SYSTEMnews ``CEO Ralph Muller (r) with the winners of the first system-wide Innovation Tournament (l. to r.): James Sampson, Beth Hoffman, Fabian Marechal, Leslie Allen, Dr. Anna Bortnick, and Dr. Paul Lanken. Not Pictured: Dr. Karen Bowles and Danielle Grant.
CEO’s corner RALPH W. MULLER
WHAT’S THE ‘BIG IDEA’? INNOVATION TOURNAMENT A RESOUNDING SUCCESS!
CEO, University of Pennsylvania Health System
As you may know, the US Supreme Court recently heard oral arguments on the constitutionality of the federal health care reform act. A decision could be made before the Court starts its summer recess at the end of June. Based on the Court’s ruling, Congress could make changes to the health-care reform legislation currently in place. The presidential election this fall might result in changes to national health policy as well. What are the potential implications for UPHS? Until the Court formally rules, of course, no one can say with certainty what will happen next. It could strike down the bill’s provision compelling everyone to purchase health insurance. Or it could end the requirement that insurance companies provide coverage to all persons, including those with preexisting illnesses or medical conditions. Other possibilities exist as well. Regardless of what the Supreme Court, Congress, or the president may ultimately do, we’ve taken a number of steps that have prepared us for almost any eventuality. You might call these “no regret” decisions. These steps include managing costs wisely, introducing new quality and safety initiatives, working hard to drive down preventable hospital readmissions, making significant IT investments to improve patient care (and our financial performance), and starting several pilot programs featuring new payment models. (continued on page 5)
INSIDE $25 Million Gift to Create Basser Research Center........... 2
For Danielle Auxer, PharmD, Pharmacy Residency coordinator at HUP, thoughts of family inspired her big idea for improving the patient experience at Penn Medicine. “I tried to think about my mother and what would make her experience better if she had to be admitted,” said Auxer. “My mom is very close to her seven grandchildren. Some of them Skype her frequently because they love to see her and talk to her. I think that if she needed to be in the hospital she would need to use Skype to keep in touch with them.” Auxer’s team’s idea, “Penn View” was one of 1739 ideas that were submitted as part of Your Big Idea: Penn Medicine’s Innovation Tournament, and one of the 10 ideas that made it to the final round. Your Big Idea was sponsored by the newly formed UPHS Center for Innovation in Health Care Financing. The Center is a collaboration between the Health System and the Leonard Davis Institute Center for Health Incentives and Behavioral Economics. “We set out with the objective of receiving good ideas from the front line. The quantity and quality of the ideas we received exceeded our most optimistic forecasts,” said Tournament facilitator Christian Terwiesch, PhD, of Operations and Information Management in the Wharton School and member of the UPHS Center for Innovation in Health Care Financing Leadership Council. “But the tournament ended up being more than just an idea management process — it released an enormous amount of creative energy and enthusiasm which left a true mark on the organization.”
RATINGS AND PRESENTATIONS NARROW SUBMISSIONS TO 10 Penn Medicine faculty and staff submitted ideas in one of three ways: idea dropboxes placed in 15 Penn Medicine locations, by email, or through the Tournament website, www.pennmedicine.org/YourBigIdea. Through a five-star rating system, similar to websites like Yelp, the submitted ideas generated over 66,000 idea ratings from our faculty and staff, amounting to an average of over 37 ratings per idea. This “crowdsourced” approach helped narrow down the 1739 ideas to 200 which advanced to the Round 2 workshops. “The Innovation Tournament engaged nearly ₁⁄₃ of our workforce — faculty and staff either submitted an idea, commented on an idea, or rated an idea,” remarked Judy Schueler, VP, Organizational Development and chief Human Resource officer. “The level of engagement is a tribute to the men and women of Penn Medicine who dedicate their talents each and every day to improve the patient experience.” During the Round 2 workshops, 200 participants had 90 seconds each to pitch their ideas. Workshop participants themselves voted on which ideas they felt would have the greatest impact on the patient experience. Through this process, the field was narrowed down to 10 ideas that would proceed to the Innovation Tournament finale. People with similar ideas were able to merge into teams, and participants whose ideas were not selected as one of the final ten were given the opportunity to join the teams of finalists. For Leslie A. Allen, senior practice administrator of Medicine, the experience of advancing from round to round was a bit of a surprise. “I submitted the idea one afternoon in-between tasks but never thought submitting an idea would develop into all of this. Then I received a call that my idea was one of the top 200 but was shocked,” said Allen.
Penn Medicine Safety Net....... 5
In preparation for the finale, members of the 10 final teams went through Penn Medicine Academy’s “Present Like a Pro” training and received a series of consultations with presentation experts and designers to help craft their final pitches. “When I made it to the finals, I was surprised that I made it, but also surprised to see how much was planned to help us prepare for the finals,” Auxer said. “I never would have thought I could have given our presentation to that panel of judges a month ago, but I decided to try it. It felt amazing to have so many people that I respect come to me and compliment me on my presentation.”
‘Caregivers’ Reach Out in West Philadelphia.................... 5
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Penn Medicine@Work..............3 Newsmakers..............................4
Awards and Accolades.............6 Magnet Times Two....................6
$25 MILLION GIFT
TO CREATE BASSER RESEARCH CENTER A $25 million gift to the University of Pennsylvania from alumni Mindy and Jon Gray will establish a center focused on the treatment and prevention of cancers associated with hereditary BRCA mutations. The Basser Research Center — BRC for BRCA — will support research on the BRCA1 and BRCA2 genes, harmful forms of which are linked to greatly increased risks of developing breast and ovarian cancer. The Center is named in honor of Mindy Gray’s sister, Faith Basser, who died of ovarian cancer at age 44. “With their profoundly visionary and generous donation, Jon and Mindy have set the stage for scientific breakthroughs that will transform the lives of women and their families for decades to come,” said University president Amy Gutmann. “In creating this first-ofits-kind center, the Grays’ gift endows Penn researchers and clinicians with the crucial resources required to identify innovative ways to prevent and treat inherited diseases.” Emphasizing outreach, prevention, early detection, treatment and survivorship, the Basser Research Center will contribute to all stages of research and clinical care related to BRCArelated cancers. The Center will be located within Penn’s Abramson Cancer Center at the Perelman School of Medicine. “We are very grateful to the Gray family,” said J. Larry Jameson, executive vice president of the University of Pennsylvania for the Health System and dean of the School of Medicine. “Their commitment to a better future for women around the world is inspiring, and it is a privilege to have them as philanthropic partners.” Susan Domchek, associate professor of Hematology/Oncology and current director of the MacDonald Women’s Cancer Risk Evaluation Center, will serve as the founding executive director of the Basser Research Center and will lead its strategic direction.
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WHAT’S THE ‘BIG IDEA’? AND THE WINNER IS… Over 200 faculty, staff and guests attended the Innovation Tournament finale in the Translational Research Center. Each of the 10 teams presented its ideas to a distinguished panel of judges (see sidebar). “There was tremendous enthusiasm from the judges — the discussion behind closed doors was very animated,” said PJ Brennan, MD, SVP and chief medical officer of the Health System and one of the Your Big Idea judges “But, most of all, the level of engagement of the staff, and the quality of ideas and presentations, just blew us all away.” After the judges’ deliberation, CEO Ralph Muller announced the winners of Penn Medicine’s first ever system-wide Innovation Tournament:
• T eam Patient Services Kiosks: Danielle Grant, Beth Hoffman, Fabian Marechal, James Sampson, and Leslie Allen
• T eam MyPenn Scheduler: Paul Lanken, MD; Anna E. Bortnick, MD, PhD; and Karen Bowles, MD
`` The 16 judges for the Innovation Tournament came from throughout the Health System.
THANKS TO THE ‘YOUR BIG IDEA’ JUDGES! • R alph W. Muller
• R aina Merchant MD
• • • • • •
CEO M ark O. Winkelman Chair, Penn Medicine Board of Trustees PJ Brennan MD SVP and CMO, Penn Medicine A l Black Chief Operating Officer, HUP S andra Jost, CNO Penn Homecare & Hospice Services N ishaminy Kasbekar Director of Pharmacy, PPMC D aniel Feinberg MD Chief Marketing Officer, PAH D eborah Driscoll MD Chair, OB/GYN, HUP
• • • • • •
Emergency Medicine, HUP Kevin Volpp Director, UPHS Center for Innovations in Health Care Financing K ristina Patterson Director of Operations, CCA T heresa Larivee Vice President, Finance M ichael Restuccia Vice President, Information Technology J effrey Drebin MD Chair, Surgery, Penn Medicine P atricia Sullivan Vice President, Patient Safety and Quality P hilip Okala Vice President, Service Line Integration, CPUP
“I am excited to see what happens over the next six months!” said Bortnick, an Interventional Cardiology fellow. “Through our team’s research, we found out that there are various groups in the Health System who are already interested in online scheduling and would like to pursue it in a coordinated way.” In fact, each of the submitted ideas was sent to leadership at the entity and department levels for possible implementation. And so, while only two ideas were chosen as winners of the tournament, ideas that did not win the Tournament are already being implemented at the local levels. “The rapid mobilization of Penn Medicine resources to test the winning ideas is one of the great outcomes of the Innovation Tournament,” said Kevin Mahoney, SVP and chief administrative officer, and vice dean, Integrative Services. “The future will require us to be nimble, take risks and continuously adapt our processes.” To learn more about Your Big Idea: Penn Medicine’s Innovation Tournament, visit the Tournament website at www.pennmedicine.org/YourBigIdea.
REACHES OUT IN WEST PHILADELPHIA Penn Medicine CAREs Helps Expand Its Reach Caregivers in the Community, an outreach program at the Beulah Baptist Church in West Philadelphia, helps members of its congregation — as well as neighborhood residents — on many levels. Sometimes it’s as simple as helping with day-to-day errands. Other times, it’s more involved. For example, when a fire at 45th and Walnut Streets destroyed several apartment buildings and displaced many people, the Caregivers in the Community adopted five families and brought them clothing and provided food vouchers for three months. They’ve fixed donated wheel chairs and brought them to those who have trouble walking, and even managed to provide a TTY system for a person with ALS who could no longer communicate her needs. “We try to meet all their needs, whether it’s emotional, physical or spiritual.” said Phillis DuPree, BSN, LPN, Billing Compliance analyst at Penn Home Care, who is part of the Caregivers group.
PENN MEDICINE SAFETY NET NEW CAPABILITIES AIM TO INCREASE PATIENT SAFETY Penn Medicine Safety Net, the new event management reporting and tracking system, is now live throughout the Health System. Replacing PORTS, the new webbased technology aims to improve patient safety by promoting awareness, increasing reporting of events, and identifying key issues and concerns. “The new system has many key benefits,” said Michael Anderson, MSIS, associate director, CEQI. “These include real-time data capture, improved information accuracy, reduced incident resolution time, and comprehensive reports to quickly determine problem areas and trends.”
Helping to keep people healthy is another component of this community group. They hold health fairs with screenings and educate people as to what their results mean. “It’s wonderful when we can provide information to someone who doesn’t understand what their illness means.” As DuPree noted, the group tries to do a lot but theirs is a shoe-string budget, with funding sometimes coming out of the Caregivers’ own pockets. Now, a Penn Medicine CAREs Foundation grant will help them reach a little further. The grant will go towards purchasing blood pressure cuffs and stethoscopes for their health fairs, a defibrillator for the church and community, and wheelchairs. “Everyone is so very appreciative.” DO YOU VOLUNTEER IN COMMUNITY OUTREACH EVENTS? If so, be sure to report your efforts on Penn Medicine CAREs (Community Activity Reporting E-niative). It’s easy. Simply go in the Intranet page and click on ‘CAREs — Community Outreach’ on the left side. If you have any questions, contact Government Affairs and Community Outreach at 215.662.7030 or e-mail CAREs@uphs.upenn.edu.
Exclusively endorsed by the American Hospital Association, Safety Net also provides: • Tools for completing customized reports to record, evaluate and prevent adverse events • A quick entry mode to simplify the process of submitting events • A clear dashboard view for managers and administrators to select options • Security features supporting HIPAA (eg, hiding sensitive information such as specific names, dates, and places) Anderson said the new system directly responds to issues seen with PORTS, including a long follow-up process with limited analysis, insufficient reporting, and extensive IT resources needed to change the system. For example, in PORTS, users could only search for a generic drug name; Safety Net searches for a specific drug. This speeds up the process of reporting pharmaceutical “near misses,” such as catching the incorrect medication before it’s given to a patient. “I think the biggest difference is the ability to graph the date and ‘drill down’ to the deatil,” said Janet Creely, RN, CPHQ, CCM, CPSO, director, Patient Safety at Pennsylvania Hospital. “Rather than having to request a report, a manager or quality coordinator can run a report or create a graph for a unit. This will be an asset to the Unit Based Clinical Leadership teams.”
HOW DOES IT WORK?
`` Phyllis DuPree (center) of Penn Home Care received a $1,500 Penn Medicine CAREs Foundation grant for the Caregivers in the Community outreach program of the Beulah Baptist Church. Shown with her are members of church leadership (l. to r.) Cheryl Simmons, Sherman Baker, Judith Weaver, and Leon Smith.
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When a case is added to the system, automated alerts and findings go to everyone involved with that particular case, leading to more learning, better quality data, improved problem-solving and better error prevention. Users can anonymously submit information, helping promote a culture of safety throughout the Health System.
These measures are already generating impressive results. For example, we’ve been focusing on reducing mortality and severe infections for the last five years. As a result, observed-to-expected mortality has been reduced by over 40 percent, saving over 1,200 lives from FY09 to FY12 year-to-date. And blood stream infections have been slashed by 95 percent over the same period.
Penn Medicine Safety Net connects with Sunrise Clinical Manager to allow users to easily search for patient information. This data is automatically populated, which helps ensure data integrity and accuracy. It also connects directly to Patient and Guest Services’ database, therefore allowing any patient comments and complaints associated with an event to be readily available to assist in solving concerns.
Our IT investments and strategies have earned us “meaningful use” status from the federal government. Employing electronic health records helps us improve quality of care, safety, and efficiency — while reducing health disparities. It also helps us better coordinate care and ensure privacy and security of personal health information. We are now at work on a comprehensive IT management strategy that will link patient records throughout the health system and beyond, ranging from the physician’s office to the inpatient unit,(deleted independent) lab, and home care, among other settings.
“The system is very user friendly,” said Patricia Remeis, MSN, RN, who manages the system for Radiology at HUP. “I have received many positive comments from the staff in Radiology who have already submitted events. They find the drop-down boxes very easy to use and much easier than writing things which they had to do with the old system.”
We’ve also intensified our interdisciplinary team-based approach to care delivery. This includes adopting the unit-based clinical leadership model, expanding our patient-centered approach in our outpatient clinics, and improving the coordination of care as patients move from our hospital beds to outpatient settings and home care.
Safety New is now up and running, but some glitches remain. For example, standards for documentation and follow-up have not been developed, and the system is not running as quickly as anticipated. Still, Kimberly Volpe, senior quality analyst, PPMC, and a Safety Net system administrator in Quality Assurance, is optimistic about the system while looking forward to seeing more progress on it. “In general, it’s userfriendly and intuitive,” she said. “While we’re still fine-tuning it, I think Safety Net will be a great resource for data to improve patient safety.” Creely said.
The new nine-minute course, Penn Safety Net for Users, is now available to employees on Knowledge Link.
Better coordination and integration of care has also become a priority at Penn. This is especially important as the federal government begins to examine a “bundled payment” approach. This reimbursement model combines previously separate payments for each service that patients receive during a period of care into a single sum. For example, whereas in the past a surgical procedure generated claims from the surgeon, anesthesiologist, hospital, and others, under the new framework the entire team is reimbursed with a single, combined payment. The goal is to provide financial incentives to deliver health care more efficiently while maintaining or improving quality. We recognize that the health care environment is changing dramatically. For example, we are preparing for a new era of reduced payments — a projection we’ve factored into our multi-year budget. And our strategic plan is focusing on ways to excel in such growing fields as personalized medicine (customized care for patients taking into account genetic factors) and biobanking (collecting and storing human biological material and related information for research purposes). Through the steps I’ve outlined here — and others as well — UPHS is well prepared to address the consequences of whatever the Supreme Court eventually decides (and future actions Congress and the president might take in response). Of course no one can predict the future. But planning for likely eventualities and remaining steadfast in our commitment to excellent patient care and responsible fiscal management puts us in a position to continue at the forefront of health care in our region.
OPEN ENROLLMENT 2012
Penn Medicine provides employees with tools to boost patient safety.
In a continuing effort to promote a healthy work environment — and to encourage healthy behaviors — this year UPHS introduced an earned premium discount on medical contributions for non-tobacco users or for those enrolled in a tobacco cessation program. Employees were also able to earn a Healthy Reward Credit (up to $130/year) for completing a Personal Health Assessment (PHA) and for participating in Healthy Behaviors. This initiative, along with others throughout the year, reflects the commitment that UPHS has to creating a culture of health and being one of the healthiest employers in the Philadelphia area.
The Performance Improvement In Action (PIIA) program encourages a culture of continuous improvement, where each employee looks at ways to improve what they do every day to support Penn Medicine’s Blueprint for Quality and Patient Safety. Recently, members of the 13 winter 2012 teams completed this exciting learning program while performing an improvement project in their areas.
To kick off Open Enrollment, the UPHS Corporate Benefits team hosted health fairs at throughout the Health System. Over 500 employees received a blood pressure and/ or BMI screening! Body fat analyzer scales, blood pressure machines, and pedometers were given out as raffle prizes at each of the fairs. Congratulations to those that won prizes and to those who received a screening for taking a positive step in Knowing Your Numbers.
Through the PIIA program, team members learned methodologies and tools to: »»Analyze the current state of their processes »» Identify areas for improvement »» Perform root cause analyses on improvement areas »» Implement countermeasures
Over the two-week open enrollment period, nearly 12,000 employees made an active election. An Early Bird Raffle for a year of free medical benefits encouraged enrollment during the first week. The 10 lucky winners were: Kathleen Haggerty, Alison Carey, Michael Donato, Heather Redman, Adam Beach, Sarah Smith, Beverly Unger, Erin O’Brien, Suzanne Walker, and Michelle Ross.
»» Sustain improvements
Look for more health promotion activities on uphshrandyou.com. The new benefit plan year will take effect on July 1, 2012. Please call the Benefits team with any questions 215.615.2675, prompt #4.
TACKLING IMPROVEMENT MEASURES AS A TEAM
Program feedback was enthusiastic; participants called the three-month program “powerful,” “exciting”, and “innovative.” Team leader John Wierzbowski, MSc., MPH, Safety and Emergency Preparedness Manager at Pennsylvania Hospital, said, “Penn Medicine Leadership Forum provided the tools and pathway I needed to define our root cause and implement the appropriate countermeasure necessary for our team to improve our efficiency, demonstrate a cost avoidance, and reduce our environmental footprint in the Operating Room.” Now, he continued, it’s time to “insert this into the OR routine to sustain the gains.” “It was clear that they truly grasped the improvement process,” said Lee Erickson, MD, chief Quality & Patient Safety officer at PPMC, of the projects the teams completed. They took the time to study and quantify the problems they tackled. They dug into the root causes and re-designed processes to solve them. And they got real results!” Facilitator Staci Oppleman-Bedell, MSW, Quality/Safety Project Manager, CEQI at HUP, spoke of the success of the Inpatient/Outpatient Chemotherapy/Oncology team. “We were able to apply the Penn Medicine PI methodology to transition certain chemotherapy agents to an alternative setting to increase inpatient bed capacity, which maintaining the patient experience at the center of these efforts,” she said. “They informed the project sponsors of stakeholders necessary for this change as well as factors to consider.” To see the list of projects from the winter 2012 Leadership Forum — Performance Improvement in Action program, go to http://news.pennmedicine.org/inside/ system-news. To learn more about PIIA, contact Christopher Klock at christopher. firstname.lastname@example.org. `` Matt Braun, Director of Patient Access and Revenue Recognition at HCHS, shows how the skills acquired in PMLF-PIIA have helped improved his process.
`` At a recent PIAA program session, Christopher Klock, Performance Improvement Consultant, described methods to help employees identify areas for improvement and ways to sustain the necessary changes.
RAD ONC PROGRAM HELPS UNITE EMPLOYEES
With just under 400 employees, Radiation Oncology is one of the biggest departments in the Health System. Aware that the key to its success is not only high-quality patient care, but also ensuring a high quality work environment for its employees, the department created an employee-run committee to maintain employee satisfaction. The “Employee Rewards and Recognition Committee” was designated to create events and programs to demonstrate the department’s commitment to employee satisfaction. The committee comprises employees from all levels and positions across the various areas of Radiation Oncology. Since its inception, the committee has coordinated highly successful events, such as Penny Wars, Valentine’s Day candy “thank you” gifts, team charity walks/runs, department happy hours, as well as the upcoming RadOnc Night out at the Phillies and “Pirates of the CUREibbean” team dragon boat race — just to name a few! In addition to coordinating social events, the committee has also established a employee recognition program where employees can nominate their colleagues for excellence in the workplace. All nominated employees are acknowledged in the department newsletter, with further recognition quarterly and annually. This program is truly designed by the employees, for the employees! Blazing a strong pathway to a top-notch employee engagement program, the department has created focus groups to foster communication and engagement. In addition, it is developing a one-of-a-kind departmental on-boarding, orientation and “buddy” program to welcome new employees into the department’s family-like atmosphere. Also in the works are workshops available to all employees throughout the department to build career development skills, as well as an internal mentoring program. The department took it one step further with the creation of its Patient Experience committee, which provides a link between patients and employees. As shown by the very successful Proton Patient Alumni event held last month, focusing not only on patient satisfaction but also on employee satisfaction — and the connection between the two — is a clear recipe for success.
NEWSmakers / / / A Step Forward for Gene Therapy to Treat HIV
/ / / Q&A with Garret FitzGerald, Expert on Drugs and Heart Risks
A new Penn Medicine study shows that treating HIV patients with genetically modified versions of their own T cells — a strategy that aims to turn patients’ own immune systems against the virus — is safe and does not lead to any dangerous side effects more than a decade after receiving the new cells. All 43 patients studied for the new paper, published in Science Translational Medicine, remain healthy 11 years after the new cell infusion, and 41 of those patients show long-term persistence of the modified T cells in their bodies. The research was led by Carl June, MD, a professor of Pathology and Laboratory Medicine. “We turned those cells into heat-seeking missiles directed against HIV-infected cells,” said Bruce Levine, PhD, an associate professor of Pathology and Laboratory Medicine and director of the Clinical Cell and Vaccine Production Facility, in a Bloomberg BusinessWeek article. The approach is not a cure, but the new data provide important clues about how patients fare in the long run after receiving the modified cells. Pablo Tebas, MD, director of Penn’s AIDS Clinical Trials Unit, told NPR. “And two, the genetically modified cells are still circulating. They perpetuate. Those are two important things this study is telling us.”
Thirteen years ago, Garret FitzGerald, MD, chair of Pharmacology and director of the Institute for Translational Medicine and Therapeutics, warned that new painkillers called COX-2 inhibitors might increase the risk of heart attacks and strokes. He was right. Since then, COX-2 inhibitors, notably Vioxx, have been yanked from the market or failed to win approval. Surviving brands have had to add a stern label warning about cardiovascular risks. Recently, FitzGerald’s lab published two studies in mice that aim to “close the loop” on the debate about exactly how COX-2 inhibitors harm the cardiovascular system. He answered questions from The Philadelphia Inquirer about the research and its implications. Stories also appeared in The Wall Street Journal, Forbes, Medpage Today, and several other outlets.
/ / / Research Questions Efficacy of Boosting ‘Good’ Cholesterol The correlation between high HDL levels and lowered risk for heart disease is so strong, it has long been thought to be a causal relationship. But a new genetic analysis brings the role of HDL into question. Benjamin Voight, PhD, assistant professor of Pharmacology, is lead author of the new study published in the The Lancet. “We studied 15 genetic variants that are known to increase the ‘good’ cholesterol in about 100,000 people,” Voight told WHYY Radio. “And what we found was that variants that increase HDL are not associated with decreased risk of heart attack.” The findings suggest good cholesterol could be an indicator of other, yet unknown factors that actually do protect the heart, factors perhaps controlled by the same genes. The new study brings into question whether trying to raise HDL artificially with supplements such as niacin does any good. And the early research does not bode well for makers of some HDL-boosting drugs currently in the drug production pipeline. In an interview with Forbes.com, Daniel Rader, MD, chief, Translational Medicine and Human Genetics, and coauthor on the paper, said “It’s certainly a strike against the overall HDL hypothesis. But I for one am not convinced that we should abandon HDL.” Coverage of the new research was also featured on CBSNews.com, theHeart. org, and HealthDay.
/ / / Obesity Fight Must Shift from Personal Blame, Said US Panel According to a panel of experts from the Institute of Medicine (IOM), America’s obesity epidemic is so deeply rooted that it will take dramatic measures — from overhauling farm policies to possibly introducing a soda tax — to fix it. In a new report, the IOM refutes the idea that obesity is the result of a lack of willpower. Instead, it embraces policy proposals that have met with stiff resistance from the food industry and lawmakers, arguing that multiple strategies will be needed to make the U.S. environment less “obesogenic.” “People have heard the advice to eat less and move more for years, and during that time a large number of Americans have become obese,” said IOM committee member Shiriki Kumanyika, PhD, professor of Epidemiology told Reuters. “That advice will never be out of date. But when you see the increase in obesity you ask, what changed? And the answer is, the environment. The average person cannot maintain a healthy weight in this obesity-promoting environment.” Coverage of the Reuters article appeared in several national outlets including the Chicago Tribune, Baltimore Sun, and CNBC. Other coverage also ran on local TV news broadcasts across the country.
/ / / Sleep Problems Linked to Obesity, Diabetes ABCNews reported on a new study in Science Translational Medicine linking lack of sleep to high blood sugar levels and weight gain. The article quotes Michael Grandner, PhD, research associate at the Center for Sleep and Circadian Neurobiology, who was not part of the study. “We live in a society that brags about how little sleep we get by on,” said Grandner. “When we hear someone brag about eating a whole pizza in one sitting, we know that was unhealthy and a bad idea. But when we hear someone brag about getting only a few hours of sleep, we don’t have the same reaction, but maybe we should. We need to make sleep a priority for our health.”
/ / / Ekso Device Helps the Paralyzed Walk at GSPP
/ / / For AEDs to Save Lives, People Need to Know Where They Are – And Use Them
Several media outlets reported on the new Ekso bionic exoskeleton device at GSPP — one of only six in the United States. Six patients suffering from lower-extremity weakness or paralysis were the first to experience the innovative new treatment — a lightweight robot worn like an exterior scaffolding around the torso and legs — including Mike Sullivan of South Philadelphia, a C7 quadriplegic. Thanks to Ekso, Mike was able to experience standing and walking for the first time since he was critically injured 17 years ago. Mike, along with Kristen Gustafson, DO, director of Spinal Cord Injury Services and assistant professor of Rehabilitation Medicine, were both featured. The battery-powered Ekso uses a combination of motors and sensors, along with the patient’s efforts to maintain proper balance and body positioning, to allow the user to walk with an efficient and reciprocal gait pattern.
The CNN show, “Sanjay Gupta MD,” reported on Penn Medicine’s MyHeartMap Challenge, an initiative that sent Philadelphians to the streets to locate and submit photos of lifesaving AEDs around the city. The contest’s director, Raina Merchant, MD, MS, an assistant professor of Emergency Medicine, explained the idea behind the contest: “Why not engage the public and use social networking to get people excited about helping to solve a public health challenge?” The story detailed contestants’ experiences locating the devices, which proved a tough challenge, since they often learned that they were held by security, or that employees were unsure whether there was a device in the building at all. The story was also featured in a HealthDay News story that ran in The Philadelphia Inquirer, U.S. News & World Report, and in several other outlets.
/ / / Receiving the Ultimate Mother’s Day Gift Time.com chronicles the journey of Melissa Brown, a breast cancer survivor from Cape May, NJ, who had a child with the aid of Penn’s oncofertility program and her sister, Jessica, a gestational surrogate. Their mother, Gail, was diagnosed with breast cancer in 1984 at the age of 30. Melissa was diagnosed with breast cancer at the age of 26, decided to undergo a bilateral mastectomy and went on to have chemotherapy infusions side-by-side with her mother. Melissa’s oncologist recommended that she undergo fertility preservation as a “sort of insurance policy for the future” for when she may want to have children. Clarisa Gracia, MD, MSCE, director of Penn’s Fertility Preservation Program, froze Melissa and her husband Steve’s embryos, which were later thawed and transferred to her sister, Jessica. Jessica successfully carried twins — a boy and girl — who were born on April 17, 2011. And this year, Melissa and her family celebrate their second Mother’s Day together, happy and healthy.
/ / / Insulin’s Role in Alzheimer’s Steven Arnold, MD, professor of Neurology and Psychiatry and director of the Penn Memory Center, told The Philadelphia Inquirer that diabetics are 50 to100 percent more likely to get the fatal, memory-destroying Alzheimer’s disease. Arnold is the senior author of a new study in the Journal of Clinical Investigation that looked at the brains of people with Alzheimer’s disease and mild cognitive impairment, often a precursor to dementia. He found insulin resistance in their brains, even though the people did not have diabetes. Arnold said the chemical differences between those who did and did not have memory problems were striking. “I’ve never seen a difference this large.” Arnold said it’s likely that people with diabetes have brain insulin resistance, but others could have it, too. He is now seeking funding to test whether, metformin, a diabetes drug that lowers blood sugar and increases sensitivity to insulin, can help people with dementia or mild cognitive impairment.
/ / / Penn Medicine Innovations, Physicians are Tops in Annual Philadelphia Magazine List In this year’s Philadelphia magazine Top Doctors issue, Penn Medicine again had the most Top Docs of any hospital or health system in the region, with a total of 193 Penn Medicine physicians on the 2012 Top Doctors list. Of these, 137 see patients at the Hospital of the University of Pennsylvania, the Perelman Center for Advance Medicine and/or Penn Medicine at Radnor, 38 at Penn Presbyterian Medical Center, and 35 at Pennsylvania Hospital.
/ / / Breast Cancer Treatment Side Effects May Last for Years Research led by Kathryn Schmitz, PhD, MPH, associate professor of Biostatistics and Epidemiology, examining the prevalence of post-treatment physical side effects among breast cancer survivors, was highlighted by U.S. News & World Report (via HealthDay News). Schmitz’s team found that more than 60 percent of women studied had at least one treatment-related complication — including lymphedema and other physical limitations, fatigue, and weight gain — up to six years after their diagnosis, and 30 percent had at least two complications. The story also appeared on Yahoo News, MSN.com, and iVillage.
To reach the Penn Medicine news website, go to www.PennMedicine.org/news
AWARDS AND ACCOLADES Jean Bennett, M.D., Ph.D., has been awarded The Jewish Guild for the Blind’s 2012 Alfred W. Bressler Prize in Vision Science. Bennett studies the molecular genetics of inherited retinal degenerations, using this knowledge to develop rational approaches for treatment of these diseases.
Arthur Rubenstein, MBBCh, former dean of the Perelman School of Medicine, was awarded the George M. Kober Medal, the highest honor of the Association of the American Physicians. The award is given for research in scientific medicine that rises to the highest level of achievement. Rubenstein and mentor Donald Steiner developed the first accurate way to measure insulin secretion in patients being treated with insulin derived from the pancreas of cattle or pigs. This was key to the commerical production of human insulin for diabetics.
Alan Wein, MD, PhD, has received the Keyes Medal from the American Association of Genitourinary Surgeons for his contributions to the field of urology. The organization established the Keyes Medal to distinguish an individual for outstanding contributions in the advancement of urology. It is considered the greatest individual citation in the specialty.
MED STUDENTS EKE OUT 5-POINT WIN This year’s Annual Penn Med Faculty vs. Student Basketball Game may have been one of the best yet. The event is usually held in an old practice gym, but this year it took place in Penn’s historic Palestra, aka the Cathedral of College Basketball. That hallowed hardwood — at one time one of the largest arenas in the world — had yet to host the level of talent that it did on May 4th - academic talent that is.
The new venue would be an adjustment for both teams, but the smart money figured the longer court would be an advantage for the students. In addition to their typically greater cardiovascular reserve, the spacing of the wider court would allow the students to further capitalize on their quickness.
Penn Presbyterian also was named one of the nation’s top 100 hospitals in the annual 100 Top Hospitals study conducted by Thomson Reuters, a first for Penn Medicine. The study evaluates performances over five years in quality, safety, patient experience, and fiscal operations. There are five separate peer comparison groups, and PPMC was listed among major teaching hospitals.
`` On his way to the basket, faculty member Jake Dubroff of Radiology tries to get past medical student Nicholas McAndrew.
The tradition is that the first year students play the first quarter, 2nd years the second and so on. The faculty just substitute like a normal team. This gives the audience an interesting picture of how the rigors of medical school affect the conditioning of a medical student over four years.
The first years usually come out hot, fresh out of college and in the midst of a pass-fail curriculum; they’re by far in the best shape. This year was no different and they sprinted to a 12-0 lead and held a 10 point advantage by the end of the first quarter. The second years are usually more of a mixed bag — they’re still in decent shape but are trying to adjust to being in the clinics and dealing with pass-fail-honors. The clinics must be particularly grueling this year as they squandered the entire lead given by the first years. Even a timeout to regroup couldn’t stop the bleeding.
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Coming out of halftime the faculty were feeling confident and the 3rd years took the floor. Luckily for the students, they were able to quell the 2nd quarter surge by the faculty and leave the 4th years with an 8-point cushion by the end of the quarter.
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The fourth years are typically the worst performers of all. They’ve spent the last few months finishing their scholarly pursuits and enjoying 4th year spring to the fullest until intern year starts. The entire game you can find them cheering on their younger colleagues, hoping desperately for a nice cushion before they come in and try to hang on. No one wants to be responsible for the first ever student loss in the storied rivalry. By far the best shooter on the floor, student or faculty, was Dr. Bill Greeley, chair of Anesthesiology at CHOP. Despite his barrage of 3 pointers to end the game, including one at the buzzer, the fourth years were able to hang on and win by 5 points. Final score: 48-43.
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After the game everyone met at New Deck Tavern for drinks and appetizers, all compliments of Ralph Muller. Enemies on the court joined as friends and colleagues at the bar and recapped the game together. It was another successful year of one of the best Penn Med traditions, the Faculty-Student Basketball Game. By Grant Mitchell, fourth year MD/MBA student at Penn
Earlier this year, HUP received re-accreditation as a Magnet organization by the American Nurses Credentialing Center. Magnet recognition, which has become the gold standard for nursing excellence, is bestowed upon less than seven percent of hospitals in the nation. “Renewal of our Magnet recognition is a tremendous honor and something in which our entire staff takes great pride,” said Victoria Rich, PhD, chief nurse executive, UPMC. “Achieving this status for another four years highlights our dedication to providing supreme patient-centered care.” Hospitals must reapply for Magnet recognition every four years based on adherence to magnet conepts and demonstrated improvements in patient care and quality. One month later, Penn Presbyterian Medical Center officially received Magnet status as well. It is the center’s first such designation. “We are incredibly honored to be recognized by the ANCC as a Magnet hospital,” said Mike Becker, PPMC chief nurse officer. “This achievement is something the entire staff can take pride in, because it truly was a group effort.”
Despite an average age gap of at least 25 years between the two teams, the faculty make it a tight game each year. This is due to their size advantage (in both height and girth) and an uncanny knack for getting all the calls. However, lead official Dr. Jon Morris (aka JoMo) has vehemently denied any bias in his officiating.
Most of the student strategy in the game is to somehow neutralize Dr. Dan Kessler, a true beast in the paint. Fortunately for them, Dr. Kessler was unable to attend this year. Unfortunately for them, CEO and faculty captain, Ralph Muller, brought in two ringers to take his place. With Jake Dubroff from radiology at a looming 6’6” and Neil Ravitz, COO of the Office of the Chief Medical Officer, the medical students had their hands full this year.
MAGNET TIMES TWO
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