leader in patient-centered care. Patient Centered Medical Home is a proactive, evidence-based approach to the delivery of coordinated patient care. It promotes quality standards and personal relationships through a patient-centered focus.
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Hospital Primary Care Education Specialty Service Nursing Home
Adult Medical Daycare St. Luke’s offers the first and only adult medical day care in the region. The Comfort Zone provides medical and social services in a safe, secure environment for people age 60 and over. On-site services include traditional assisted living accommodations as well as coordination with outpatient services and other health care needs. Outpatient Geriatric Assessments Geriatric assessments provide a comprehensive evaluation of an older adult’s physical, social and cognitive health, as well as the needs of the caregiver. A multidisciplinary team of geriatricians, social workers, physical therapists and nurses assess each person’s individual needs and develops a care plan that is then shared with the client, family and family physician. Geriatric Surgery Through our comprehensive Senior Surgical Services Program (SSSP) designed for seniors, our senior care surgery coordinator works closely with a team of health care providers. St. Luke’s is the second hospital in the region to implement the SSSP and has improved post operative hospital length of stay, re-admission rate and a zero fall rate over two years.
Geriatric Fracture Program The Geriatric Fracture Program (Own the Bone) at St. Luke’s University Hospital is dedicated exclusively to the care of older patients with fractures. Each patient follows a clinical pathway that will manage pain and reduce time spent waiting for surgery. This approach helps patients achieve faster and fuller recovery. Our comprehensive and interdisciplinary teams work together to provide the highest level of care available. St. Luke’s was recognized in US News and World Report’s 2017 Best Hospitals edition as a star performer with the Own the Bone initiative. Fellowship With the rapid growth of the United States’ aging population and with the concurrent decline in the numbers of licensed geriatricians, it is our program’s goal to dedicate our professional lives to care for older adults and to educate Geriatric Fellows to achieve expertise in: • Providing clinical care for seniors living in the community and in skilled nursing facilities • Managing and preventing geriatric syndromes • Developing practice models and better care for older adults • Evaluating cognitive deficits while preparing complex treatment plans
Older Adult Behavioral Health Unit St. Luke’s opened a special Older Adult Behavioral Health unit. A geriatric-trained psychiatrist, a gerontologist, medical-surgical nurses, mental health technicians, case managers and activity therapists staff the unit. In addition to treating patients’ behavioral health conditions, the team also addresses the medical health concerns that often accompany advanced age, such as diabetes, hypertension and heart disease.
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INNOVATION cont. FIRST IN THE WORLD TO IMPLANT STIMULATOR St. Luke’s functional neurosurgeon, Dr. Steven Falowski, was the first surgeon in the world to implant Medtronic’s full-body, MRI-compatible paddle electrode leads for the Restore® neurostimulator system. According to Medtronic, studies show that 82 percent of patients implanted with a spinal cord stimulator are expected to need an MRI within five years of receiving their implant. St. Luke’s is among the first hospitals in the nation to offer full-body MRI imaging to patients with Medtronic Deep Brain Stimulation systems. According to Dr. Falowski, seven of 10 DBS-eligible patients may need an MRI within 10 years of receiving their device and 62 percent of all MRI examinations for DBS-eligible patients with movement disorders are in regions of the body other than the head. FIRST IN THE REGION TO OFFER DISSOLVABLE STENT St. Luke’s Heart & Vascular physicians are the first in the region to offer Abbott’s Absorb™, the recently FDA-approved dissolving cardiac stent. The bioresorbable vascular scaffold is a major advance in the treatment of coronary artery disease, which affects 15 million people in the United States. This advanced technology gives our medical team even more of an edge as we offer our patients the best possible options for their treatment. We continue to be at the forefront of cardiac medicine, translating into that on which we pride ourselves most: top quality, individualized care for our patients in a personalized setting.
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SPECIAL FEATURE: MORAVIAN COLLEGE
St. Luke’s University Health Network and the Department of Rehabilitation Sciences at Moravian College have partnered to develop collaborative graduate and post professional programs in athletic training (AT), occupational therapy (OT) and physical therapy (PT) to deliver a truly inter-professional educational experience in an environment modeled after the best practices in clinical settings. A master of science in athletic training program (MSAT) was launched in June 2016 while a doctor of occupational therapy (OTD) is scheduled for launch in June 2017. Future program development includes a doctor of athletic training (DAT); doctor of physical therapy (DPT); doctor of rehabilitation sciences (PhD); and master of science in speech language pathology. This program is one of only eight in the country with a rehabilitation sciences program that places athletic training, occupational therapy and physical therapy under one administrative and physical roof. The new Sports Medicine & Rehabilitation Center on the Moravian College campus features specialized labs to promote collaborative learning across all three disciplines.
St. Luke’s helps complete the inter-professional model of health care education and enrich the learning environment through its use of physicians, nurses, ATs, PTs, OTs, CSCSs, exercise physiologists and other sports and rehabilitation experts who practice their skills in the field as well as teach others. The inclusion of St. Luke’s patient-care facilities and state-of-the-art equipment in this building will allow students to complete both didactic and clinical observation/education in the same location. Students will benefit from Moravian’s combination of entrepreneurial spirit and unique curricular structure, and St. Luke’s 140-year history of meeting the needs of the community and clinical innovation. Students will work closely with faculty members, health care professionals and fellow students in a setting that will foster the highest level of learning and engagement across multiple disciplines. St. Luke’s and Moravian College have a long and successful history of collaboration and partnership.
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KNOWLEDGE “The only source of knowledge is experience.” – Albert Einstein
An exceptional commitment to the advancement of medical education has been a core St. Luke’s focus since its inception in 1872. St. Luke’s is one of only 400 members of the prestigious Council of Teaching Hospitals. MEDICAL EDUCATION Temple/St. Luke’s School of Medicine St. Luke’s and the Lewis Katz School of Medicine at Temple University partnered to develop the first and only medical school campus in the Lehigh Valley. The second class graduated on May 13, 2016 in Philadelphia and went on to match at St. Luke’s University Health Network as well as other prestigious institutions. These include Duke University Medical Center, Hershey Medical Center/Penn State, Kaiser Permanente, Pennsylvania Hospital, Temple University Hospital and University of Pittsburgh Medical Center.
• 120 medical students • Average MCAT: 31.59
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School of Nursing Additionally, St. Luke’s School of Nursing is the nation’s oldest operating nursing school. The fully accredited, 20-month program currently enrolls 150+ students. Graduate Medical Education Health care education is a major focus of St. Luke’s University Health Network. Teaching staff hold faculty appointments at Temple University, The University of Pennsylvania and Philadelphia College of Osteopathic Medicine, Johns Hopkins University and East Stroudsburg University of Pennsylvania. St. Luke’s International Surgical Studies Program A newly restored St. Luke’s ambulance embarked on a 5,000 mile journey to Mbingo Baptist Hospital in Cameroon, Africa this summer as part of St. Luke’s International Surgical Studies program. St. Luke’s surgeons and residents rotate at the African hospital to learn, teach and save lives. Patients of Mbingo currently walk, hitchhike or ride in the backs of trucks to reach the hospital — the donated ambulance will be the hospital’s first. Read more on our blog, stlukesabroad.wordpress.com.
BY THE NUMBERS
To view the full Research. Innovation. Knowledge. 2016 Annual Report please visit research.sluhn.org.
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QUALITY “Quality is not an act, it is a habit.” – Aristotle
THORACIC The Division of Thoracic Surgery at St. Luke’s is strongly committed to excellence in clinical care, quality improvement, research and teaching. William Burfeind, MD, chief of thoracic surgery, and Matthew Puc, MD, participate in both national and international clinical trials to advance the fight against lung cancer. In fact, St. Luke’s was the largest enroller of patients in an international trial examining a specialized sputum test to detect lung cancer noninvasively. Drs. Burfeind and Puc have also championed St. Luke’s efforts to encourage at risk patients to have lung cancer screenings after a 2011 National Institutes of Health clinical trial showed its effectiveness in identifying early-stage tumors. Shortly thereafter, St. Luke’s began providing low-cost lung cancer screening CT scans for present or past heavy smokers between the ages of 55 and 74. More than 1,500 people were screened and cancer was found in one of every 100 people, compared with 1 of 320 in the national trial. Of those who were found to have lung cancer, half were early stage, underwent minimally-invasive resections, and are cancer free today as a result. Drs. Burfeind and Puc have shown their dedication to quality improvement through their decade-long participation in the Society of Thoracic Surgeons General Thoracic Surgery Database. Programs that participate in the database have significantly lower death and complication rates for lung and esophagus cancer operations than non-participating programs. Even when compared with other database participants, St. Luke’s consistently performs better than expected.
Thoracic Surgery at St. Luke’s is strongly committed to excellence in clinical care, quality improvement, research and teaching.
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“Our goal is to optimize outcomes, provide the highest level of care, support our patients throughout their journeys — and do it all while looking for efficiencies and areas to contain costs.” — Leonardo Claros, MD BARIATRIC Patient outcomes and best practices are top priority at St. Luke’s Weight Management Center, led by medical director Leonardo Claros, MD and co-medical director Maher El Chaar, MD. With an average of 500 surgical cases a year, the center’s outcomes for mortality, readmission and length of stay far exceed national averages and offer insight into the very best clinical approaches.
center and elsewhere, the objective was to compare LRYGB vs LSG in terms of safety profile and weight loss. Different from other published studies comparing weight loss, we went a step further in stratifying patients from the LSG group by initial BMI. “Our analysis showed that there was a statistically significant negative correlation between initial BMI of LSG patients and percent EWL achieved at 3, 6, 12 and 24 months (r=-0.13 to -0.41, p<0001).
“Laparoscopic Sleeve Gastrectomy Versus Laparoscopic Roux-En-Y Gastric Bypass: A Single Center Experience with two years Follow-Up,” published in Obesity Surgery (2014) was authored by Dr. El Chaar, Dr. Claros and others. With increasing requests for the sleeve gastrectomy in our
With these findings, we are able to better counsel our patients with high BMI on the expected weight loss difference between LRNYGB and LSG. This chart, in addition to the patient’s individual comorbidities, is used by our surgeons and dietitians when discussing procedure choice.
r. El Chaar recently published D a book answering the 40 most frequently asked questions about weight-loss surgery for patients who have already had surgery and for those considering surgery.
Dr. Claros hosts a radio show for Spanish-speaking community members that features specialists from around the network.
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QUALITY cont. SENIOR SERVICES The St. Luke’s University Health Network Senior Surgical Service Program (SSSP), which uses a Geriatric Nurse Navigator (GNN) to guide older adults throughout the surgical process, shows promise in reducing length of stay and re-admissions, according to a recent study. The study compared St. Luke’s geriatric surgical data with the outcomes experienced by program participants. The GNN performs a comprehensive assessment via the Pre-Operative Geriatric Assessment Tool (POGAT) that identifies each patient’s individual needs. Assessment areas include: • Nutrition evaluation • Cognitive assessment (Mini-Cog→) • Railty • Depression screening • Medication/pain management • Functional performance • Caregiver burden • Gait and mobility The SSSP participants had an average length of stay of 3.71 days, as compared with 6.52 days for the same population that were not enrolled in the program. Similarly, the program participants had an average readmission rate of 5.28 percent, as compared with 13.4 percent for those geriatric patients not enrolled. ORTHOPAEDICS Acute Kidney Injury (AKI) is associated with increased mortality, length of stay and hospital costs. Patients are also at an increased risk for chronic kidney disease after experiencing AKI. Looking to improve quality patient outcomes in the orthopaedic total joint population, we identified an effort to reduce the AKI rate and improve patient outcomes. A multidisciplinary taskforce was formed to evaluate our risk-screening process pre-operatively and during postoperative management. Pre-operatively, interventions include evaluating GFR rates, implementing consistent nephrology consults for patients at risk for AKI, evaluating and discontinuing of NSAIDs and specific antihypertensive medications and implementing recommended guidelines for patients having bilateral knee surgery. Post-operatively, a protocol was initiated to ensure appropriate management of NSAIDs and antihypertensive medication, fluid resuscitation and close post-operative monitoring.
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“Our passion to provide the best care possible will drive us to not only maintain our achievements in quality but surpass them with new and innovative ways to deliver cutting edge care to our youngest patients.” — Jennifer Janco, MD With additional decision support from EPIC and overall dedication from the taskforce, we were able to eliminate AKI in both August and September of 2016 for all total joint patients at Bethlehem. We continue to track our pre-operative and post-operative patient outcomes and identify areas of opportunity and improvement. NEONATAL INTENSIVE CARE UNIT St. Luke’s participates in the Vermont Oxford Network (VON), an international database consisting of more than 1,000 hospitals throughout the US and other countries. Participation allows St. Luke’s to assess our performance in comparison to other national (and international) NICUs. St. Luke’s is also now part of the micro–premie collaborative with the VON.
The mirco-premie collaboration consists of a select group of 10 hospitals that are working on improving outcomes in the smallest of premature babies — those weighing less than 1,500 grams. A comprehensive team of various specialists and subspecialists, and, at times the parents of the babies, are working together with the VON to use evidenced-based and innovative methods to improve outcomes. The initial goal of the program was to achieve appropriate admission temperatures. In 2016, 100 percent of babies attained target temperature ranges and St. Luke’s has presented their data at the VON annual conference.
AWARDS At St. Luke’s, our vision is to lead the region in clinical quality and safety performance. St. Luke’s has been honored with more than 120 health care quality awards including, but not limited to:
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RESEARCH.SLUHN.ORG 2016 EDITION