MUSC Catalyst

April 8, 2011

MEDICAL UNIVERSITY of SOUTH CAROLINA

Vol. 29, No. 32

Campaign champions clinical trials InsIde By dawn Brazell

Safety eScort

Public Relations

3

P

The story behind the face on the poster ...

S

eeing pictures of herself plastered on the backs of buses or on life-sized posters in the lobby at Hollings Cancer Center takes some getting used to.

Ann Ramsdell recalls coming into the Hollings Cancer Center (HCC) lobby with her son, Griffin, who got excited when he saw the poster. “He asked, ‘Mommy, when we took that picture, did it help you feel better? Did it help you not be so sick?’”

She told him yes, in more ways than he could know.

If the images lead to just one person enrolling in a clinical trial, it’s worth it to researcher Ramsdell, Ph.D. The developmental biology scientist and associate professor who works at HCC is one of many patients who are allowing their stories and pictures to be used as part of a campaign to raise awareness of the importance of clinical trials.

Ramsdell, who was diagnosed in June 2009 with stage 3 breast cancer, said her diagnosis shocked her. She was training

for a marathon, ate well and had no history of breast cancer. “I did everything right. I was not a person who was supposed to get cancer.”

Yet, the diagnosis. Life goes like that sometimes.

Ramsdell absorbed the shock, her mind racing to her two boys, ages 3 and 5 at the time. “The very first thing I said was ‘Oh, my God, my children—my boys,’ and then the second thing I thought was how do I do cancer without needles? I hate needles.”

Researching clinical trials before she even met with her doctor, she knew she would be enrolling in one because they offer access to the latest treatments and medications.

“I wanted whatever would be the most aggressive form of treatment. Secondly, as a scientist, I think there is great value in participating in clinical trials, not only for oneself but for future generations of patients. I truly believe that. Being scientists, we run experiments every day.

See Ramsdell on page 10

atients come and go, but there are those who leave that indelible imprint. One of those for Robert K. Stuart, M.D., was his first cancer patient—a teenager with advanced Hodgkin lymphoma. He met him on the first day of his oncology fellowship in 1976.

Stuart’s faculty supervisor thought the case hopeless.

Stuart, too young to know better, thought otherwise, and opted to treat him on a clinical trial.

“Not only did he survive, he eventually invited me to his wedding,” he said. “I had no hesitation in recommending a clinical trial for my wife when she needed one.” The only reason he didn’t volunteer for a clinical trial when he had kidney cancer was there were none at the time.

Times have changed.

Hollings Cancer Center (HCC) wants to make sure everyone knows that through a clinical trials awareness campaign aimed at getting more patients campuswide involved in clinical trials. HCC is striving for Comprehensive Cancer Center status with the National Cancer Institute, the highest See Trials on page 8

Public Safety offers assistance 24 hours a day for employees, students and visitors.

Vir clinic

6

New outpatient clinic provides follow up care after minimallyinvasive surgery.

2 Donate to YES Meet Angello

5 11

Classifieds

t h e c ata ly S t online Terri Matson stands beside a HCC campaign poster featuring Dr. Robert K. Stuart and his family.

http://www. musc.edu/ catalyst

2 The CaTalysT, April 8, 2011

EmployEE WEllnEss

During the month of April, MUSC Employee Wellness will offer events and programs that focus on ways to become fit for life. To raise awareness of the importance of physical fitness and to promote the idea that fitness is fun, there will be a Zumba Fest at noon, April 13 in the Horseshoe.

Zumba incorporates Latin dance to create a dynamic and effective fitness system. Instructor James Johnson from the MUSC Wellness Center will be leading what will be the largest outdoor class held at MUSC. The free event is open to the public and no experience is necessary.

Healthy vendors will also be on hand, including CSA Farmers, Giddy Goat Cheese, Roti Rolls and Happy Camper Snoballs.

Physical inactivity and unhealthy eating contribute to being overweight and obese and a number of chronic diseases, including some cancers, cardiovascular disease and diabetes.

These lifestyle-related conditions are among the most prevalent, costly and preventable of all health problems.

The leading causes of death in this country as well as South Carolina are heart disease, cancer and stroke. Sixtyfive percent of adults in the state are overweight or obese and more than half of the adult population does not get enough exercise to reduce their risk for chronic disease.

That’s the bad news. The good news is that leading a healthy lifestyle by avoiding

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

843-792-4107 Fax: 843-792-6723 Editor: Kim Draughn catalyst@musc.edu Catalyst staff: Cindy Abole, aboleca@musc.edu Dawn Brazell, brazell@musc.edu

tobacco use, being physically active and eating well greatly reduces a person’s risk for developing chronic disease.

Employee Wellness events q MUSC employee fitness series: A free Pilates class will be held from 12:15 to 12:45 p.m., April 12 at the MUSC Wellness Center. Participants will also receive a free one-day pass to the Wellness Center. E-mail musc-empwell@ musc.edu to register. q Wellness Wednesday: Experts from the Weight Management Center will be available from 11 a.m. to 1 p.m.

April 13 at the Wellness Wednesday booth outside Ashley River Tower cafeteria. BMI and body composition measurements will be available. q Mobile mammograms: The Hollings Cancer Center Mobile Van will be conducting mammograms from 9 a.m. to 3 p.m. April 20 next to the Basic Science Building loading dock, behind the College of Dental Medicine. Call 7920878 to schedule an appointment q Happy Healthy Hour: A 10-week weight loss program will be held from 5:30 - 6:30 p.m Thursdays at the Institute of Psychiatry, Suite 410 South, 67 President St. The cost is $98 and payroll deduction is available. Sign up at sign up at musc-empwell@musc.edu.

Contact Susan Johnson at johnsusa@ musc.edu to become involved in employee wellness at MUSC. Events, speakers, classes, or any other ideas are welcome.

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.

Employees Gerald Garza, left, and Jim Fisher, right, are congratulated

by MUSC President Dr. Ray Greenberg during the 2011 Yearly Employee Support Campaign Loyalty Awards Ceremony April 4.

Garza and Fisher, along with Betts Ellis, Sherry Gillespie-Miller and Margaret Schachte, have been donating to the campaign since its inception in 1985. More than $6 million has been donated to support the university’s mission. To donate, visit http://www.musc.edu.

Dear Colleagues:

We are writing to ask you to join each of us in support of the 2011 Yearly Employee Support (YES) Campaign. For years, this annual campaign has helped to provide the margin of excellence needed to change what’s possible in patient care, research and health-related education. We hope that you will join us in making an important contribution toward this pursuit.

The campaign is an internal fund-raising drive that allows us all to make a personal gift to the MUSC Foundation fund(s) of our choice. Some choose to support medical research, while others contribute to scholarships, outreach programs, the medical center or their own department. With more than 1,200 funds from which to choose, you are sure to find a program that has special meaning for you.

Thank you for all that you do every day. At MUSC, every employee plays an important part in making this a special place for the students, patients and families who have entrusted us with an important part of their lives. Now, you have the opportunity to change what’s possible for these individuals through a gift to the YES Campaign.

With deepest appreciation, Raymond S. Greenberg, MD, PhD MUSC President Stephen A. Valerio Chief Executive Officer University Medical Associates

W. Stuart Smith VP for Clinical Operations Executive Director, Medical Center Howard A. Evert, MD Carolina Family Care President

The CaTalysT, April 8, 2011 3

Safety Escort Program ensures safety, available 24/7

By KaTIe sTaCy Public Relations

A

fter three violent attacks within blocks of the MUSC campus in the last month, the Department of Public Safety wants to highlight what is being done to prevent similar attacks from happening at MUSC. One important service is the Safety Escort Program that was created to ensure a safe environment, especially for those working night or early morning shifts.

The closest attack was within two blocks of campus on Vanderhorst Street, where a 23-year-old woman was punched and then dragged to a parking lot where she was sexually assaulted. Major Kevin Kerley, patrol commander, strongly encourages people to take advantage of the Safety Escort Program. The service is completely free and available 24 hours a day, seven days a week. In 2010, there were 2,517 safety escorts. There also are 163 active call boxes that anyone can use to get help around campus.

Another program offered is the Rape Aggression Defense (RAD) class. Students, faculty, staff and volunteers are eligible to participate in the free class.

However, the class does fill up quickly and can only hold 20 participants. The class, for women only, has four sessions that are each about three hours long. The

focus is to teach awareness, prevention, risk reductions, risk avoidance and hands-on defense.

A student of the class who wished to remain anonymous said taking the course was one of the best things she could have done. “I am confident in speaking for all of us participants when I say that RAD was a very empowering and eye-opening experience providing us with very practical knowledge and skills necessary for minimizing personal risk. Our instructors made the experience comfortable, accessible—even fun— without down playing the seriousness of the topic.”

Some of the students were particularly apprehensive about the hands-on training, especially the live simulation at the end, but she found those aspects of the course to be the most beneficial, she said.

“I can't wait for a follow-up course. I would recommend it for anyone. It's surprising the many small ways in which we all can decrease our vulnerability of being attacked each day.”

Kerley and Lt. Fred Wanner said there are a things you can do to avoid getting in dangerous situations. q Try to always walk in groups especially at night q Walk on the lighted side of the street q Look around and do not text so that you are aware of your surroundings q If you are on the phone, give them an idea of where

you are coming from and where you are going q Take advantage of services such as the Safety Escort Program to prevent the possibility of being assaulted To receive an escort, call 792-2261 and provide your name, current location, baggage (if any), destination, and physical description of yourself. For information on the service, visit http://www.musc.edu/publicsafety/ escort.shtml. For information on RAD, go to http:// www.musc.edu/publicsafety/rad.shtml.

Protect yourself from theft, secure vehicle Recently there has been an increase in the number of thefts from vehicles in the downtown Charleston area. MUSC has experienced two oncampus incidents during the week of March 28.

Take the time to secure personal property out of sight, including any mounting hardware for GPS and electronic equipment, if possible. Make sure the windows are closed and the vehicle is locked.

Report any suspicious individuals you see in the area immediately to MUSC Public Safety at 7924196. Provide the dispatch with a description of the individual(s) to include clothing, what you observed them doing, the location where you saw them and the direction they were going.

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CurrEnts April 5 People–Fostering employee pride and loyalty

Sodexo update Brad Masteller, Dietetic Services general manager, and Mary Basel, chief clinical dietitian and nutrition manager, reviewed highlights from a recent expectations meeting with MUHA administrators. He reviewed details from completed projects such as last August’s Phase 2 renovation and grand opening (University Hospital Cafeteria); At Your Request Room Service Dining (University Hospital); Sodexo’s Star Chef Club; Sodexo’s Global Chef program and other programs that contributed to improved patient satisfaction scores.

Basel spoke about progress made in clinical nutrition from staff presenting research, Dietetic Services Partnership (enteral ordering and delivery); parenteral nutrition, MUSC-Citadel’s Heart Health program to a partnership with Weight Management Program supporting food service employees.

Other successful projects include Healthy Holiday Cooking demonstrations, food swap, Stuff the Bus campaign; sustainability harvests with local farmers, Katie’s Krops, recycling and other activities.

HR update Helena Bastian, MUHA Human Resources director, presented the following topics: q New HR Performance Improvement Initiative—Recruiters now rounding monthly on pool of new hires with goals to improve— retention of new hires, application tracking system (People Admin), On boarding process, and HR Web site to include New Hire links q SuccessFactors Job Transitions — If an employee is in a new job or if the job has significantly changed, a Transitional Planning form is available in SuccessFactors to assist managers with the evaluation process. Contact Kim

Duncan, 792-1962, duncanki@musc. edu or Michelle Forman, 792-6219, foreman@musc.edu. q Retirement Plan selection (employees in regular [permanent] positions)—All employees hired into regular (permanent) positions, regardless of the number of hours worked, must participate in a retirement plan and make a selection in first 30 days of regular (permanent) employment. For information, contact the Benefits Desk, 792-0826. q LDI Tracking Database update— The database is down from 10-11 a.m., Tuesdays and Thursdays. Managers are encouraged to close out the database prior to 10 a.m. on those days.

LDI tracking database classes are offered from 1-2:30 p.m., the second Thursday of each month. Register via CATTS Staff Qualifications form update —POCT, CATTS and Annual Unit/ Dept. Position competency fields are now reported as an “expire date or not applicable” field (similar to the BLS, ACLS and Respiratory Fit Testing) Key points to staff qualifications update—new date fields have been automatically populated with a Dec. 1 date (you may change these dates to coincide with your unit requirements as needed). CATTS field will be updated to reflect 2010 data; reports for new fields were updated as of March 31; staff qualification reports should now reflect new data MUHA PTO Transfer Request for 2011 Yes Campaign In support of 2011 YES Campaign, MUHA will afford eligible employees the opportunity to transfer PTO hours to support the campaign. This request is separate and independent of any other YES Campaign pledges. Employees may transfer the cash value of PTO hours.

MUHA will write a check for the total cash value of PTO hours transferred Transferred hours will not be considered gross income. Employees will not pay normal taxes on the value of leave transferred.

MUHA has been advised by tax

To Medical Center Employees: At the April 5 management communication meeting Brad Masteller, general manager, Sodexo Dietetic Services, and Mary Basil, nutrition manager, gave the management team an impressive update on a wide variety of initiatives ranging from optimizing nutrition for very low birth weight babies to community support projects. The opening of the renovated University Hospital cafeteria and the “at your request bedside meals,” as discussed by Masteller, have both been a big hit this year. Masteller mentioned the January AVATAR patient satisfaction results indicate a mean score of 92.34 for “room service” and, for the Children’s Hospital, a Press Ganey survey ranking of 95th percentile for “quality of food.” Additional details are included in this newsletter.

Christine Lewis, Coding and Processing manager, updated the management team on a major project underway to convert the International Classification of Diseases (ICD) 9 codes to ICD-10 codes for diagnoses and procedures. The Centers for Medicare and Medicaid Services is requiring these changes by October 2013. The changes will involve a dramatic increase in the number of new codes and will require a new system and education. We can expect a number of related operational and policy changes in the future. Additional details are in this newsletter.

On another matter, recently you may have read an article in The Catalyst concerning advancements with social media. Our Public Relations, Marketing and other departments throughout the organization have been creative in using social media to enhance our communication and business operations. Not surprisingly, abuse of social media, such as Facebook, has been observed here and at other hospitals. I have asked a task force to revisit our current guidelines and policies and prepare recommendations on how we can maintain access to Facebook and other social media while eliminating onthe-job abuse. The task force’s recommendations will be disseminated in or around June 2011.

Finally, we continue to make progress with drilling down on our 5 + 5 cost savings plans as discussed in previous Currents newsletters and town hall meetings. Our goal is to reduce costs (using fiscal year 2009 as the base year) by 5 percent this year and 5 percent next year while improving the quality of care. We are using the IMPROVE performance improvement tool to structure and track our cost savings. We currently have more than 300 individual costs savings (IMPROVE) plans covering topics such as: reductions in average length of stay; operating room turnover; discharge process; standardization of contracts, supply savings, reduction of bloodstream infections; improved blood utilization; reduction of overtime and many others. At this point our costs, in general, appear flat over the base period, but we have absorbed a pay increase and routine inflation increases.

I am optimistic that in the next several months that we will see the results of much hard work. I want to thank everyone involved for your dedicated efforts.

Thank you very much.

W. Stuart Smith Vice President for Clinical Operations and Executive Director, MUSC Medical Center counsel that PTO hours transferred cannot be claimed as a tax deductible gift and eligible employees must have a remaining balance of 120 PTO hours Employees may request to transfer a minimum of eight hours/maximum of 40 hours of accrued PTO to support the campaign.

MUHA PTO Transfer Request will be available via My Record on or around April 10.

Benefit of the Month—April Fitness at Work—MUSC Employee Fitness Series; Wellness Wednesday Booths, National Start! Walking Day (April 20); Earth Day Celebration (April 21); Bike to Work Day (April 21); Fitness Fair (April 27) and Fitness Fun Facts posted on broadcast messages Classification of Diseases—ICD-10 Revision See Currents on page 9

The CaTalysT, April 8, 2011 5

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6 The CaTalysT, April 8, 2011

New outpatient VIR clinic offers convenience

By CIndy aBole Public Relations

A

month ago, Lisa Miles struggled to do simple chores around her country home in Cordova, just miles outside of Orangeburg. Years earlier when Miles underwent a successful double bypass heart surgery at MUSC she entrusted the physicians and staff for her specialized care. Recently, Miles returned to MUSC to help manage other medical complications and was guided to the care of physicians at Ashley River Tower’s new Vascular Interventional Radiology (VIR) outpatient clinic.

The VIR clinic was established to provide quality comprehensive medical care and expertise in a visible and accessible location for patients. The weekly clinic, located in the same first-floor clinical area shared by cardiology, vascular and gastrointestinal surgery, opened its doors last November. Since 1993, the division established themselves by performing about 1,300 minimally-invasive procedures. Today, thanks to advances in technology and patient outcomes, that number has almost quadrupled to more than 7,500 specialty procedures in 2009.

Marcelo Guimaraes, M.D., assistant professor of vascular and interventional radiology in MUSC’s Heart & Vascular Center, said that the VIR clinic is a dedicated clinic focused on patient care services while working collaboratively with referring primary care physicians and other medical specialists.

“The new clinic is dedicated to accommodating patients for both pre-and-post operative procedures and for the screening of patients with peripheral arterial disease. We’re focused on patient education, prevention and early management of peripheral vascular disease which is highly prevalent in South Carolina,” he said.

The VIR clinic also enhances and increases the level of quality service and patient care that we strive to provide our patients, he said. Medical innovation and the development of minimally-invasive procedures guided by imaging under the Division of Interventional Radiology has been present at MUSC since the 1990s.

It was vascular and interventional radiologists who pioneered balloon angioplasty and stent placement to treat peripheral arterial disease. The VIR team has since worked in collaboration with vascular, cardiothoracic surgery and cardiology in this field.

Traditionally, interventional radiologists were regarded as procedure-operator specialists based solely in dedicated suites and units under the Department of Radiology’s Vascular and Interventional Radiology Division. Later, their expertise evolved and they became more available for specialty consults for procedure planning in a patient’s team approach to care. But the practice and need for more patients to be treated using

VIR clinic physician Dr. Marcelo Guimaraes checks the lungs of patient Gail Kemp.

“I feel the clinic helps meet the needs of what our services couldn’t provide before—a comprehensive approach to minimally-invasive procedures.”

Dr. Renan Uflacker non-surgical, low-risk procedures continue to grow, according to Guimaraes. The MUSC Interventional Radiology team knew they needed to plan how to best accommodate patients with more convenient and comprehensive services, such as the weekly clinic as a resource for optimum care.

Renan B. Uflacker, M.D., Interventional Radiology director, said he feels the clinic meets the needs of what their services couldn’t provide before—a comprehensive approach to minimally-invasive procedures.

“The patients know ahead of time what the procedures are about, understand the indications and the risks and benefits involved and know what to expect in the future. The clinic is just one tool our Interventional Radiology Division provides to improve services by treating more complex patients with the highest standards of medical care as possible. We feel much more proactive today, working like surgeons, in closing that gap of care and providing long-term follow up care for our patients.”

The VIR division has five interventionists who share strong training and experience in minimallyinvasive therapy procedures. These specialists can perform more than 50 different types, including treating patients diagnosed with arterial and venous disease (atherosclerosis, blood clots) carotid stenosis and oncology patients (using cryo, microwave and radiofrequency ablations, as well as chemoembolization—all under image guidance) used to treat cancers of the liver, kidney and lungs. Once a patient receives care, they are redirected to their referring or primary care physician.

Results from a peripheral vascular test in January led Miles to the VIR clinic and Guimaraes’ care. On March 15, she traveled to Charleston for a 45 minute-long abdominal aortic stent placement procedure conducted

by Guimaraes. Hours later, Miles was walking around and resting back at home.

“I felt good,” she said, comparing her recovery time from the invasive procedure to previous open heart surgery. “I felt blessed to be able to walk and do things around my house again.”

“It is important to share with our colleagues a shift in the way we are practicing medicine and our full commitment to the best care for our patients, not only as minimally invasive techniques operators, but as VIR physicians capable of providing comprehensive care,” Guimaraes said.

ART’s VIR clinic is open on Thursday afternoons. To schedule an appointment, call 876-5558.

conSult MuSc online DietitianS How many eggs should I eat in a week? What are low potassium and low sodium foods?

Which is better, butter or margarine? Today there are many discrepancies about food and nutrition. MUSC dietitians are available online to answer employee questions about food and diet. At MUSC there are more than 25 registered dietitians who are experts in nutrition.

To ask your question, visit the website http://www.muschealth.com/dietitianqa.

The Catalyst, April 8, 2011 7

Eating smaller portions not easy

Many have heard the saying “everything in moderation” in relation to weight control, but American restaurants and manufacturers are making this motto difficult to follow. Not only are fast food and sit-down restaurants giving more generous servings, but even common grocery products are increasing in size.

This trend has been occurring for hundreds of years, with the most dramatic increases happening in the last 20 years. Scientists at Cornell University have even studied depictions of mealtimes in major works of art such as the “The Last Supper” and found that plate sizes and Jillian Butt food quantities in art have increased over time.

Combine increased portion sizes with downward trends in time spent exercising, and we could have a serious problem on our hands.

Eating out and buying groceries have become a challenge when trying to maintain or lose weight.

Common fast food restaurants have super-sized menus that provide patrons with portions far surpassing

Nutrition matters

those recommended by the 2010 Dietary Guidelines for Americans set by the United States Department of Agriculture. For example, Burger King has recently added a new larger, 12 ounce burger option, equaling two days worth of the recommended meat portion.

Many of these companies recently have even changed the names of their sizes such as Biggie and Great Biggie to Medium and Large without changing the portion, thus lulling the consumer into a false sense of security.

In addition, commonly available foods in grocery stores have increased in size with some being as high as seven times the recommended amounts.

There are a few tricks to make your food choices the right portions. When eating out at a restaurant, always look for highlighted healthier options. For example, TGI Friday’s recently advertised their “Right Portion, Right Price” menu with smaller, healthier lunch and dinner options. Also, consider sharing a larger meal between two people or have half of the meal boxed before it is even brought to the table. Make fast food trips a rare occasion, and always choose the smallest size. When eating at home, choose smaller plates, bowls and utensils. Finally, take the time to learn what proper portion sizes look like.

For information and examples, visit http://www. mypyramid.gov.

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TrIals Continued from Page One distinction that a cancer center can receive with only 40 centers in the nation having achieved it. One way to achieve it is to have at least 15 percent of patients enrolled in a clinical trial. HCC has just passed the 12 percent mark.

The campaign’s motto: “The next breakthrough could be yours.” Stuart, HCC medical director of clinical trials, said the campaign isn’t just for HCC, but for all departments in the hospital.

“Frankly, we need more physician involvement. We need M.D.s who are not satisfied with the status quo, who believe in trials as the only way to improve outcomes, who get involved enough to find the best trials, and who are willing to recommend—not just offer—trials to their patients.”

Greater knowledge of the human genome has uncovered a huge number of potential “targets” for cancer therapy.

This means the need for clinical trials and the potential for meaningful improvements in treatment have never been greater, another reason he feels so passionate about HCC’s campaign, he said.

“Clinical trials are the only way to advance new ideas and discoveries from the laboratory to the clinic. I have personally seen lives saved by participation in clinical trials. Today cancer patients in North America have a two-thirds chance of surviving their cancer; in the 1970s, it was only a onehalf chance. How do you think that happened?”

Terri Matson, director for research administration at HCC, knows how it happens.

“We’re definitely going in the right direction,” said Matson, who is helping to spearhead the awareness campaign that is targeted to faculty, staff and patients. “Discoveries only can come about because of clinical trials.”

Common Misconceptions Matson hopes the campaign will correct some misconceptions that keep patients from participating. Some patients fear they won’t be getting the “real” treatment that could save their lives. “This couldn’t be further from the truth, since all patients get the same standard of care. Being in a clinical trial

The following websites offer important information about clinical trials: http:// scresearch. org/; http:// hcc.musc.edu/ clinicaltrials; and http:// clinicaltrials. gov/ct/gui. wouldn’t prevent that. What it could do is shed light on what tomorrow’s standard of care will be,” she said.

Matson said what many people fail to realize is that participation in a trial actually gives them an added layer of security.

“There’s another level of monitoring.”

There’s an altruistic side of participating in trials in that some patients feel they might benefit the next generation. Of course, patients with life-threatening illnesses hope they have landed a trial that offers clues to a cure or better treatment, she said. Sometimes that doesn’t happen, but it’s part of the process.

At HCC, about 12 percent of all patients or about 270 a year enroll in trials. At any given time, there will be more than 1,200 patients involved in various trials, covering a wide range of objectives.

The campaign features life-size posters and flyers in lobbies and waiting areas.

Though the patients featured are cancer survivors, the campaign is to raise awareness in all specialties of the value of clinical trials, she said. Staff members are wearing buttons and have been trained in how to field questions.

“This campaign affects every single faculty and staff member here. We want patients to feel comfortable asking about clinical trials and physicians to feel motivated to get their patients enrolled.”

More patient enrollment translates to better research and bodes well for faster development in the field of personalized medicine, she said. “That’s where the future of health care is going. Patients

are going to respond differently because we have different genetics.”

Her advice to patients and medical professionals is to ask questions and become aware of the latest ongoing trials in their area of interest. There can be different types of trials, such as treatment or screening, and different phases that they can be in.

One tip she has for newly-diagnosed patients is to seek out an academic medical center for a second opinion and ask about the availability of clinical trials before seeking treatment.

“Patients should evaluate all their options.”

Pediatric Role Model An area that has had the most success in getting patients enrolled is pediatrics. Historically, pediatric cancer clinical trials have been a model in that nationally 80 percent of eligible children enroll. At MUSC’s Children’s Hospital, it’s 85 percent, according to Michelle Hudspeth, M.D., director of pediatric blood and marrow transplantation and division director of pediatric hematology/oncology.

Offering high-quality clinical trials is an inherent part of pediatric oncology.

The dramatic improvements during the last 30 years in the cure rates of childhood cancer are directly linked to clinical trials, she said.

“When faced with a newly-diagnosed cancer patient, pediatric oncologists instinctively ask, ‘What clinical trials are available for my patient?’ We are all aware of the tremendous legacy of clinical trials in our field and are eager to

hopefully have our generation of patients become part of the next breakthrough in treatment.”

Hudspeth said parents need to understand the amount of planning and monitoring that is involved. She typically takes the time to explain to families the level of intense scientific scrutiny that has happened on a national level in the development of the cooperative Children’s Oncology Group trials.

“I also make sure they understand that trials have stopping rules and undergo frequent review by data monitoring and safety boards. For instance, if there is a clear benefit to a particular treatment or an unacceptable rate of toxicities occurs, the trial is stopped, and we are immediately notified. Because childhood cancer is overall rare, significant advances in treatment can only occur through involvement in cooperative group trials.”

For enrollment in clinical trials to happen, physicians have to be willing to make the time to do the education required, she said. In her area, families are understandably in shock when their child is diagnosed with cancer.

“We have a tremendous responsibility to make sure patients and families understand what clinical trials are, how the therapy may differ from standard of care and that participation is truly their choice. Physicians need to be able to have the time to spend with families to explain the process and their options.”

She hopes future efforts for clinical trial enrollment will look at novel ways of educating patients and families about clinical trials, such as better utilizing technology to share information and help families make complex decisions.

Stuart agrees, and hopes patients realize the need to be proactive. While it’s the role of doctor and investigator to evaluate trials and determine their quality, feasibility and appropriateness for the patient population, it may be the patient who is most motivated to start the discussion, he said.

“We encourage patients to educate themselves about clinical trials, ask whether they are eligible for a trial and seek a recommendation from their physician. I have concluded that the best way to motivate physicians to become involved in trials is for their patients to ask about them. That’s why we are doing this awareness campaign.”

The CaTalysT, April 8, 2011 9

CurrenTs Continued from Page Four

Nurse Manager Council Natalie Ankney, R.N., chair of Nurse Manager Council, introduced details about the council and how clinical staff can submit an agenda item and present to the council. Last fall, the group focused on improvements making it more efficient, productive and approachable. They added a new steering council to help streamline proposed topics and presentations. Presenters may complete and submit a Nurse

Manager Council topic request form by the end of the month and prior to the steering council’s monthly meeting (1st Wednesday). For information, visit their website via the MUHA intranet.

Quality—Providing quality patient care in a safe environment

Announcements q April is National Donate Life Month; On April 22, the MUSC Transplant Center will host a blood, bone and marrow and South Carolina organ donor registry drive at the portico from 11:30 a.m. to 3 p.m. For information, call Sara Stello at 792-4658. q The next meeting is April 19.

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Pat Gaylor, R.N., quality and safety specialist, spoke about this year’s Culture of Safety Survey.

This survey serves to support a leadership standard set by the Joint Commission that leaders create and maintain a culture of safety and quality throughout the organization. As of April 4, 26 percent MUSC employees completed the survey with the top three areas for completion being Environmental Services (100 percent), Dietetics (82 percent) and Facilities (61 percent). Gaylor encourages all employees to complete the survey.

Individual employee survey responses are confidential. The survey is open until April 15.

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Implementation Christine Lewis, Health Information Services and Medical Records, explained changes with the international classification of diseases (ICD-9) procedure code sets. Beginning in fall 2013, the Center for Medicare and Medicaid Services will implement a new version of procedure code sets with ICD-10 (diagnoses) and ICD-10-PCS (inpatient procedures). MUSC and all payors must comply with this change by Oct. 1, 2013. Migrating accurately to this new coding system will affect the medical center’s revenue. The new ICD-10 system provides room for expansion and upgrades the institution to international standards. To prepare for this migration, all MUSC systems must be synched. An implementation team was formed to guide this complex process. In January 2012, the hospital will change its version 4010 to version 5010 billing specs to reflect the ICD-10 change. The team is evaluating its coding processes, work via audits and analysis as well as preparing an educational plan to train and communicate changes.

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Here was an opportunity to do so on a whole different level. It was an opportunity to give back.”

Many patients fail to realize that all participants in a clinical trial receive the highest standard of care that would be delivered to any patient. The only difference is that they may also be getting another layer of care, such as a drug or technique, she said.

She enrolled in a trial and proceeded with her treatment, which included chemotherapy, surgery, radiation, physical therapy and medication. One part of her treatment at HCC that she found beneficial was working with a neurobehavioral oncologist.

“Having someone capable of talking to me about these life issues is huge.

I’m a scientist. I can push him on the numbers. We can have some very direct conversations. Some patients don’t want to know, but I do.”

Getting through treatment was one of the hardest things she’s had to do, but everyone from a volunteer with the snack cart to members of her oncology team kept her from staying stuck in what can become a dark, depressing time, she said. “I have a dream team.

There’s a lot of compassion here. There were days when I could barely get myself here, but there was the power of a smile or someone calling me by my name or asking about my children.”

During treatment, she unexpectedly found a new calling.

Having five-hour days to spend in an infusion suite gave her time to research breast cancer. For the past 15 years, her research has focused on embryonic heart development and congenital heart defects, but what she found in her reading was that many genes involved in heart development also are associated with breast cancer.

Her excitement grew as she started making more connections, developing a research plan that received grant funding from the National Institutes of Health this month. It’s engaging to switch gears, she said. “When you bring people into a field that’s new, it can bring fresh insights.”

Her collaborative project with Demetri Spyropoulos, Ph.D., will investigate whether these genes are

“I’m more conscious of what stays and what goes—what’s really important. If my children want to linger five minutes more over pancakes, then we do.”

Dr. Ann Ramsdell deregulated during mammary gland formation and if so, whether this elevates the risk for developing breast cancer later in life. In collaboration with Joan E. Cunningham, Ph.D., the work will extend into population-based studies of breast cancer patients.

Ramsdell said she had no idea how long and extensive her recovery would be. She’s finally back to going for her runs and working out with a personal trainer. She’s grateful for the insights she’s gained through her battle with cancer and the way her life has changed for the better. She’s done a reassessment of her life on all levels of what’s important to her, including her research, she said.

“I’m happier now. I’m more conscious of what stays and what goes—what’s really important. If my children want to linger five minutes more over pancakes, then we do.”

She’s glad her experience can be a part of HCC’s campaign to raise awareness on the importance of clinical trials. “It takes education. If people really understood that the benefits are really high—the potential is really there for a better form of treatment, then people would have more incentive to participate.”

Ramsdell said it never occurred to her to not be in a clinical trial.

“It’s a matter of preserving my life.

As a mother with young children, I have that responsibility to go after the most aggressive treatment possible.

I’m not private about my diagnosis or my treatment experience. Part of that is that I want people to understand about clinical trials. I hope I’m helping others.”

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ramsdell Continued from Page One

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