Digital Edition of System News - 4/15/2016

Volume 15

Issue 4

April 2016

SYSTEMnews CEO’s corner RALPH W. MULLER

CEO, University of Pennsylvania Health System

At Penn Medicine, “precision medicine” isn’t just a buzzword.

Increasingly, it’s shaping everything we do.

The field, one of the fastest-growing in health care, makes use of sophisticated research and highly sensitive analytical tools to fine-tune diagnosis and treatment in a way that individualizes the care of each patient. This new arena has also swung open doors to new understanding of diseases affecting nearly every part of the body. For example, adenocarcinoma of the lung, once considered a single disease, is actually a collection of distinct disorders, each with characteristic molecular features. This new understanding allows oncologists to apply made-to-order treatments that have a much greater chance of working.

While physicians have long tried to determine a path of treatment that would be best for each patient’s situation and life, remarkable advances in technology now enable truly tailored treatment regimens. No longer, for instance, is a single, highly toxic chemotherapy the treatment of choice for a given cancer. Instead, so-called “next-generation” gene sequencing of patients’ tumors, companion diagnostics, biomarkers, and other transformative measures come together to plot a unique treatment path. Together, these technologies also increase efficiency by reducing trial-anderror spending on imperfectly-matched therapeutics.

Penn Medicine has a strong culture of innovation and research and development well suited to the precision medicine enterprise. It is testimony to our outstanding faculty and staff that we are one of only a handful of institutions actively adding precision medicine approaches to everyday clinical practice.

This is exceptionally demanding work, requiring research excellence; information-technology expertise; clinicians who can skillfully select, adapt, and apply new treatments; and sweeping re-designs of processes and systems throughout the care continuum, from diagnosis to physician decision-support and data collection and assessment.

These efforts were strengthened this past January when David B. Roth, MD, PhD, was appointed director of the new Penn Center for Precision Medicine. Under his leadership, the center is creating a guiding plan with strategies for expanding precision medicine research and patient care system wide. An accelerator fund, translational laboratory, and demonstration/ implementation projects will help our researchers take their new discoveries directly to patients. Data-gathering on both clinical and economic outcomes — not only how did patients fare medically, but did we provide cost-effective care to help them get well? — will help refine what we do.

Dr. Roth and his team are also providing assistance to Penn investigators as they pursue funding from President Obama’s

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INSIDE INSIDE Rubenstein to Ensuring a High-Quality Step Down.................................2 Patient Experience....................2 From Pastels to PDA’s...............2 Novartis-Penn Center for Advanced Cellular RoundtableFree Skin Therapeutics Unveiled..............2 Cancer Screening......................3 Penn Medicine@Work..............3 Shortakes...................................4 Newsmakers..............................4 Another Title..............................5 Living With Mild Cognitive Impairment................................4 SOM Ranked #2.........................6 UPHS Quality & Patient Safety Award.............................5 Leadership Transitions.............6 Awards and Accolades.............6 Upcoming Expansion at Chester County..........................6

CPUP AT

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Penn’s Integrated System: A Model for Other Academic Medical Centers A decision made 40 years ago to create the Clinical Practices of the University of Pennsylvania (CPUP) has helped keep Penn Medicine strong in a perpetually changing and sometimes volatile health-care environment.

CPUP had its start in 1976 but the process to unite all of HUP’s faculty practices under one central umbrella wasn’t a quick process or an easy one. Edward Stemmler, MD, who was dean of what is now the Perelman School of Medicine from 1975 to 1988, led the reorganization. According to an article about the dean in the Spring 1989 issue of Penn Medicine, the medical school’s alumni magazine, “for established physicians the implementation meant not only organizational but cultural and psychological changes as well.”

“It’s been evolving over four decades,” said Peter Quinn, MD, DMD, vice dean for Professional Services and senior vice president of UPHS. “It took a long time to have physicians, researchers and Health System administrators coalesce around a single point of view called ‘Penn Medicine.’”

Creating an integrated clinical practice was necessary to provide a more uniform approach to teaching, research and clinical care, the organization’s tripartite mission. It would also help to centralize and better manage the flow of funds from the practices and the hospital to the School of Medicine. Quinn explained that, historically, members of HUP’s medical faculty were already employed by the hospital but each of the clinical specialties was basically an independent practice with its own goals and needs. “Independent practices were the norm back then,” he said. In consolidating them, “we were ahead of our time.”

While CPUP started at HUP, today its physicians practice throughout the region.

Quinn noted that although more than half of the physicians in the country are currently employed, as opposed to independent, “academic practices are different from other group practices. We don’t have just a pure patient care model. It’s much more complex because we have three missions to support.”

A clinical department chair initially served as CPUP’s director but eventually a board of directors, comprising each of the department chairs, was formed to give each a voice. Today, the group meets twice a month. “It’s amazing how 18 chairs can make up their minds to do something and we get things done.” For example, when PJ Brennan, MD, chief medical officer and senior vice president of the Health System, needed a uniform approach to handling the Ebola virus, he asked the chairs directly at one of these meetings and they worked together to develop a strategy. “You can’t do this without these structures in place.”

`` CPUP physicians care for patients at approximately 150 locations throughout the region, including in Physical Medicine & Rehabilitation at Penn Medicine Rittenhouse.

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Perelman School of Medicine Ranked 3rd in Country The Perelman School of Medicine has been ranked the 3rd best medical school in the United States in the annual medical school survey in U.S. News & World Report’s “Best Graduate Schools” report. This is the 19th year in a row the school has been ranked among the top five medical schools.

“Our strong showing and rise in this year’s U.S. News & World Report rankings reflect the exemplary education that the faculty and staff provide for the clinicians and scientists of tomorrow,” said J. Larry Jameson, MD, PhD, dean of the Perelman School of Medicine. “As the nation’s first medical school, we’re proud to be among the top medical institutions in the country.”

The U.S. News rankings placed the Perelman School of Medicine in a three-way tie with Johns Hopkins University and the University of California—San Francisco.To read more go to bit.ly/1S6Lcdds.

PennOmics Receives Innovator Award........................6

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CPUP AT

Uniting Under One Umbrella

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In 1986, the University trustees made two significant changes. They combined CPUP, HUP, and the School of Medicine to create the University of Pennsylvania Medical Center. (The Medical Center evolved to become the University of Pennsylvania Health System in 1993 and then Penn Medicine in 2001). The trustees also centralized authority by appointing a single leader to have control of all three parts. Stemmler was the first to hold that dual position. Today J. Larry Jameson, MD, PhD, is executive VP of the University of Pennsylvania for the Health System and dean of the Perelman School of Medicine.

“An integrated system such as ours provides a unified way to manage resources intelligently, to cross subsidize so we can support all our missions instead of pitting one group against another,” Quinn said. “This was unique then and still is.”

While this integration improved the flow of funds among the three components, a financial resource management model developed by Elizabeth Johnston, CPUP executive director, and David Kennedy, MD, former vice dean for Professional Services, in 2005 “was a defining moment in CPUP’s history,” Quinn said. Rather than having each of the clinical departments independently negotiate financial arrangements with the hospitals and School of Medicine, the fund flows model standardized methodologies to align financial support across the academic and clinical missions.

Structured for Continued Success In today’s health care environment, more and more insurer payments are based on metrics, such as our Press-Ganey scores, re-admission rates, and infection rates. “As more payments are linked to quality factors, the integration between doctors and hospitals is even more important,” Quinn said. “CPUP can respond to all these changes in a unified fashion.”

Much of inpatient care has moved into the outpatient realm and the CPUP practices have expanded to meet those needs. The construction of Penn Medicine’s three anchor ambulatory facilities for its city hospitals (the Perelman Center for Advanced Medicine, Penn Medicine Washington Square, and Penn Medicine University City) not only enhanced the clinical practices but also provided inpatient services with the needed space to grow. This uniting of CPUP practices also resulted in a new focus on the patient experience. (See accompanying article).

“People from other academic medical centers come here and want to know how this integration works — how we get it to work. We are the model around country because we’ve been at it so long,” Quinn said.

“That’s our advantage. No matter what’s coming down road, we’re structured to manage it,” he continued. “It’s remarkable what has been accomplished. We’ve done incredibly well in a world where you can’t always say that.”

`` Participants of the first ever PSR Academy executing a team-building activity during class.

Ensuring a High-Quality Patient Experience at CPUP The opening of the Perelman Center for Advanced Medicine (PCAM) in 2008 served as a turning point for CPUP. Not only did it bring together most of CPUP’s clinical specialties into one brand new, state-of-the-art facility, but it also provided the opportunity to rethink how both clinical care and service were delivered to patients. Prior to moving in to the new site, a renewed commitment to service was declared, principles of practice were adopted, and a series of training sessions for all staff was conducted.

While there was a noticeable change in the patient experience during the first couple of years following the opening of PCAM, it became clear that new facilities and one training course were not sufficient to sustain and further improve on initial gains. “We had to completely rethink how we hire a critical front line role,” said Elizabeth Johnston, CPUP’s executive director. “The patient service representatives [PSRs] are often the first and last person with whom a patient interacts — this is where the patient experience starts. We could no longer afford to ‘post and hope’ that an open position would be filled by someone with the right aptitude and attitude for service.”

Instead, leaders established the PSR Academy. Candidates were sourced from non-traditional industries that tend to place a high premium on service training such as banking, restaurants and hotels. Selection criteria valued an orientation to service over technical experience. “We can train people on our practice management information systems, but we cannot teach folks empathy,” said Johnston. The first cohort of 25 individuals, selected from a pool of more than 1,000 applicants, underwent a five-week curriculum that included service training, EPIC training, and a proctored experience in the outpatient clinics. Upon graduation, almost 70 percent of the now fully trained graduates were hired into open positions. The remainder worked in the internal float pool, and had permanent positions within two months. Since starting this program, the time needed to fill open positions has significantly shortened and the caliber of candidates has improved. “A number of our PSR Academy graduates hold undergraduate or even master’s degrees, and many have gone on to leadership positions in Penn Medicine,” Johnston said.

A similar investment in existing staff was also required, if long term change was to be sustained. To that end, CPUP leadership and The Penn Academy partnered to develop the Penn Patient Experience training program. This was a series of manager summits, staff training modules (team-based, classroom learning), and customized one-one-one simulations with standardized patient actors. “We developed scenarios specific to each specialty practice, so the experience would resonate with the individual staff member,” Johnston said. “I wanted them to leave the training thinking ‘How do I apply what I have learned today when I go back to my practice tomorrow? How do I become part of the change?’”

These programs continue to evolve and expand. In addition, “reward and recognition programs, and Health System-wide celebration events such as UPHS Patient Experience Week, reinforce what we value,” she said.

CPUP is also tackling the issue of access. Getting an appointment with a CPUP specialist in a timely manner is critical not only to enhancing the patients’ experience with Penn Medicine, but it is also key to quality. New tools have been developed to measure how much capacity should be available in the clinics in terms of provider appointments, as well as how well that capacity is utilized. “If we are failing to fill open appointment slots, patients may be waiting longer than necessary to see a provider,” Johnston said. New electronic scheduling questionnaires are being built in EPIC’s practice management system which will ultimately pave the way to patients being able to schedule their own appointments online. A multi-pronged approach to reducing wait times within the clinic sessions is underway.

Together, these varied efforts are paying off. Between 2012 and 2016, CPUP’s Likelihood to Recommend scores (as measured by Press-Ganey), increased from the 26th percentile to the 83rd percentile nationally. As Johnston said, “We are constantly thinking of new ways to reinvigorate our commitment to service on behalf of our patients.”

Novartis-Penn Center for Advanced Cellular Therapeutics Unveiled In February, physicians, scientists and leaders from the Perelman School of Medicine and Novartis officially unveiled the Novartis-Penn Center for Advanced Cellular Therapeutics (CACT). The Center, which is located atop the Henry Jordan Medical Education Center, will expand Penn’s groundbreaking research using chimeric antigen receptor (CAR) technology. This therapy enables the patients’ own immune cells to be reprogrammed outside of their body and re-infused to hunt for and potentially destroy their cancerous tumors.

“In only a few years, we have generated significant achievements that have moved the field of personalized cellular therapies forward, opening clinical trials to test these treatments not only for patients with blood cancers, but also those with solid tumors,” said Carl June, MD, director of the Center for Cellular Immunotherapies. “The CACT will allow us to leverage this progress to develop and test new approaches more quickly and expand our ability to manufacture personalized cell therapies for a greater number of trials.”

Taking part in the official ribbon cutting was Bill Ludwig, the first patient to receive CAR therapy in 2010, to fight the leukemia that was taking his life. Five years after treatment, he remains cancer free. `` (From left): Jonathan Epstein, MD, CEO Ralph Muller, Glenn Dranoff, MD (Novartis), Bill Ludwig, Bruce Levine, PhD, Carl June, MD, Chi Van Dang, MD, PhD, and J. Larry Jameson, MD, PhD.

$27 million

in construction costs

2

23,610 sq ft

of laboratory and cell therapy manufacturing space

Capacity to manufacture cellular therapies for up to

400 patients per year

Staffed by 100

highly specialized cell therapy professionals

6,300 sq ft

of “clean room” space for cell engineering

penn medicine

work

Annual UPHS Health Fairs and Open Enrollment Coming in April!

Open Enrollment this year begins on Monday, April 25, and runs through Sunday, May 8. Look for the Annual Open Enrollment newsletter being mailed home to all UPHS employees in early April that will outline the benefit information and changes for the 2016-2017 plan year.

All employees are encouraged to read through the newsletter thoroughly and contact the Benefits Team with any questions by calling 215.615.2675, option #4, or emailing BenefitsQuestions@uphs. upenn.edu. More information can be found on the HR and You website (www.uphshrandyou.com).

Any changes made during Open Enrollment will take effect on July 1, 2016 The annual Health Fairs will be held during the first few weeks of April at several UPHS locations.

These fairs allow you to visit with many vendors, be entered into raffles for cool prizes, grab free giveaways, sign up for an upcoming biometric screening, and learn about your medical plan and other benefits as a UPHS employee.

Driving Change at the Front Line Penn Medicine Academy announces the creation of Performance Improvement at Penn Medicine, an educational framework to drive change at the front line.

“Healthcare is changing. The resources that we have are changing. The diseases that we treat are changing. The patients are changing. We have to change with them,” says Neil Fishman, Associate Chief Medical Officer, UPHS. “The advantage that Performance Improvement offers is that it allows us to have a structured, measured, planned response to the change.”

The goal of this self-guided learning resource is to build knowledge of Performance Improvement (PI) methodology, language and tools, while simultaneously enhancing one’s PI mindset. Performance Improvement at Penn Medicine includes the following components:

• E-BOOK: The Guide to Performance Improvement at Penn Medicine will provide you with a structured approach to problem solving.

• MICROLEARNINGS: These concise videos provide educational content on the Performance Improvement processes and tools.

• TOOLS & RESOURCES: Templates and reference materials to assist in each phase of a Performance Improvement project.

• PROJECT TRACKER: A searchable database of in-progress and completed projects.

PI is a process which, when applied to a problem, can improve existing processes in an organization. While Performance Improvement involves a systematic approach using specific methodology, there are a variety of approaches to problem solving that should be considered. Each methodology focuses on improvement but uses different methods to achieve the best result. Performance Improvement at Penn Medicine uses a sixphase methodology. (See phases below.) More information on how to execute each of these phases can be found in the PI at Penn Medicine eBook.

You can access Performance Improvement on the Penn Medicine Intranet by opening Internet Explorer from any computer connected to the Penn Medicine network and typing “piatpenn” in the URL or visit http:// pennpointplus.uphs.upenn.edu/sites/PIatPennMedicine/SitePages/Home.aspx.

For additional information on Performance Improvement at Penn Medicine, contact Christopher Klock at Christopher.Klock@uphs.upenn.edu.

Gateway to the Operating Room: OR Training Program for Nurses The Gateway to Perioperative Nursing embraces new-topractice nurses as well as seasoned nurses with little operating room experience. An inclusive, six-month program involving classroom instruction and hands-on practice, candidates go through rotations of all clinical specialties in the operating room.

Santina Mazzola, RN Clinical Nurse II at HUP, and a graduate of the program, said it really helped her career. “It’s great for new nurses; it’s great for experienced nurses,” she explained. “You learn a lot about anatomy, advocacy, safety and medications. It’s a great way to jump start your practice as a clinician.”

Through both mentorship and self-learning, there are many touch-points to review progress and identify opportunities.

“Each Gateway candidate is assigned a mentor, who is the candidate’s go-to person for the entire six-month program,” said Michael Murphy, RN Clinical Education Specialist at Pennsylvania Hospital. “In addition, as the educator, I try to sit down with the candidate each and every day. We talk about the day, what went well today, what are some of the things that we could do better, how can I help.”

As healthcare practice becomes more complex, perioperative nursing must evolve. “The role of the Periop RN is ever changing,” said Roselyn McGrath, MSN, RN, CNOR, the Nursing Professional Development Specialist in HUP Perioperative Services. “The Periop 101 program that we use for our orientation is evidence-based and built on standards and practices recommended by the Association of Perioperative Registered Nurses. It’s a very structured and current program that delivers the same information to all of our students along with blended online learning, clinical rotation, classroom work, role play and interactive teaching.”

The distinctiveness of perioperative nursing over bedside or floor nursing can mean a change in work environment for many. “You get to the operating room in nursing school, but it might only be one or two days. It’s not as extensive as let’s say a med surg floor or an ICU. I knew I liked it then, I just didn’t know enough about it,” Mazzola said. “In learning about the Gateway program, you get great exposure to perioperative nursing as a whole. It’s a different side of nursing that is so unique and has so much autonomy.”

“The most successful candidate is someone who knows they want an operating room environment.” said Jeffrey Shapiro, Supervisor of Nurse Recruitment. “The operating room is very much a strong team environment. It’s multidisciplinary. You have doctors literally working hand-in-hand with nurses. It’s also very technology motivated. Working in one of the ORs at Penn Medicine, you would expect to work with the latest technology.”

The investment of nurses who enter the Gateway to the Operating Room is apparent from the very beginning. “That’s one unique aspect about this health system. They do nurture you,” Shapiro said. “They nurture the nurses to become leaders, to really reach down and help you become the best nurse you can be.”

For more information about the Gateway to the Operating Room program at Penn Medicine, please visit: www.PennMedicine. org/nursing.

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Penn Medicine

NEWS makers / / / High “Good” Cholesterol Not Always a Good Sign Evidence has been mounting for a few years that raising “good” cholesterol levels is not necessarily helpful in preventing heart disease. Media outlets around the world covered a new study led by Daniel Rader, MD, chair of Genetics, which explained a piece of that complicated puzzle, at least for people with a particular genetic quirk.

/ / / Could Twitter Be a Recruitment Tool for Cancer Trials?

Twitter might help boost the number of cancer patients who enroll in clinical trials of potential treatments, according to a new study in JAMA Oncology from researchers at the Abramson Cancer Center. The study, led by Mina Sedrak, MD, a fellow in Hematology/ Oncology, received media coverage across the nation.

/ / / Interlocks Cut Alcohol-Related Crash Deaths Alcohol-related traffic deaths were 15 percent less common in states that required ignition interlocks, which make drivers pass a Breathalyzer-like test before the engine will start, than in other states, according to a study led by Elinore J. Kaufman, MD, a student in Penn’s Health Policy master’s degree program. The study, published in the American Journal of Public Health, was reported in multiple outlets.

/ / / Penn Medicine Teams Pitch Ideas for Improving Patient Care Eight teams of Penn Medicine health care professionals with diverse ideas for improving patient care presented progress reports in the hopes of gaining additional funding for their projects. The Philadelphia Business Journal reported on the eight projects that last year received seed funding from the Innovation Accelerator Program to kick start their ideas and reached out to David A. Asch, MD, MBA, executive director of the Penn Center for Health Care Innovation, regarding the program.

/ / / Two Studies Strengthen Links Between the Zika Virus and Serious Birth Defects Sara Cherry, PhD, an associate professor of Microbiology, commented in The New York Times about two Zika virus studies on the link between the virus and microcephaly. She noted that cells used in the highlighted preclinical study were infected with a Zika strain “quite distinct” from the one now infecting people in Latin America.

/ / / Testosterone Boosts Libido And Mood In Study — But Beware Of Caveats Results from The Testosterone Trials, led by Peter Snyder, MD, a professor in Endocrinology, Diabetes and Metabolism, and a team of researchers, found that testosterone treatment improves sexual activity, walking ability and mood in men over 65 with low T levels. Findings were published in The New England Journal of Medicine and were covered nationally.

Living With Mild Cognitive Impairment How does MCI (mild cognitive impairment) affect the lives of those living with it? What’s a typical day for them?

That’s what Tigist Hailu, coordinator for Diversity in Research and Education at the Penn Memory Center, hopes to discover, using photos and in-depth interviews. “We want to understand the lives of older adults diagnosed with MCI by using photos as a tool to encourage conversation,” she said.

People with MCI, a disorder that affects as many as 20 percent of Americans age 65 and older, have a measurable memory impairment. While not as serious `` Tigist Hailu with participants in her MCI study. as dementia, it may affect instrumental activities of daily living, a term that describes the ability to do life’s daily tasks such as managing medications, cooking and taking care of bills. As part of the study, participants will take photos that “represent or reflect features of their every-day life that frustrate, assist or challenge their memory and the tools they use to overcome them,” she said.

Then, during one-on-one interviews, Hailu will talk with them about their images. “Our goal is to get them to talk about every-day experiences with this diagnosis, to gain insight into how they’re living with MCI,” she said. The Penn Medicine grant she received has helped with the purchase of the cameras as well as other associated costs. Read more about the study at http://news.pennmedicine.org/inside/system-news.

If you volunteer your time in community outreach, you may be eligible to receive a Penn Medicine CAREs grant. To learn more and apply, go to http://uphsxnet.uphs.upenn.edu/ community/CARE/grant.html. The deadline for the next round of grants is Wednesday, June 1.

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/ / / Racial Disparities Persist in Some Types of Cancer Cancer deaths have dropped overall for black and white Americans, but disparities still exist, a new report shows.

Health experts say progress is slow-going across all of health care and medicine. “We haven’t been successful in moving that needle with a significant force,” Eve Higginbotham, MD, Vice Dean for Inclusion and Diversity, told CBS News.

/ / / The Many Colors of Breast Milk Christine Jaslar, RN, IBCLC, a lactation consultant at HUP, appeared live on Fox29 to discuss the reasons behind how breast milk helps babies fight infections and why breast milk may change colors. “Diet is usually the culprit for changing colors in breast milk,” Jaslar explained, adding that colors may include pink, blue, or even black, and no color should automatically be cause for concern.

/ / / Inside the OR: Stabilizing a Chronically Dislocated Shoulder The Philadelphia Inquirer went “Inside the OR” with G. Russel Huffman, MD, MPH, an associate professor of Orthopaedic Surgery, to observe and photograph a shoulder-stabilization surgery. Huffman, the patient and Selina Luger, MD, director of the Leukemia Program in the Abramson Cancer Center, were quoted throughout the piece.

/ / / A Wager Works Better than a Bribe in Motivating Overweight Workers to Exercise Media outlets across the nation reported on a new study showing that the potential to lose a reward is more effective at increasing physical activity than the possibility of earning one. Lead author Mitesh S. Patel, MD, MBA, an assistant professor of Medicine and Health Care Management, said the research team expected that the participants most likely to meet their goals would be the ones who saw their reward shrink if they didn’t.

/ / / Fatigue Factor in Taxi Drivers Gets a Hard Look In crafting regulations for taxi and car-service drivers, New York City will have to consider safety and industry needs. Rules intended to ensure drivers are well rested are generally aimed at preventing the most egregious violations, David F. Dinges, PhD, director of the Unit for Experimental Psychiatry and chief of Sleep & Chronobiology, told The Wall Street Journal.

To reach the Penn Medicine news website, go to www.PennMedicine.org/news

UPHS QUALITY & PATIENT SAFETY AWARDS Each year, Penn Medicine recognizes those departments that have exhibited leadership and innovation in activities that ensure high quality clinical outcomes, patient satisfaction and safety, and cost effiency. Congratulations to the 2015 UPHS Quality and Safety Awards winners below, chosen from over 100 submissions!

Quality & Patient Safety Award Operational Award UPHS Development, Implementation and

Evaluation of a System-Wide Nurse Driven Removal Protocol for Indwelling Urinary Catheters

Joel Betesh, MD, FACP; Kim Calhoun, RN, MSN, CCRN; Courtney Maloney, MSN, RN; Deborah A. Christopher, MSN, RN, CPHQ; Katherine Dimedio, BSN, RN-PCCN; Sitha Dy, MSN, RN, CCNS; Mika Epps, MSN, RN; Asaf Hanish, MPH, Kathryn Farrell, MSN, RN; Neil Fishman, MD; Rebecca Fitzpatrick, DNP, RN, CIC; Jessie George, MSN, RN; Denise Gilanelli, RN, BSN, MS; Robyn Hilliard, MSN, RN; Robert Hossain, BS; Terese Kornet, MSN, RN; Bridget Major-Joynes, MSN, RN; Colleen Mallozzi, BSN, RN, BSIS; Matthew D. Mitchell, PhD; Julia Lavenberg, RN, PhD; Diane Newman, DNP, FAAN, BCB-PMD; Kimberly Pavan, MSN, CRNP; David Pegues, MD; Nina Renzi, BSN, RN; JoAnne Resnic, BSN, MBA, RN; Jessie Reich, MSN, RN, ANPBC, CMSRN; Cynthia Richardson, MSN, RN-BC; Debra Runyan, BS, MT(ASCP), CIC; Sean R Sarles, MSN, RN, CCRN; Laura Solano, RN, MSN, CCNS, CCRN; Ray Sutter; Craig Umscheid, MD, MSCE; Margaret Yoho, MSN, RN

CCA Delancey Internal Medicine: Improving Patient Access

GSPP Increase Compliance with Restraint

UPHS Employee Hypertension Program

GSPP 100% Compliance with Individualized Plan

Lisa Jarrett, BSN, RN; Linda Stevenson, MSN, RN-BC; Laure Ames, BFA, BSN, RN; Carolyn Brant, BSN, RN; Sana Calabrese, BSN, RN; Natalie Blanden, BSN, RN; Nina Renzi, BSN, RN, CCRN

Nicole McHenry, RN; Matthew Rusk, MD; Donna Donia, MA; Kate Clayton, BA; Nish Kasbekar, PharmD; Michael Serpa, BA; Sue Southard, MSN, CRNP, RN; Sheila Sweeney, DGIM; Jen Brady, MA, RD, LDN; Judith McKenzie, MD, MPH; Amy Behrman, MD

F ranklin E. Caldera, DO, MBA; David Lenrow, MD, JD; John Mcgreevey, MD; Andrew Goldfrach, FACHE; Jeff Landgraf; Sunrise Clinical Manager Team

UPHS Development of an Integrated Health-

Illness Management

Documentation

HCHS Home Care and Hospice Services Orthopedic Clinical Care Pathway

S cott Rushanan, MS, OTR/L, MBA; Eric Hume, MD; Archell Dandy; Taleemah Johnson; Tamyra McKinley; Charlina Towler; Kim Mckain; Dianna McCollum , RN BSN; Melissa Griffi; Penn Home Care Therapy Services (PT and OT clinical staff)

HUP Standardizing the Transmittal of Hospital

Discharge Summaries and Obtaining Outside Hospital Records to Improve Care Coordination

of Care

HCHS Comprehensive Longitudinal Advanced

System Based Specialty Pharmacy

Richard F. Demers, MS, RPh, FASHP; Nishaminy Kasbekar, BS, PharmD, FASHP; Suzanne Brown, MS, RPh; Donna L. Capozzi, PharmD, BCOP; Lindsay Aaronson, MBA; Joseph K. Favatella, PharmD, BCP

David Casarett, MD, MA; Meghan Coleman, DNP, RN, CRNP, AOCNP; Susan Foster, BSN, RN, CHPN; Laura Bender, BA; Meredith Dougherty, MS; Michelle Brooks, MSS, LCSW; Patrick Brown, MBA, MS; Ida Eckhardt, BS, RN, CHPN; Patty Gibbons

CCA Decreasing Penn Medicine Safety Net Events

HUP The Effectiveness of an Intensive Care Unit Quality Resource Nurse: An Innovative Tool to Achieve and Sustain Reductions in Hospital Acquired Complications

Kathleen Bailer, MSN, RN; Brenda Hayes, MBA; Sheila Doyle, BS; Lori Hoffman; Kristi Johnson; Cassandra Bullard; Tina Burnett; Jill Esrey; Tim McInnes; Karen Lyons; Margaret Bulley, BS, MT (ASCP), MS; Sheri Digs, MBA, BSBT; Kara Geibel; Deborah Mincarelli, BS, MT (ASCP), CSSGB

R ebecca Miller, BSN, RN, WCC, CCRN; Stephanie Maillie, MSN, RN, WCC, CCNS, PCCN, CCRN; Cheryl Maguire, MSN, RN, CCRN-K, NEA-BC; Jessica Fuller, BSN, RN, CCRN, NE-BCs; Barry D. Fuchs, MS, MD; M ark E Mikkelsen, MD, MSCE

CCH Chester County Hospital MRI Capacity

PAH Ebola Virus Disease Preparedness Planning

Specific To Phlebotomy Related Issues

Rosemary Kearney, MD; Karen Lyons, MBA; Melissa St. Marie; Derrick Stevens; Paul Cohen, MD; Julie Kershner; Jennifer Fonseca; Melody Williams; Raza Ahmad, MD; Lisa DeCicco; Tiffany Parilla; Kristen Quinn; Joel Betesh, MD; Jasmyn Farrare; Enitsa Santiago; Faith Mebane

CCH Blueprint for Quality: Reduce Catheter

Associated Urinary Tract Infection

Jenna Chrisanthon, BSN, RN; Betty Ann Boczar, MS, BSN, RN, NEA-BC; Frances Bennett, MSN, MHA, RN; Nicole Pavone, BSN, RN, CMSRN; Nicole Nolte, BSN, RN; Michael Newcomb, BSN, RN, CMSRN; Kathryn Gallagher, MS, BSN, RN, NE-BC; Michael McFall; Janeen Davis; Judy Crawford-Waters; Jennifer Myers, MD; Matthew Garin, MD; John McGreevey, MD; Dan Pugilese, MD; Rich Urbani; Rutvij Patel; Jeffrey Landgraf; Beverly Spiece

PAH A Multidisciplinary Approach to SSI Reduction from Preop to Recovery T racey Borgstrom, BA, RN, CMSRN; Kirby Cannon, BSN, RN, CMSRN; Sonya Hash, MSN, RN, CEN; Terry Honey, RN, CNOR; Leigh Holman, MSN, RN, CMSRN, CNML; Mary Jo Steffes, BSN, RN, CAPA; Charleen Faucette, MT(HEW); Patty Paulley, BSN, RN, CEN; Julie Musantry, MSN, RN; Jen Greyson, BSN, RN, CMSRN; Rick Terkowski, MSN, RN, CEN

CPUP Use of an Enhanced Multidisciplinary

Medication Adherence and Safety Program to Improve HIV Virologic Suppression and Reduce HIV Transmission Risk

Eileen Hollen, MSN, CRNP; Amy Graziani, BS, PharmD; Susan Hansen-Flaschen, MSN, CRNP; Janet Hines, MD; Nagham Abdulnour, BS; Bernadette Allison, RN, BSN; Judith Anesi, MD; Katie Bar, MD; Todd Barton, MD; Ashley Blocker; Emily Blumberg, MD; Bryce Carter, PhD; Amy Cheng, PharmD; Barbara DeMagnus, MSW; Jillian Dougherty, PharmD; Brittany Foxworth, CMA; Ian Frank, MD; Abbi Goldman; Phil Green, MD; Debbie Gudonis, LPN; Deborah Kim, BS, RPh; Sarah Kraus, PharmD; Sara Longworth, MD; Jonathan Nunez, MD; Joseph Quinn, RN, BSN; Brittany Rogers; Karen Russo; Joe Smaltini, LPN; Pablo Tebas, MD; Blair Weikert, MD; Marissa Wilck, MD; Julia Weiner, PharmD; HUP Outpatient Pharmacy; My Penn Pharmacy

aria Vacca, BSN, RN, CIC; Gordon Baltuch, MD, PhD; John M Stern, MD; Hanane Chaibainou, ACNP-BC; Michael Murphy, MSN, RN, CNOR; Michael Kinslow, CRNA, MS; Linda Michael, BSN, RN; Terry Bada, BSN, RN; Patricia Moriarty, BSN, RN, CNOR; Nazime Rystem, ST; Debra Runyan, BS, MT(ASCP), CIC; Claire Stango, RN, CIC; Emily Coughlin, CRNP; Dana Dolce, CRNP; Kristyn Rupich, CRNP; Elaine Joyce MSN, RN, CNOR, CRNFA; Sean Rowland, CRNA, MS, MBA; Elizabeth Sabo, PharmD, BCPS; Ida Macri, BSN, RN, CIC; Deborah A. Christopher, MSN, RN, CPHQ; Marie Albert BSN, RN, CMSRN; Anne Thompson, RN, BSN, MBA

Michael Barber, MHA; Bahareh Assadi, MD; Carl Adkins, MBA, FACHE; Bahareh Assadi, MD; Stephanie Ciccarelli, MD; Kristen Petticord Mason, RT (R) (MR); Colleen Scelsa, BS, RT (R); Mary Lou Lafreniere, RHIA, CPHQ, MBA; Katie Costantini, MSN, RNC; Dana Casar, RT (R) (MR); Kevin Fitzgerald, RT (R) (MR); Leigh Holman, MSN, RN, NE-BC, CMSRN; Jill Doyle, BSN, RN, CEN; Debbie Jaeger, MSN, RN; Sandy Garrison, BSN, RN, MBA; Nicholas Polymenakos; Paul Morris; Marilyn Miller; Maria Kania, RN-BC

CPUP Primary Care Anywhere

PPMC Improving Tobacco Dependence Treatment for Hospital Inpatients

ida Shumacher, MSN, RN, CNL; Ann Schwoebel, MSN, A CRNP, RNC-NIC; Annette Tantillo, RN, MSJ; Bryan Anthony, MHS; Carolyn Tobin, BS, BA; Claire Stango, RN, CIC; Daniel Feinberg, MD, FAAN; Daniel Wilson, BSN, MBA, RN, FABC; David O’Brien, MSN, RN, ONC; Deborah Christopher, MSN, RN, CPHQ; Debra Runyan, MT(ASCP), CIC; Diane Angelos, MSN, RN, CCRN; Florence Vanek, MSN, RN; Gretchen Kolb, MS; Heidi Beris, MSN, RN, CPN; Janice Radway; Jeffrey O’Neill, AIA, ACHA; Joan Smith, BSN, MSEd-MHA, RN; John Brennan, MSN, RN, CNHA; John Stern, MD; John Wierzbowski, MSc., MPH; Kathleen Nasci, MD; Leigh Kennedy, DO; Lisa O’Neill, MPH, BSN, CMSRN; Lisa Verseput, MSN, RN, CEN, NE-BC; Margaret Markunas, MBA, CNMT; Mary Del Guidice, MSN, BS, RN, CENP; Michael Murphy, MSN, RN, CNOR; Olivia Fermano; Patricia McCartney, MSN, RN; Phillip Landis, DNP, RN, CEN; Ruth DiLeo, MSN, RNC-OB; Tanya Carmichael, MSN, RNC-OB; Tina Barnett; Tonya Johnson, DNP, RN, CCRN, NEA-BC; Wayne Harris

PPMC Impact of a Redesigned Process on Outcomes of Patients Presenting with Acute ST Segment Myocardial Infarction Gillian Lautenbach, MD (PIMA); Susan Day, MD (PIMA); Bob Cato, MD (PCPC); Mark Lari, MBA, PTA; Tiffany Smith; Denaja Miller, MHA; Steven Smith, MBA, RRT; Tia Hope; Angela Starnes; Alison Maurer; Lindsay Prendergast; Michael Cella; Ambulatory Access Center Primary Care Scheduling Team; All Participating CPUP Providers; All Participating CCA Providers

Frank T. Leone, MD, MS; Sarah Evers-Casey, MPH, MTTS; Danielle Peereboom, MPH, MTTS; Jody Nicoloso, MTTS; Susan Chodoff, MBA; Kim Pavan, MSN, CRNP-BC; E. Annie La Mura McGowan, BSN, RN; Hubert Porter, BSN, RN; Kendal Williams, MD

Matthew J. O’Donnell, RN, BA, BSN; Christopher Edwards, MD; Leighann Mazzone, RN, BSN; M ichael McDonald, RN, BSN

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LEADERSHIP TRANSITIONS David Roth: Director of Penn Center for Precision Medicine David B. Roth, MD, PhD, has been appointed director of the new Penn Center for Precision Medicine. In his new role, he will lead efforts to accelerate the implementation of precision medicine into clinical care. Roth is an internationally recognized expert in DNA repair and mechanisms of programmed gene rearrangements during immune cell maturation.

Roth, who will remain chair of Pathology and Laboratory Medicine, will work with senior leaders at Penn Medicine to develop a strategic plan to better integrate academic research with clinical operation in this field. “By leveraging our many strengths in biomedical research and developing synergies with our clinical programs, a primary goal of the new center is to create and implement precision medicine-based clinical care pathways embedded in systems of care,” Roth said.

Kevin Baumlin: Chair of EM at Pennsylvania Hospital Kevin M. Baumlin, MD, FACEP, has been named chair of Emergency Medicine at Pennsylvania Hospital, and vice chair of Emergency Medicine for the Perelman School of Medicine. Baumlin is a globally recognized physician leader, and an accomplished clinician with a unique combination of applied capabilities, including informatics, operational innovation, and quality and performance improvement.

Baumlin was previously chair of Emergency Medicine at Mount Sinai Beth Israel Hospital in New York, a position in which he had direct oversight of the facility’s 265 clinical care providers, 110,000 patients, and 45 residents. During his time in this role, Kevin oversaw the development and implementation of programs that resulted in significant operational improvements, including a dramatically reduced wait time in the Emergency Room and improved Press Ganey scores.

Kevin’s academic interests lie primarily in informatics and geriatric emergency medicine. He has published and lectured widely on both topics in leading academic journals.

AWARDS AND ACCOLADES Joseph Bavaria, MD, director of the Thoracic Aortic Surgery Program, has been elected the 2016 president of The Society of Thoracic Surgeons. Its mission is to enhance the ability of cardiothoracic surgeons to provide the highest quality patient care through education, research, and advocacy.

David F. Dinges, PhD, chief of Sleep and Chronobiology, has been awarded the 2016 Pioneer Award from the National Space Biomedical Research Institute. This award recognizes an individual whose efforts and accomplishments have blazed new trails on behalf of the Institute, its partnership with NASA and the space biomedical community at large.

Joan Doyle, executive director of Penn Home Care and Hospice, has been appointed a member of the Governing Council for Long-Term and Rehabilitation (in Region 2) of the American Hospital Association. The Council promotes understanding and support for their member needs, participates in AHA policy development and recommends advocacy strategies to the AHA board.

Kiran Musunuru, MD, PhD, MPH, of Cardiovascular Medicine and Genetics, received the Presidential Early Career Award for Scientists and Engineers. The annual award, the highest honor bestowed by the U.S. government on outstanding early-career scientists and engineers, recognizes Musunuru’s outstanding achievements in research on the genetic factors behind heart attack, sudden cardiac death, and other cardiovascular disorders.

CEO’s corner (continued from cover)

Precision Medicine Initiative and elsewhere. The goal is straightforward: capitalize on the opportunities afforded by precision medicine to shorten the timeframe from accurate diagnosis to individualized, effective therapy.

The new center will work closely with several units at the Abramson Cancer Center which are already heavily involved in precision medicine research and treatment.

The Center for Personalized Diagnostics, a joint venture between the ACC and the Department of Pathology and Laboratory Medicine, uses next-generation DNA sequencing to discover mutations in tumors. Launched three years ago under Dr. Roth’s leadership and now led

by Kojo Elenitoba-Johnson, MD, the center has performed more than 4,000 advanced diagnostic tests, trolling within tumors to detect genetic mutations in 75 percent of cases and creating opportunities for more effective treatments that clinicians would not have known to offer without these specialized test results. The Center for Rare Cancer and Personalized Therapy has begun “basket trials” to link patients with rare genetic mutations to drugs that have shown success in targeting those mutations in patients with other types of cancer.

At the new Center for Precision Surgery, patients with lung, pituitary and other tumors are being injected with a special, investigational dye before cancer surgery. The dye causes a green glow in tumor tissue under infrared light in the operating room — including lighting up areas of cancerous tissues doctors could not otherwise see — setting the stage to eradicate the whole tumor and prevent recurrence. The Basser Center for BRCA, the first facility in the world solely devoted to cancers related to mutations in the BRCA1 and BRCA2 genes, is forging ahead in efforts not only to identify and counsel patients at risk of these cancers — including those of the breast, ovarian, prostate, and pancreas — but to prevent them with novel strategies like vaccines.

The Cancer Immunotherapy Research Program in our division of Hematology and Oncology develops novel immune therapies for treating cancer. The anti-cancer strike force at the heart of these efforts is making use of techniques that would have seemed like science fiction not long ago: cancer vaccines, gene therapy, monoclonal antibodies, and T cell engineering. In fact, it’s this work that helped catch the eye of Vice President Joe Biden, who came to the Abramson Cancer Center to inaugurate the national cancer “moonshot” at Penn in January.

And that’s just the start. Today precision medicine is most recognized for turning up the heat on cancer, but we’re also investigating its use in other areas. For instance, we’re working to uncover biomarkers that help doctors identify which patients are most likely to be helped by drugs used to prevent blood clots after heart attacks or stroke.

Taken together, these efforts are a big beginning, providing a sound basis for optimism in so many ways.

To our way of thinking, a powerful new engine has been started. We can hear the humming, and the journey is just beginning.

SYSTEMnews EDITORIAL STAFF:

Upcoming Expansion at Chester County Chester County Hospital has begun construction on a 700-space parking garage to accommodate the growing need for parking spaces on campus. After the garage is open, the hospital plans to begin an expansion project to build new leading-edge operating suites, create additional private patient rooms, enlarge the Emergency Department, relocate the helipad, and establish a new front entrance. This larger effort, which is still pending approvals, is anticipated to begin in late 2016 and will conclude in 2021.

Note for Penn Medicine employees: If you plan to travel Chester County Hospital, talk to your meeting’s organizer in advance to know the recommended parking location. Available parking spaces will be limited.

Sally Sapega, M.A. Editor Trissy Laurito Graphic Design

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Susan E. Phillips Senior Vice President, Public Affairs Holly Auer Director of Communications

LET US HEAR FROM YOU:

PennOmics Receives Innovator Award Penn Medicine received co-third-place in the 2016 Innovator Awards program for PennOmics, its research data warehouse that provides physicians and researchers access to huge amounts of de-identified, aggregate patient data in one platform. The Innovator Awards Program, given by the editors of Healthcare Informatics, recognizes health care leadership teams who have effectively employed information technology to make a difference in their organizations and in the industry at large. PennOmics provides a vast potential to contribute to the field of translational medicine.

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