MUSC Catalyst 12-12-2014

Dec. 12, 2014

MEDICAL UNIVERSITY of SOUTH CAROLINA

Vol. 33, No. 17

Inside Marine Ball creates Cinderella moment State

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ProviSoS

State provisos change standard of care for uninsured.

trauma nurSe Program

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Trauma nurse program sets MUSC apart.

2 Around Campus 5 Meet Ashley 11 Dental Day t h e C ata online

ly S t

http:// www.musc. edu/ catalyst

By Dawn Brazell Public Relations

K

endra Crosby looks fabulous in red.

And, she loves nothing more than to be flying through the wind on the back of one of her four horses, something she misses as it has taken much of her energy to get through multiple surgeries and several rounds of chemotherapy.

That she looks great in red is a new find, but then again, Crosby is only 20. It can take time for women to know these things about themselves, particularly as she is more at home on a horse than in a ballgown.

Crosby got a chance to learn just how good she looks in red at the recent Marine Ball Nov. 22 at the Francis Marion Hotel. Marine Cpl. Terry Profit asked officials at the Medical University of South Carolina’s Hollings Cancer Center if there was a young cancer patient who might enjoy attending the upcoming ball, and Crosby came to everyone’s mind.

The two got to meet just before the ball when Profit made a visit to the hospital where Kendra was receiving treatment, and they set up details for the big night. Profit told her how much he was looking forward to the ball.

“You’ll be my personal guest of honor,” he said, decked out in his dress blues uniform, his hat in hand.

“Thank you so much. I’m so honored,” she said. “I tweeted about it.”

Profit smiles shyly, uncomfortable being in the

Photo by Sarah Pack/Public Relations

Marine Cpl. Terry Profit visits patient Kendra Crosby during one of her hospital stays. Below, they enjoy the Nov. 22 Marine Ball at the Francis Marion Hotel. limelight. “You’re fighting a way bigger battle than I’ve ever thought of. I have a lot of respect for someone who’s actually fighting for your life. You are motivation for me.”

“You’re awesome,” she said, obviously touched. “It’s cool to meet someone who understands it’s a hard fight.”

And that’s what happens when two people with big hearts first meet.

Profit, 28, went to boot camp Oct. 10, 2011, to honor his uncle who was a Navy Cross recipient and died in Vietnam. The North Charleston native plans to be a drill instructor and said he wrestles with managing his temper at times.

He’s quick to say he’s no hero.

“I just want to make better leaders in the military and then in the civilian world,” he said of his plans to be a drill instructor.

He’s an interesting mix of tough and tender. “I want to become the person my grandmother wanted me to be. She was a very humble person — very even– keeled,” he said.

Meeting Kendra was inspiring to him. “It seems she’s upbeat even with what she’s going through.”

That’s the sentiment of her friends and many of those involved with her care at MUSC. Crosby found out she had cancer at her first gynecological exam

See CinDerella on page 7

Photo Provided

2 The CaTalysT, Dec. 12, 2014

PeoPle

Around Campus

Mark S. George

ARROW Faculty Award

Mark S. George, M.D., distinguished professor of Psychiatry, Radiology and Neuroscience and the Layton McCurdy Endowed Chair, took part in President Obama’s BRAIN Initiative at the White House in November.

George, who was recognized for his transcranial magnetic stimulation research as a treatment for depression, received a NARSAD grant from the Brain & Behavior Research Foundation.

George Whitener

George Whitener, M.D., is an assistant professor in the Department of Anesthesia & Perioperative Medicine.

Whitener is a graduate of UNC-Chapel Hill School of Medicine and completed both an anesthesiology residency and cardiothoracic anesthesiology fellowship at Brigham and Women’s Hospital in Boston. Since 2011, he has worked as a clinician and educator at

Editorial of fice MUSC Office of Public Relations 135 Cannon Street, Suite 403C, Charleston, SC 29425.

843-792-4107 Fax: 843-792-6723

Editor: Cindy Abole

catalyst@musc.edu Catalyst staff: Mikie Hayes, hayesmi@musc.edu Dawn Brazell, brazell@musc.edu J. Ryne Danielson, daniejer@musc.edu Helen Adams, adamshel@musc.edu Sarah Pack, packsa@musc.edu Jeff Watkins, watkinsj@musc.edu

evenTs

photo by Noni Langford, Engineering & Facilities-Grounds

MUSC’s Arbor Day celebration on Dec. 3 at the Horseshoe featured a nature-themed vendor fair with local businesses, MUSC Go Green and the Urban Farm, Charleston County Parks and Healing Farms. The MUSC Arboretum staff sold 140 poinsettias that were grown by one of MUSC’s bedding plan nursery vendors. Money from the poinsettia sales will be used to support the Arboretum. Read more about the MUSC Arboretum by visiting its Facebook page.

Duke University Medical Center and is nationally recognized for his expertise in intraoperative echocardiography.

Stephanie Whitener

Stephanie Whitener, M.D., is an assistant professor in the Department of Anesthesia & Perioperative Medicine.

Whitener is a graduate of Clemson University and went on to complete her medical school at UNC-Chapel Hill.

She later completed her residency The Catalyst is published once a week.

Paid adver tisements, which do not represent an endorsement by MUSC or the State of South Carolina, are handled by Island Publications Inc., Moultrie News, 134 Columbus St., Charleston, S.C., 843-849-1778 or 843-958-7490. E-mail: sales@moultrienews.com.

at Brigham and Women’s Hospital followed by a fellowship at Massachusetts General Hospital.

Before joining MUSC, Whitener worked for several years as a clinician and educator at Duke University Medical Center.

MUSC’s ARROW (Advancement, Recruitment and Retention of Women) Initiative, formerly the Women Scholars Initiative, will honor the 2014 Advancement of Women Award winner, Rosalie Crouch, Ph.D., Distinguished University Professor, Department of Ophthalmology. This annual award recognizes a member of the MUSC community who has made outstanding contributions to the university through championing the advancement of women faculty at MUSC. The ceremony and reception will take place from 4 to 5:30 p.m., Thursday, Dec. 18, Colcock Hall lobby.

Fall Craft Vendor Sale Come out and finish your holiday shopping at the 2014 Fall Vendor Craft and Food Extravaganza, Dec. 11-12 in the MUSC Portico and Horseshoe.

Santa’s Workshop Santa’s Workshop and the Salvation Army are in need of volunteers to organize donated toys from MUSC’s Angel Tree and other Tri-county donations. Volunteers are needed from 9 a.m. to 5 p.m., Monday through Saturdays and 1 to 6 p.m., Sunday, until Dec. 16. For information, call The Salvation Army, 763-9881 or email Jennifer_Richmond@uss.salvationarmy.

Holiday Break The Catalyst will not be published Dec. 26 or Jan. 2 and will resume publication Jan. 9. For information, call Cindy Abole at 792-2795 or email catalyst@musc. edu.

For advertising information, call the Moultrie News at 958-7480 or email sales@moultrienews.com.

The CaTalysT, Dec. 12, 2014 3

Cyber Security awareness wrapup, winners announced

By Dan Furlong OCIO October was National Cyber Security Awareness Month, and MUSC hosted a month-long effort to raise awareness about the cyber threats that face us each day. The importance of staying aware of cyber security, however, does not end in October. We must remain vigilant throughout the year in order to protect our patients, employees and students.

National Cyber Security Awareness month was a big success, with more than 4,400 people signing pledges promising to follow good security practices.

Pledge names were entered into various drawings including two lucky employees who won new iPad Air 2 tablets. Frank Clark, Ph.D., and Dan Furlong presented Melanie Feaster, Ambulatory PACU R.N., and Jonathan Heywood, Rheumatology & Immunology research specialist, with their new iPads on Nov.14. We also had 50 winners of $10 gift cards and 25 winners of $20 gift cards — all redeemable at the medical center cafeterias or our on–site Starbucks. All winners have been notified of their good fortune.

Please remember some basic cyber safety tips: q Always lock your devices when not in use q Refrain from clicking on hyperlinks in suspicious

Winners of OCIO’s pledge campaign for the iPad Air 2 tablet drawing were Melanie Feaster, Ambulatory PACU, left, presented by Dan Furlong, and Jonathan Heywood, far right, Rheumatology & Immunology, presented by Dr. Frank Clark. emails q Never reply to an email asking for a password q Don’t use the same password for your MUSC account as for your personal accounts q Avoid storing non-encrypted files on local, removable or cloud-based drives

q Install MDM on any mobile device used to access MUSC systems, including email q Password protect all mobile devices A big thank you goes out to the following people who helped make the October initiative a success: Ryan Tober, Melanie Richardson, Molly O’Quinn, the OCIO Project Management Office interns, the Clinical Informatics team, the Epic Training team, and Jennifer Paige. Without them, the initiative would not have been such a huge success.

Be sure to continue visiting our web page http:// www.BeginsWithMe.musc.edu where you will find more tips and tools to improve the security of your work and home computer systems, smartphones, and other digital devices. If you have any comments, questions or suggestions on how to improve cyber security at MUSC, please send them to BeginsWithMe@musc.edu.

Survey finds 20,000 sexual assault victims in the military By helen aDams Public Relations

A government-commissioned survey found that about 20,000 of the U.S. military’s 1.3 million active-duty members experienced one or more sexual assaults in the past year.

Dean Kilpatrick, Ph.D., director of the National Crime Victims Research & Treatment Center at MUSC, helped create the survey. He’s a longtime expert on research on sexual assault and rape.

He said getting solid data is the starting point in being able to effect change.

Previous surveys were criticized for asking confusing questions. So for the 2014 survey, the Pentagon asked the independent RAND Corporation to step in. Kilpatrick joined RAND’s team to help ensure that the questions were clear. About 170,000 service members, or 30 percent of the 560,000 invited,

answered questions for the RAND Military Workplace Study, one of the largest of its kind.

It found more than 4 percent of activeduty women and 1 percent of active-duty men were sexually assaulted during the past year. Only about a quarter of them reported the attacks, but that was an increase from the 2012 reporting rate of 10 percent.

The Pentagon released a statement: “The importance of this upward trend in reporting cannot be overstated.”

The survey also showed the complexity involved in the decision to report an assault. It found 62 percent of women who reported unwanted sexual contact felt social retaliation from peers or coworkers.

The survey also provided a big-picture view of how sexual assault affects different branches of the military.

The Air Force has the lowest rate. The Marines and Navy have the highest.

Dr. Dean Kilpatrick explains his research results.

Kilpatrick, a professor and vicechairman for research in the Department of Psychiatry and Behavioral Sciences at MUSC, helped formulate survey questions and served on the scientific advisory board for the RAND team.

“You have to take the legal elements of sexual assault crimes and translate them into understandable English so people can understand what you’re talking about,” Kilpatrick said.

The president asked for a preliminary report by the first of December.

Kilpatrick said his team worked quickly but carefully.

“The most important thing was everybody wanted to get it right,” Kilpatrick said.

He thinks they did.

“I’m very pleased with the product,” Kilpatrick said. “Lord knows when you do research in an area that has such incredible political and public policy interest, it’s different than doing other kind of research.”

Now that the results are out, the analysis will shift to the reasons behind the findings. Kilpatrick said people can “cherry-pick” the numbers, but the survey provides a solid foundation that everyone can return to.

“Data to some degree, especially if you present them in a balanced way, keeps us honest. I get some respect for being a good scientist and being careful and not over-interpreting things. I’m opinionated too, but it’s the data that keep you honest.”

Kilpatrick said he’s proud and honored to have been included on the military sexual assault research team.

View the complete Pentagon report on sexual assault in the military at http:// www.rand.org/surveys/rmws.html.

4 The CaTalysT, Dec. 12, 2014

MUSC Medical Center Communications Corner Medical Center Year in Review

The 2014 year was monumental for the medical center. Thanks to contributions from our employees, we went live with our electronic health record system, Epic, developed new MUSC Health values and standards of behavior, kicked off the historic Diversity & Inclusion strategic planning process for the entire MUSC community and within the medical center, and made significant progress in our Quality and Transparency efforts. We served more than 36,000 inpatients and a total of more than 1 million outpatient visits. All of these things embody MUSC Health’s mission to “improve health and maximize quality of life through education, research, and patient care;” and none of these achievements would have been possible without the unwavering passion and dedication of our medical center team members. Here are a few medical center highlights from calendar year 2014. Thank you for a great year!

muSC had an ePiC Summer

July came in with a bang as the Hospital, Access and Revenue Cycle areas, and Clinical Research successfully adopted Epic as their integrated electronic health record — joining the Ambulatory Care clinics that have been using the software system since 2012. By having an integrated EHR such as Epic, patient safety increases, clinical communication advances, and overall documentation improves. More than 7,650 employees were trained to use one or more of the 21 new applications launched with Epic Enterprise. The Epic team continues working on improvements and enhancements for users. More features will also come with a system upgrade scheduled for May 2015.

ConneCting to PurPoSe through miSSion, viSion and valueS Important strides have been made in creating organizational alignment through our mission, vision, values and standards of behavior. This renewed focus will help us connect our daily work to a higher purpose, align our strategies for the future and foster a culture of shared accountability.

This work was only possible through significant engagement across the organization, involving hundreds of employees, leaders, and physicians. Beginning with MUSC’s Mission and Vision statements, we clarified our core purpose and vision for the future. Then, a team of leaders and employees reviewed MUSC Health’s organizational values, identifying new values aligned with our mission and vision. Departmental leaders and their teams also redefined their own departmental mission and vision statements.

In late August, leaders began working together in over fifty work teams to define behavioral standards, ensuring that our standards of behavior help us “live our values” in our daily work.

Fourteen employee focus groups and committees involving over one-hundred employees provided their input on these new standards of behavior. The new standards of behavior will be introduced to the organization in 2015.

MUSC Mission — We improve health and maximize quality of life through education, research, and patient care.

MUSC Vision — MUSC will be nationally recognized as a premier academic medical center.

We will change what’s possible by relentlessly transforming expertise, learning and discovery into unrivaled care. As the state’s leader in advanced care, we will improve the health of South Carolinians. Interdisciplinary teamwork, coordination and accountability across our unified clinical enterprise will generate the performance and resources that fuel the rising trajectory of our reputation.

MUSC Health Values — • Compassion: We treat all patients and their families with kindness, empathy and dignity.

• Teamwork: We recognize that people are our greatest asset and everyone has an important role on our care team.

diverSity & inCluSion

MUHA — • Established the Diversity and Inclusion Task Force in Summer 2013.

• Launched the Diversity and Excellence Steering Council in Winter 2013.

• Announced the appointment of their first Executive Director of Community Health Innovation and Chief Diversity Officer as part of the medical center’s leadership team in Summer 2014.

• Adopted “diversity” as one of five core values for the organization.

MUSC — • Kicked off an MUSC enterprise-wide strategic planning initiative on May 28, 2013.

• Approximately 35 MUHA staff participated in one of five working groups focused on: 1) Recruitment and pipeline development; 2) Education and training: 3) Engagement and inclusion; 4) Communication, community relations and outreach; and 5) Performance outcomes and metrics • Over 100 students, faculty and staff worked 900–plus hours and recommended goal statements for each of the five working groups, objectives and strategies to best promote diversity and inclusion at MUSC, key milestones and target dates.

• The plan includes five goals, 12 objectives, 44 strategies, and 87 milestones.

• MUSC board of trustees approved the Diversity and Inclusion strategic plan in October • The Implementation Phase will begin in January.

• Diversity: We strive to build an inclusive community of learning, understanding, acceptance, and respect.

• Accountability: We are responsible for our words, actions and use of resources.

• Innovation: We encourage new ideas and practices that lead to the continuous improvement of experiences and outcomes.

Quality highlightS • Major improvements in “expected” mortality, currently ranked ~25th in UHC. • Sustained reductions in Patient Safety Indicators (PSIs), which are administrative data definitions of harm.

• Major reductions in catheter associated urinary tract infections (CAUTI), achieving zero CAUTI in October 2014.

• Improvements in all but one domain in the Culture of Safety survey from 2013 to 2014 and performing at or above benchmark in all but one domain.

• Major inroads into transparency efforts in quality – safety, operations and pricing. For more information, visit http://www.muschealth.org/transparency.

• When Ebola arrived in the United States, the medical center was prepared. A specialized medical team of 40 M.D.s, nurses, and RTs volunteered to receive extensive education and training in donning and doffing personal protective equipment and caring for a patient with Ebola or suspected Ebola.

The CaTalysT, Dec. 12, 2014 5

Meet Ashley

Ashley Tice

Department Referral Call Center — Business Development & Marketing Services How you are changing what’s possible at MUSC Making sure the community knows about MUSC’s premier doctors, nurses and research facilities How long at MUSC 2 weeks Pets Golden Retriever, Luna Last book read The Girls of Atomic City: The Untold Story of the Women who helped win World War II Favorite type of food Sweets — brownies, ice cream, cookies Favorite place in the world Nosara, Costa Rica Your idea of a dream vacation Camping and hiking in the backcountry — no cell phones!

Favorite quote “This is your life. Do what you love and do it often.” —Holstee Manifesto

6 The CaTalysT, Dec. 12, 2014

MUSC on board with statewide approach to delivering care By mikie hayes Public Relations

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s emergency room visits for many continue to take the place of a doctor’s office appointment, Gov. Nikki Haley is continuing her efforts to work with South Carolina hospitals to reduce emergency room utilization and improve health outcomes for uninsured South Carolinians.

Uninsured people are more likely to go to the local emergency room rather than a doctor’s office when they are sick. However, the ER is the most expensive setting for non-emergent care. And when ERs serve as primary care clinics for the uninsured, not only can they quickly become crowded and overburdened, but wait times are considerably longer for people actually requiring emergency care.

While many states recently have expanded their existing Medicaid programs or established state-run insurance exchanges to address the needs of uninsured citizens, South Carolina’s leadership has decided to take a different approach.

According to Mark Lyles, M.D., MUSC’s Chief Strategic Officer, South Carolina is working to better coordinate medical care for the uninsured rather than relying on young and healthy people to sign up for insurance plans so their premium dollars subsidize care for sicker people.

Lyles said: “South Carolina decided to create the Healthy Outcomes Plan to use its limited resources to address the needs of the sickest of the sick rather than placing the burden on the insured. The state’s novel plan, now in its second year as of Oct. 1, initially targeted uninsured emergency room ‘super-users’ — those who used the same ER more than five times in a calendar year and have one or more chronic comorbid conditions such as diabetes, hypertension, or heart disease. This demographic now has access to more personal medical care.”

Chronic super-users account for approximately 1 percent of the state’s uninsured. The initial goal was to find these patients, who rely on emergency

graphic provided

This model demonstrates the two referral pathways into AccessHealth Tri-County Network’s “Hub” which provides system navigation so the uninsured are able to efficiently obtain health care services. rooms for primary care, a medical home and primary care provider who they can visit when they are ill or need preventive care. During its first year the plan targeted roughly 8,500 chronic ER users throughout the entire state.

In an effort to coordinate a statewide effort to address the needs of the uninsured in this state, the legislature passed a series of provisos that significantly impact how care is delivered to them.

First, in June 2013, the SC Legislature passed Proviso 33.34 which created the Healthy Outcomes Plan. Under this provisio, the state withheld 10 percent of each hospital’s disproportionate share (DSH) dollars. If a hospital agreed to partner with other local providers, and better coordinate care for the uninsured, the 10 percent DSH was returned to the hospital.

Additionally, in 2013, Medicaid base rates for technical and professional services were increased by 2.4 percent to provide hospitals and providers additional dollars to care for the uninsured.

In most rural regions and smaller towns, a single local hospital partnered with one or two free clinics or federally qualified health centers (FQHCs) to deliver and coordinate care for the uninsured. In larger cities, coalitions were formed between multiple hospitals and community partners.

For example, in the Charleston area, the leadership of MUSC, East Cooper Medical Center, and the three hospitals in the Roper–Saint Francis network partnered with more than a dozen local clinics to create the “Charleston Coalition.” healthy outCome PlanS During the Healthy Outcomes Plan’s first year, the legislature asked hospitals to devise “healthy outcome plans” that focus on the most frequent, uninsured users of their emergency rooms who were dealing with chronic conditions.

Hospitals had only a couple of months to develop their plans which were designed to connect these chronic emergency room users with less-expensive community resources to meet their health care needs. While participation in the HOP is free for patients who qualify, it’s important to note that the plan neither provides them with health insurance nor does it cover emergency room care.

Hospitals were not required to participate in the Healthy Outcomes Plan, but every hospital in South Carolina chose to participate. With all South Carolina hospitals accepting the requirements of the proviso, each hospital was able to tailor its response to meet the specific needs of its local residents. Rather than create a brand new program, the Charleston Coalition

decided to leverage existing community resources and work in concert with AccessHealth Tri–County Network.

In late 2013, the initial target population of the partner hospitals in the Charleston Coalition HOP totaled 1,243 ER high-user patients.

Melanie Matney, executive director of AccessHealth South Carolina, said, “MUSC is a hospital member of the largest Healthy Outcomes Plan in the state and has the largest number of patients to enroll and serve. At the end of September 2014, the Tri–County HOP had enrolled over 100 percent of its targeted patients patients. Across the state, HOP provides a framework of care management that encourages outreach to complex patients and compels partnerships between hospitals, providers and social service agencies. What was quite impressive for the Charleston Coalition was that they leveraged existing community resources to meet the requirements of the Healthy Outcomes Plan.” aCCeSShealth tri-County network With support from AccessHealth SC and The Duke Endowment, the AccessHealth Tri–County Network (AHTN) was created in 2010. The mission of AHTN is to coordinate a sustainable provider network of care for low–income, uninsured residents in Berkeley, Charleston and Dorchester counties. The objectives of the network focus on appropriate client referral; navigation to a medical home and specialists’ services; and use of health information technology that allows for shared health information and electronic health records.

AHTN comprises 27 partners, providing a wide range of health care and health–related services that work together to provide uninsured residents in the Tri-County area with a coordinated approach to access to health care. In addition to hospitals, the network’s partners include free clinics, FQHCs, outreach providers, the SC Department of Mental Health, local health departments, and volunteer

See Proviso on page 9

The CaTalysT, Dec. 12, 2014 7

CinDerella Continued from Page One when she was 18. She had no warning symptoms. “It was terrifying,” she recalled.

Crosby had made it to a pivotal moment in her life. The Walterboro native and ‘preacher’s kid’ had left home to work on a horse farm in Greenville. She was giving riding lessons and enjoying her first real taste of independence.

She had to call her mother, Kay, an ICU nurse in Walterboro, and father, Ricky, pastor of Shiloh Baptist Church, from the doctor’s office. “I said my doctor is about to call you with some news. I’m really sick. She said, ‘Stop, this isn’t funny.’ I said ‘Mom, ‘I’m serious. I may have cancer.’ She said, ‘I’m on my way.’ My dad thought I was pregnant.

Later, he said he wished I had been pregnant.”

Crosby came home and consulted Jennifer Young Pierce, M.D., a gynecological oncologist at MUSC, and found she had Stage 3 ovarian cancer. They scheduled her surgery as soon as possible and she had a radical hysterectomy, had her appendix and the top capsule of her liver removed, her diaphragm scraped and portions of her bladder, bowel and abdominal lining removed on July 5, 2012.

Six weeks later she started chemotherapy, which she had for six rounds every three weeks until Dec. 12, 2012, when she was considered to be in remission. She then started a maintenance chemotherapy treatment and decided to go back to school to become a nurse.

Unfortunately, Crosby began to not “feel quite right” and had to withdraw.

Shortly afterward, she found a lump in her groin and felt it was growing. A biopsy came back positive. “A CT scan showed little spots like everywhere.”

Crosby said she had her second surgery Dec. 5, 2013, where her doctors removed small tumors they had found, and recently she had to have another surgery just before the ball. Ironically, the medical terms she struggled to learn in nursing school come easily to her now.

She’s grown up fast. She and her family have adapted to life with cancer.

“My relationship with Jesus is a lot

Photos provided

Crosby helped her friend Kaila Bishop (pictured far left), when her thenfiancee was diagnosed with cancer. At right, Crosby loves to compete and ride for fun. stronger. If it wasn’t for him, I don’t think that I would still be alive. There would be no purpose in life for me.

That’s just how I feel. I appreciate life a lot more — the blue in the sky and the green in the grass. I take more time to notice details that I overlooked before.

I’ve learned to find joy in everything, even though it sucks to have cancer.”

When Crosby’s best friend became engaged and found her fiancée had cancer, she asked Crosby if she minded talking to him. Not only did Crosby take the time to visit, she checked on him regularly and helped him through some harrowing moments, some of which he almost didn’t survive. The two still have a special bond.

She also took the time to set up a fund to help other patients with ovarian cancer and, with the help of friends, held a walk of awareness in her hometown of Walterboro this year that raised $1,700.

Crosby said she hopes to start a non– research fund for oncology gynecological patients who have few resources to provide financial support, such as assistance with transportation or lodging.

“We’re just in the beginning process of doing this. I don’t know why I have cancer, but I think it’s to help other cancer patients.”

As Crosby talks about her plans, various hospital employees stop by to check on her, even some not assigned

to her floor. Dr. Pierce, who arranged for Crosby to have her hair and makeup done on the day of the ball, said this isn’t unusual. There’s a quality deep down — her courage and her ability to find the joy in small things — that inspires everyone around her.

“From the moment I met Kendra, she has amazed me with her spirit and her joy. She has never let ovarian cancer define her or get the better of her,” she said, adding that on some days she knows Crosby has had to fake it.

“Since her diagnosis, she has jumped out of a plane, traveled, continued to ride horses and teach gymnastics, and most recently organized a walk to raise money for other ovarian cancer patients.

She has managed to do all of this while receiving treatment for cancer.”

Crosby is quick to return the praise, calling Pierce awesome.

“She makes me feel like I’m her one and only patient. I know she does that to all her patients, but she really makes me feel like she cares about me. We get carried away talking about kids and horses, and I’ll tell her, ‘You have other patients to see. Go, see them.’ She makes me feel I’m part of her family.”

Pierce is constantly looking into possible new treatments and the latest clinical trials.

“It says a lot about her and her heart for it that she’s checking into trials for

me. Sometimes she’ll cry, and I’ll say ‘Dr. Pierce, I’m not crying so you have to stop.’ But I know she doesn’t like operating on this young body.”

Crosby hopes to go to Israel in the spring on a church tour to retrace Jesus’ steps and see the places she grew up hearing about. When asked how she stays so positive, she shrugs. “From the beginning I realized I don’t have a choice. I can sit at home and be miserable all the time or I can get out and do stuff while I find joy in life.”

She also somehow has the maturity to know she’s blessed. One good part of her cancer journey is how much closer she’s grown to her family and friends, particularly her mother. “She will stay up as late as I need her to even if she has to work the next day,” she said of her mom.

“She’ll sleep in the bed with me if I need comfort. Or if I have an accident in the middle of the night, she’ll clean me up. It doesn’t matter what she’s doing, she’s going to be there.”

Crosby has her eyes open to those special moments. She holds them in her heart and treasures them, such as the ball and meeting Cpl. Profit Profit, someone who like herself enjoys nothing better than bringing someone else joy.

When asked about the best part of the ball, Profit said that it was being able to offer the magic of an evening. “I just liked to give her something that for one night she could forget about all the trouble she’s had. My favorite part had to be knowing she was enjoying herself even though she was in pain.”

Crosby, who was back in the hospital shortly after the ball for further treatments, said she had a great time, even though she didn’t get to dance. “It was wonderful,” she said, getting out her phone to show off some photos. “I liked watching this community of people who put their lives on the line every day for their country yet know how to loosen up and celebrate with a party.”

She shows off a picture of herself in her red dress. “I did feel like Cinderella.”

8 The CaTalysT, Dec. 12, 2014

New trauma nurse specialist program meets national goals

By J. ryne Danielson Public Relations

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s a Level I trauma center, MUSC has made a commitment to continuing medical education for all nurses involved in the care of trauma patients. To meet the requirements set forth by the American College of Surgeons, nurses from MUSC’s emergency department, in conjunction with their colleagues in the surgical trauma ICU, have developed a trauma nurse specialist program consisting of five weeks of classroom and clinical training.

“This program has increased satisfaction between staff members, the trauma team and the ED, and it serves as an important avenue to streamline and improve care.”

Roberta Dawson “This has been entirely nurse–driven,” said Roberta Dawson, R.N., the assistant nurse manager in the Adult Emergency Department and Chest Pain Center.

Dawson was a member of the program's founding group of nurses and now facilitates continued development of the trauma nurse specialist program.

“The program,” she said, “has increased satisfaction between staff members, the trauma team and the ED, and it serves as an important avenue to streamline and improve care.”

Nurses from MUSC presented a poster with details of the program at the Southeastern Trauma Symposium in Colombia, South Carolina, in October.

“There’s nothing like this in South Carolina,” she said. “There is only one certified program like it in the nation, and that’s the direction we would like to take this program. We’d like to make this a nationally accredited program.”

Dawson said their next goals include

partnering with the simulation lab to add more hands on training to the program, as well as partnering with the pediatric unit, and increasing participation overall. “From there, we’d like to expand locally and open the program to other hospitals in South Carolina,” she said, “then eventually progress up to national accreditation.”

Three classes have been held so far and approximately 25 nurses have completed the program which launched one year ago. To undertake the course, nurses must receive peer recommendations as well as doctor recommendations.

Eligible nurses must have at worked at MUSC at least six months, with prior ED experience, or one year with no prior experience.

“The trauma nurse specialist program is critical to MUSC’s success as a Level I trauma center,” said Terrie Stewart, RN, MUSC’s new trauma program manager.

“Not every hospital or trauma center has that. It really sets us apart.”

As the Lowcountry’s only Level I trauma center, MUSC plays a key role in providing top–level care to patients from across the region who have a serious illness or injury. MUSC is one of only two such centers in the state to be accredited by the ACS, whose requirements, in addition to providing continuing medical education, also include a dedicated team of trauma specialists available 24 hours a day.

Stewart said: “Some smaller EDs might have to go all over the hospital to find qualified doctors and nurses because they don’t have the resources we have.

One of those resources is the trauma nurse specialist program.”

Another requirement of the ACS is that the program must focus on injury prevention and rehabilitation not just the treatment of injuries.

“MUSC provides a complete continuum of care,” Stewart said.

“We start with injury prevention. Our perspective is that all injuries can be prevented and we could put ourselves out of a job.”

MUSC’s injury prevention outreach program, whereby doctors and nurses engage with the community — giving

photo provided

MUSC nurses Mandy Gainey, from left, Steve Kimsel, Karen Degueldre and Brian Cox (not pictured) presented a poster on the Trauma Nurse Specialist Program at the October symposium. talks in schools and hosting town halls — is an important step toward that goal.

She continued, “We also work closely with paramedics in the pre–hospital phase on education and feedback. Then there is the acute care phase and, finally, discharge and rehabilitation. Nurses are involved in every phase of a patient’s care. And, truly, they’re not just our

patients while they’re at MUSC; they’re our patients until they return to their previous standard of living.”

According the New England Journal of Medicine, the full range of care afforded by a Level I trauma center may increase patient survival rates up to 25 percent.

“Well–trained nurses are key to such successful outcomes,” Stewart said.

The CaTalysT, Dec. 12, 2014 9

Proviso

Continued from Page Six

primary and specialty care providers.

South Carolina residents who apply to AHTN are screened to determine if they are eligible for other sources of health insurance, including Medicare, Medicaid or VA benefits. Patients who do not have other insurance options, and who also meet all income, residency and eligibility requirements, can be approved to receive coordinated care through AHTN. Covered patients who need primary or specialty care services are referred on a rotating basis to all AHTN partners such as MUSC. Renee Linyard, program manager, AccessHealth Tri–County Network, said, “MUSC has long been committed to helping the uninsured. Drs. Cawley and Lyles have been at the table working with AccessHealth Tri–County Network on these issues even before the mandate came down from the state. Since then, great progress has been made. The program has broken down important barriers related to health access, and we are all collectively working to impact an issue that is important to all of us: the uninsured. The Healthy Outcomes Plans have reinforced the need for an integrated system of care coordination to address the needs of the uninsured.” ahtn Covered ServiCeS Since the goals of the proviso and AHTN are the same, the Charleston Coalition chose to partner with AHTN’s existing network to coordinate primary and specialty care services and minimize unneeded care.

Each AHTN patient is assigned a “medical home” with a primary care provider. traCking Each hospital is required to report annually to the state the total dollar amount of services that are delivered under the Healthy Outcomes Plan. To track the dollar amount of care delivered, AHTN–covered patients who are seen at MUSC are registered with the special new insurance code that is currently under development by the MUSC Revenue Cycle Team.

MUSC patients with the new code are not required to pay visit deposits, deductibles or coinsurance for services covered by AHTN. Instead, the hospital is to use its increased Medicaid reimbursements and returned DSH dollars to cover the expenses. Emergency room visits, elective procedures, bariatric surgery, or dental services are not covered. AHTN covered patients seen at MUSC will continue to be screened by MUSC’s Revenue Cycle Team to determine if they have become eligible for Medicaid or other insurance programs.

The hospital will waive technical reimbursement for HOP patients and will budget these dollars as charitable care. To compensate MUSC providers for professional services they deliver to HOP patients, in addition to the increased Medicaid base rates the state gave providers

in 2013, MUHA will reimburse MUSC providers for AHTN covered services at base Medicaid rates.

These dollars will be added to MUHA’s existing annual service contracts with MUSC departments and divisions. new ProviSoS for fiSCal year 2015 In June 2014, the SC Legislature passed Proviso 33.26 and continued the Healthy Outcomes Plan for another year. This proviso also included important updates for the 2014–2015 version of the plan. The Charleston Coalition will continue to work with AHTN, and Trident Hospital recently joined the coalition.

Changes were not dramatic and included increasing the number of uninsured people who receive care; increasing the dollar amount of care that is delivered; and demonstrating to the state that an appropriate “plan of care” has been developed for and communicated to each recipient. No longer will enrolling a patient in the plan suffice; the patient must have established service with a primary doctor, go to an appointment, and the doctor must document a plan of care.

This year the state is requiring hospitals across South Carolina to enroll 12,756 super–users in the program: Of that number, 10,205 have been enrolled already.

While the rest of the state has reached 76 percent of their target goal, the Charleston Coalition has already reached 90 percent: 1,682 of 1,863.

According to a recent U.S. Census count, there are more than 760,000 residents in South Carolina without health insurance; 90,000 of them children. A total of 135,000, or 19 percent, are from the Tri–County area.

To the MUSC research community: This notice confirms that the NIH and AHRQ will require use of a new biosketch format in applications for research grants submitted for due dates on or after January 25, 2015. Between now and that time, applicants will have the choice of using the old or new biosketch format. new format The revised forms and instructions are now available on the SF 424 (R&R) Forms and Applications page.

The new format extends the page limit from four to five pages, and allows researchers to describe up to five of their most significant contributions to science, along with the historical background that framed their research. Investigators can outline the central findings of prior work and the influence of those findings on the investigator’s field. Investigators involved in Team Science are provided the opportunity to describe their specific role(s) in the work. Each description can be accompanied by a listing of up to four relevant peer-reviewed publications or other non-publication research products, including audio or video products; patents; data and research materials;

“MUSC is happy to partner with other hospitals in the Charleston Coalition and work closely with the AHTN to make this possible.”

Dr. Mark Lyles With one–in–five South Carolinians considered medically uninsured, the state still has a long way to go, but the Healthy Outcome Plans certainly represents a positive start. According to Linyard, this program may well serve as a prototype for the state to address the larger issue of uninsured South Carolinians in terms of best practices and a replicable, sustainable infrastructure.

Lyles said, “The Health Outcomes Plan is a creative approach to providing a continuum of care for many of those who, in the past, repeatedly came through the emergency department. MUSC is happy to partner with the other hospitals in the Charleston Coalition and work closely with the AHTN to make this possible.

Already, we are having success in meeting the needs of the uninsured, and we look forward to continued collaboration with our state officials.” databases; educational aids or curricula; instruments or equipment; models; protocols; and software or netware that are relevant to the described contribution. In addition to the descriptions of specific contributions and documentation, researchers will be allowed to include a link to a full list of their published work as found in a publicly available digital database such as MyBibliography or SciENcv. tool to helP Build the new BioSketCh The Science Experts Network (SciENcv), which serves as an interagency system designed to create biosketches for multiple federal agencies, will be updated and available within a few weeks to support the new biosketch format. SciENcv pulls information from available resources making it easy to develop a repository of information that can be readily updated and modified to prepare future biosketches. A YouTube video provides instructions for using SciENcv. Please share this information with everyone involved with grant proposal submissions (including progress report submissions) or grant proposal administration in your areas.

10 The CaTalysT, Dec. 12, 2014

Culinary events feature local chefs Finance & Administration Sodexo and the Office of Health Promotion are hosting the fourth Wellness Events Celebrity Chef event from 11 a.m. to q Take the monthly 1 p.m., Wednesday, Dec. 17 in the mindful challenge and University hospital cafeteria, World be eligible for prizes by Cuisine and ART Cafeteria. completing a short survey This popular series features a at the beginning and collaboration between local chefs end of the month. One and Sodexo chefs to promote healthy employee will be featured versions of popular restaurant in our “Spotlight on dishes that meet Sodexo’s Mindful Wellness” column in The criteria for calories, fat, sodium Catalyst. The December and cholesterol. Featured Chef challenge is to bring Susan Johnson Jared Young, from the Bohemian balance to your holidays.

Bull, will be assisting Sodexo chefs To begin, take the first in preparing some of the Bull’s most December Monthly Mindful Challenge popular dishes with a mindful twist. survey at http://tinyurl.com/lhsef25.

Items available for purchase include q Chair massages — Free massages their Po Boy Shrimp Burger and the are offered to employees midday on Hippie Black Bean Burger, both available Wednesdays. Check broadcast messages with a side Boho salad. Chef Jared will for locations and times. be available from 11 a.m. to 1 p.m. at q Farmers Markets — Fresh fruits and World Cuisine to answer questions and vegetables are available from local provide short cooking demonstrations. farmers on Fridays from 7 a.m. to 3:30 In addition, free samples and recipe p.m. at the Horseshoe. cards will be available, and MUSC q Flu Shot Satellite clinics will be held — employees and students can enjoy a 10 6 to 10 p.m., Thursday, Dec. 11 2 West percent discount at Bohemian Bull from Classroom Dec. 17 to Dec. 24. Visit their website q MUSC Employee Fitness Series Class at www.bohemianbull.com for more — Abs, 4:15 to 4:45 p.m., Wednesday, information, menus and directions.

Dec. 17 at the Wellness Center. Free day On Thursday, Dec. 18, employees and pass to MUSC’s Wellness Center for all students are invited to a special “Learn at participants. This class involves cardio Lunch Series” at the Southern Season in and resistance training that targets the Mount Pleasant to learn creative tips on abdominal core using props. To register, how to make food healthy and delicious. email musc-empwell@musc.edu.

The cooking school staff teams up q Worksite Screening — Friday, Dec. with Debbie Petitpain, Sodexo’s MUSC 12, Wellness Center Auditorium. This Wellness dietitian, and George Roberts, screening, valued at about $350, is president and CEO of East Cooper available to employees with the State Meals on Wheels, in Southern Season’s Health Plan (including MUSC Health fabulous Viking kitchen featuring Plan) for only $15 (covered spouses also beautiful marble counter tops and warm can participate for $15). Employees and inviting décor for an experience one and spouses without this insurance can can never forget. participate for $42. Register at http:// The menu will feature citrus salad with www.musc.edu/employeewellness a kick, meatballs over pureed cauliflower and click “Worksite Screening and seasonal poached pears.

Appointment.”

The class is discounted to $20 for MUSC employees and participants will MUSC Urban Farm also receive a 10 percent off coupon to q Midday Work and Learn — 12:15 to use in the store that day. To register and 12:45 p.m., Tuesdays receive this special price, call Southern q Early Bird Maintenance — 7:30 to 8:30 Season at 881-9350 and ask for Jenny or a.m. Wednesdays. Get your day started at Kim. the farm.

The special MUSC discount cannot be q Sunset Work and Learn — 4 to 5 p.m., applied to online registrations.

Thursday.

Health at work

Division recognizes 2014 EOY

The Rewards and Recognition Programs of the University’s Finance & Administration Division recognize and reward their employees each quarter for significant accomplishments in customer service and performance. The objective of these programs is to create a culture in which employees and managers value, respect, emulate and promote MUSC Excellence and all that it stands for. emPloyee of the year At the end of each fiscal year, the RRC selects one employee to be named “Employee of the Year.”

Lisa Montgomery presents the department’s The winner is chosen 2014 EOY award to Doris Washington. from all Employee of the Quarter winners from the preceding fiscal year. The RRC had the difficult task of selecting only one winner from the numerous worthy candidates.

The winner was Doris Washington of University Housekeeping in Engineering & Facilities. Washington, who works in Harborview Office Tower, was presented with a personalized plaque and a monetary award during the F&A Annual Employee Appreciation celebration on Nov. 5.

Among the dozen complimentary comments made about her, one colleague said: “Ms.Washington is recognized as an individual who goes the extra mile. Although there is no control as to the exterior appearance of Harborview Office Tower, the interior of the building looks great. It is because she cares. She cares about the building and the people who occupy it, visit it and call it their work place. She makes sure that areas are clean, supplies are well stocked and that restrooms and kitchens are maintained. Ms. Doris will complete tasks without a complaint; in fact, she never says an unkind word. Her warm and caring smile, her kind words and greetings as well as the love of her job radiate from her presence.”

Peer PoStCard Program The PEER Postcard is an employee “thank you”card used to recognize coLisa Montgomery recognizes Bob workers observed practicing standards Hedin as PEER of the Year. of behaviors consistent with MUSC Excellence. The 2014 “Cindy Garmon” PEER of the Year winner is Robert “Bob” Hedin of Engineering & Facilities. Hedin received a plaque and gift card also at the employee appreciation celebration.

The CaTalysT, Dec. 12, 2014 11

Prospective students get a glimpse during Dental Day event

By Jane ma Public Relations

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On Oct. 31, the College of Dental Medicine hosted its 16th annual Dental Day, an event designed to provide prospective dental students with information on what to expect from the processes of applying for and attending dental school.

More than 100 high school seniors and undergraduate students attended the day’s events. Most of the students were from South Carolina, but roughly 5 percent traveled from out–of–state schools, such as Appalachian State and East Tennessee Universities.

The Dental Day program was started by Gwendolyn Brown, DMD, director of the Office of Diversity in the CDM. This year’s activities were coordinated in their entirety by Pearl Givens, student services coordinator in the college’s Office of Diversity.

The students’ day included presentations from multiple faculty members and guests. Tariq Javed, DMD, as well as Sabra Slaughter, Ph.D., senior advisor to the president for diversity and community relations, opened the program with introductions. Michael Kern, Ph.D. spoke to the students about the DMD/ Ph.D. dual degree program. Joe Vuthiganon, DMD, (affectionately referred to by his students as “Dr. V.”) kept the students laughing with his Harry Potter-themed presentation about the application process to “The School of Witchcraft and Dentistry Arts”—complete with Gryffindor robes and magic wand.

Other topics of discussion included preparation for the dental admissions test, paying for dental school and potential specialties. But the highlight of the day for many students was the Q&A panel and

Students from area and statewide colleges and universities as well as out-of-state schools gathered to meet faculty, students and admissions counselors.

photo provided

Dental Medicine Diversity Director Dr. Gwendolyn B. Brown, far left, shares the microphone with current dental students as they answered questions from prospective students during the Oct. 31 Dental Day event. tour with current dental students. This was when the prospective students were able to ask the questions related to lifestyle and experience: “Do we have to wear scrubs everyday?” “Is it easy to find places to live in Charleston?” “How many hours a week do you spend studying?” These were the questions that couldn’t be answered by a brochure or a Google search.

The dental students responded honestly and enthusiastically. More than 20 of them volunteered their time to come and help out with this event; they were a diverse group including students from each year of study. They were incredibly reassuring, and familiar and friendly with each other and their audience.

After the Q&A session, they split the guests into groups of 10-12 and everyone broke off to see the dental buildings with at least one current dental student acting as the group’s tour guide. The dental students took the students to see the labs they’d be learning in, the clinic they’d be working in (with actual patients,) and pointed out some great spots for food or coffee during the school day. They outlined the general curriculum of the four years of dental school and spoke on why they each chose to attend MUSC. Getting to visit with so many current dental students was what made the experience unique and valuable.

Blake Holt, a senior student at The Citadel, said, “I can’t believe so many dental students volunteered their time out of a regular school day to come and give us advice. I really feel like MUSC creates a tight community, and that’s why I really want to come here.”

Another senior student from Tennessee commented, “It was really helpful. I wish I’d come sooner. I’ve been interested in the MUSC College of Dental Medicine for a while. Had I attended this event last year, it would have sealed the deal that much earlier.”

12 The CaTalysT, Dec. 12, 2014

Students recognize excellence in outstanding faculty

By J. ryne Danielson Public Relations

Each year the MUSC chapter of the American Medical Student Association and the College of Medicine hold the Golden Apple Awards to recognize outstanding faculty at MUSC. “We stand on the shoulders of our teachers,” said Deborah Deas, M.D., interim dean of the College of Medicine, who presented a lecture in memory of Robert P. Walton, a pioneering physician, scientist and teacher who joined MUSC in 1942.

Deas shared her favorite story about Dr. Walton. “One day he was walking by a lecture room and saw students milling about in the corridor,” Deas said. “He questioned them, and they told him the lecturer was ill. Dr. Walton asked the topic and proceeded to give the lecture just as well as if he had come prepared for it.”

“Like Dr. Walton,” Deas continued, “your teachers are extremely dedicated

and they labor to prepare you to be the next generation of competent, compassionate physicians who will impact many lives.”

First–year awards were presented by Travis Benzing, president of the class of 2017. The faculty award winner was Paul McDermott, Ph.D., Department of Medicine. The student body award winner was Inda Johnson, M.Ed., Education Division, Dean’s Office.

Second–year awards were presented

by Taylor Hughes, president of the class of 2016. The faculty award winner was Laura Kasman, Ph.D., Department of Microbiology and Immunology. The student body award winner was Gabrielle Redding, Student Affairs Division, Dean’s Office.

Clinical–year awards were presented by Dil Patel, president of the class of 2015.

The faculty award winner was Stephanie Montgomery, M.D., Department of Surgery. The house staff award winner was Benjamin Kalivas, M.D.,

photo by Tim Roylance, Digital Imaging

Winners of the 2014 Gold Apple Awards are Dr. Donna Kern, from left, Dr. Deborah Deas, Dr. Laura Kasman, Inda Johnson, Dr. Paul McDermott, Dr. Benjamin Kalivas, Dr. Stephanie Montgomery, Gabrielle Redding, Ruth Fortini and Dr. Debra Hazen-Martin.

Department of Medicine. The student and Donna Kern, M.D., for the work body award winner was Ruth Fortini, they do behind the scenes in developing Department of Surgery. and implementing the basic science and An award of special appreciation was clinical science curricula. presented to Debra Hazen-Martin, Ph.D.,