Stanford Health Care People - Fall 2016

STANFORD HEALTH CARE

A PUBLICATION FOR EMPLOYEES OF STANFORD HEALTH CARE

FALL 2016

PREMIER PRIMARY CARE NEW STANFORD HOSPITAL YEAR IN REVIEW JUST DANCERS

AROUND SHC

PREMIER

Events and cool happenings from around the Stanford Health Care campus … Clockwise starting with bottom left photo: President & CEO David Entwistle speaking at the Medicine X Conference held at Stanford.

The conference explored the future of medicine and role of technology … Punkie the doodle greets an SHC employee during Cuddles for Caregivers. The service dogs are part of the Pet Assisted Wellness (PAWS) program that brings smiles to patients and staff at SHC … Sarita Gupta participates in the Hula Hooping class in the Stanford Hospital atrium … David Entwistle and Stanford Children’s Health President & CEO Christopher Dawes enjoy a stroll on campus in the annual CEO Walk … Did you get your flu shot? Lab assistant Pedro Angulo (top row, middle) received his. Participation in the influenza program is mandatory for all SHC employees, per California state requirement … Kudos and congrats to our nursing team, which received Magnet recognition for the third time (top row, far right, L to R): Lisa Meyer, Theresa Cotter and interim CNO Wendy Foad celebrate the news with their team.

from the CEO Dear Colleagues, My first three months at Stanford Health Care have been an amazing start. Thanks to all of you for the warm welcome, for saying hello in the hallways, for attending my first Town Hall meetings this month, and for helping me get to know this remarkable place.

One of the distinctive qualities that drew me to Stanford is the spirit of innovation for which it is recognized worldwide. It has been exciting to see how that spirit infuses Stanford Health Care with a continuous drive to improve every aspect of our services.

This issue of SHC People shows how innovation here comes in many forms. The launch of Primary Care 2.0 demonstrates that we are looking across the entire continuum of care in new ways and questioning old assumptions. The progress report on the new Stanford Hospital shows our commitment to reimagining health care from the ground up by creating innovative and technologically advanced healing environments. The movement class held at the Stanford Neuroscience Health Center for patients dealing with the profound physical impacts of Parkinson’s disease is a wonderful example of finding creative ways to help people live fully throughout their personal health journeys.

Health care is changing rapidly today, presenting both significant challenges and unprecedented opportunities. Our commitment to innovation not only generates improvements; it is a key differentiator that makes patients, families

STANFORD HEALTH CARE PEOPLE is a publication of the SHC internal communications department: Gary Migdol, Director; Katie Lipovsky, Manager; Allison Carleton, Specialist. Photography by Norbert von der Groeben.

Grace Hammerstrom, Mandy Erickson, Writers. Send comments to connect@stanfordhealthcare.org.

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Primary Care

SHC’S COMMITMENT TO BUILD A PRIMARY CARE NETWORK THROUGHOUT THE BAY AREA IS IN FULL SWING

O

VER THE PAST FIVE YEARS, STANFORD HAS BEEN STEADILY BUILDING A NEW PRESENCE IN THE HEALTH CARE MARKETPLACE; THAT OF A BAY AREA–WIDE PRIMARY CARE PROVIDER. Today, individuals can receive Stanford Primary Care from more than 400 providers in five counties across the bay. At the same time, Stanford is bringing its relentless focus on innovation and excellence to the field of primary care,

and employers choose SHC. It also helps us attract the outstanding physicians, nurses and staff who thrive on always pushing the bar. I look forward to meeting more of you in the months ahead and to hearing your innovative ideas and invaluable feedback.

redefining how care is delivered.

It all started in 2011 when leadership examined the changing health care

DAVID ENTWISTLE PRESIDENT & CEO

PHYSICAL THERAPIST WILL WATERMAN WORKS WITH A PATIENT AT PORTOLA VALLEY PRIMARY CARE CLINIC.

CONTINUED ON PAGE 4

ON THE COVER: On the cover: (top row, L to R) Clinic assistant Sayra Soria Landeros at the Express Care Clinic, Hoover Pavilion; construction of the new Stanford Hospital; patients in the Dance for Parkinson’s class. In the main photo, Martin Rangel (L) and Trevor Towne (R) at Santa Clara Primary Care.

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CONTINUED FROM PAGE 3

PRIMARY CARE AT SHC CAN BE FOUND IN FACULTY-BASED CLINICS AT HOOVER PAVILION, PORTOLA VALLEY, LOS ALTOS AND SANTA CLARA, IN ADDITION TO 61 UHA PRACTICES. PHOTOS FROM L TO R: MEGAN MAHONEY, MD, AT THE FAMILY MEDICINE PRACTICE AT HOOVER PAVILION; DRS. KURT HAFER, MD, AND SANG-ICK CHANG, MD. AT SHC’S PORTOLA VALLEY PRIMARY CARE CLINIC; AMANDA HERNANDEZ PROVIDING CARE FOR PATIENT NOHEMI CARRANZA.

landscape and health policy research, and came to the conclusion that something had to change. No longer could Stanford remain an academic and research institution, available only to patients with the most complex conditions. It needed to become a full health system to care for individuals throughout their lifespan.

That meant expanding its primary care presence.

“Stanford understood that the future of health care is in the coordination of medical care across both primary and specialty care,” said Sang-ick Chang, MD, MPH, the physician Stanford brought on board to lead this effort. “Stanford needs primary care so that we can be a cradle-to-grave health system that can help solve the problems of health care today.” The goal, he said, is to achieve a triple aim: to improve the patient experience, improve the health of populations and reduce the cost of health care.

Step One: Grow the Network When Chang came on board in 2011, Stanford had two faculty-based primary care clinics—one in family medicine and one in internal medicine—with 20 physicians in all. The primary goal of these clinics, he said, was to support the teaching mission of the medical school, to offer a place for students to observe and practice primary care.

After a concerted expansion effort, Stanford now has 85 Stanford faculty physicians working in 14 4 / STANFORD HEALTH CARE PEOPLE

“Stanford needs primary care so that we can be a cradle-to-grave health system that can help solve the problems of health care today.” different practices. These include a senior care clinic, an ambulatory intensive care clinic (Stanford Coordinated Care), the ClickWell virtual care clinic, a concierge clinic, an executive health clinic, three employer-based clinics and two Express Care locations, offering sameday appointments for minor illnesses and injuries.

Concurrently, Stanford also opened community-based medical practices in Santa Clara, Los Altos and Portola Valley, with several more locations in the development pipeline, including Burlingame and South San Jose.

In addition to expanding its faculty practices, Stanford Health Care and the School of Medicine created University HealthCare Alliance (UHA), a local network of physicians that broadens Stanford’s reach. Rather than building new practices from the ground up, UHA acquired existing medical practices. In five years, UHA grew from 40 providers at Menlo Medical, the first clinic to join its network, to more than 300 primary care doctors, specialists and advanced practice providers in 61 practices across the bay.

“That growth happened in parallel with the expansion

of faculty-based practices,” said Bryan Bohman, MD, Chief Medical Officer for UHA. Because UHA brought on a variety of different medical practices, from individual practitioners to multispecialty clinics, it had to create commonality between its practices. “The first thing we did was put everybody on Epic, the same as the faculty practices, and implemented C-I-CARE across the board,” said Bohman, a clinical associate professor of medicine.

THERESE MACASIRAY TRUONG, RN TALKS WITH PATIENT AT HOOVER PAVILION.

PINOLE

CONTRA COSTA COUNTY

OAKLAND SAN FRANCISCO

PLEASANTON

SAN MATEO

ALAMEDA COUNTY

SANTA MATEO COUNTY

Primary Care Practices (including UHA)

Stanford’s primary care network included two faculty-based clinics and 20 physicians in 2011. It has now ballooned to 75 clinics, including faculty and UHA, and more than 400 primary care doctors, specialists and advance practice providers across the Bay Area. SHC’s growing map extends south to Los Gatos, east to Brentwood and as far north at Pinole.

SAN JOSE

Stanford Hospital Stanford Health Care – ValleyCare

Where’s Primary Care?

SANTA CLARA COUNTY

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“Stanford is changing primary care by moving away from the doctor-patient visit-based care model to continuous, proactive team-based care. ... That’s our innovation. It’s not a new procedure or a new drug discovery, but rather how the patient interacts with the health care system in a way that serves their needs more effectively than the old model.”

Jody Ostrander, a Patient Service Representative at Alliance Medical Group in San Pablo, appreciates the standard workflows and the automated appointment reminder system that came with joining UHA. “Referrals and authorizations are a lot more streamlined now,” she said. “And it’s quicker and easier for the patient.”

When University Medical Group Campbell opened as a part of UHA, Medical Assistant Helen Parry had to learn to do her job in a whole new way. Rather than randomly rooming patients for any of 12 doctors, she is now assigned a doctor to support. “I know what each doctor needs now, and that benefits my patients and me.”

Much of the standard work being applied in UHA clinics today is being tested using a Model Clinic concept, said Bohman. Essentially, Model Clinic is applying the Stanford Operating System, a continuous improvement method, to patient care and workflows in the various clinics. The goal is to have more uniformity in the way that calls are answered, the way that medical assistants room the patients, and the way that population health metrics are handled.

Step Two: Improve Care Delivery With expansion efforts well underway, leaders from Stanford and UHA began redesigning the traditional primary care model. The team settled on a team-based

THIS PAST JUNE, SANTA CLARA PRIMARY CARE BECAME THE OFFICIAL TESTING SITE FOR PRIMARY CARE 2.0, THE INNOVATIVE CARE DELIVERY MODEL DEVELOPED BY STANFORD OVER THE PAST YEAR AND A HALF. ITS PHYSICAL SPACE WAS DEVELOPED TO SUPPORT THE MODEL, AND THE CLINIC WAS FULLY STAFFED TO DELIVER IT.

REBECA ROMAN (LEFT) TAKES NOTES AS KORINA DE BRUYNE, MD, EXAMINES A PATIENT DURING A ROUTINE OFFICE VISIT THAT EXEMPLIFIES THE PRIMARY CARE 2.0 MODEL AT SANTA CLARA.

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concept that disperses the job of caring for patients among a group of providers and takes a proactive approach to helping patients maintain good health.

Called Primary Care 2.0, the model is being tested in Stanford’s newest primary care clinic in Santa Clara.

The goal, said Chang, is to do a better job of respecting patients’ time. “Half the visits, double the touches” is a mantra the model follows. The idea is to reduce the number of in-person patient visits but increase the number of times a patient is contacted. That means scheduling video and telephone visits when appropriate, and proactively reaching out to patients regarding preventive care and health goals.

“Stanford is changing primary care by moving away from the doctor-patient visit-based care model to continuous, proactive team-based care,” said Chang.

“That’s our innovation. It’s not a new procedure or a new drug discovery, but rather how the patient interacts with the health care system in a way that serves their needs more effectively than the old model.”

Today, Santa Clara Primary Care has seven primary care physicians, 11 care coordinators, a pharmacist, a social worker and a dietitian, as well as specialists who rotate through the clinic. The space also includes physical therapy, a lab, x-ray and phototherapy. “We tried to make it a one-stop shop,” said Kari Perrin, RN, Clinic Manager.

The clinic’s exam rooms are equipped with two doors, one leading to the patient area and a second leading to the behind-thescenes provider workspace. There, care teams consisting of a physician, an advanced practice provider (nurse practitioner or physician assistant) and four care coordinators sit together in pods. “This makes it easier to have direct communication between providers and medical staff,” said Perrin.

IT’S OPEN ENROLLMENT SEASON Mark your calendar for the benefits open enrollment period near you!

For Stanford Health Care, ValleyCare and UHA employees, open enrollment begins in the upcoming weeks and runs through mid-November. Open enrollment for SHC employees begins October 24 and runs through November 11; ValleyCare open enrollment is October 19 through November 11; UHA employees’ open enrollment is November 1–18.

When making your selections, employees can consider selecting Stanford Health Care Alliance (SHCA), a health insurance plan created for the Stanford community. Learn more at stanfordhealthcarealliance.org.

Care coordinators greet patients in the lobby, take their medical history and vitals, and then stay in the room during the exam to document the visit. This frees the physician to interact face-to-face with the patient, without constantly referring to the screen. If labs are needed, a tech comes to the exam room.

If medication management is an issue, the pharmacist can provide additional education and reconcile medications.

Managing patients’ health when they’re not in the clinic is an important part of this new approach, said Perrin. Care coordinators follow up by phone with test results, check patients’ progress toward health goals or remind them to schedule preventive care. “The goal is to be proactive, to reach out to patients more frequently, before they get ill.”

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FOCUS ON… Endocrinology Clinic There’s no real secret behind achieving the rank of No. 7 in the nation, say the staff at the Endocrinology Clinic.

Simply following the C-I-CARE framework, ensuring that the clinic runs smoothly and offering excellent care have earned Stanford Health Care a spot as one of the top hospitals for diabetes and endocrinology, according to U.S. News and World Report.

“When I follow C-I-CARE, 90 percent of my job is done,” said Nilgun Adkins, clinical assistant, medical assistant and patient coordinator at the clinic.

The C-I-CARE framework helps clinicians provide courteous, respectful care and good communication with patients. That communication is especially important for a specialty

in which patients play a major role in managing their disease.

“We have to provide a lot of education, because diabetes patients need to do so much of the management themselves,” said Marcia Garilli, RN, assistant manager of the clinic. “Our work is naturally very patient centered because of that,” she added.

Most of the clinic’s patients are diabetic, though the clinic also sees patients with thyroid disease, osteoporosis, reproductive disorders and other hormone-related conditions.

The staff noted that good care isn’t just about good communication with patients—it also requires a well-run clinic. The administrative staff and the nurses need to respond to phone calls quickly, avoid long wait times and keep on top of lab reports.

The clinic has come up with some creative solutions to fitting patients in: Twice a week, it holds nurse follow-up hours, when patients can receive extra guidance or care between physician visits. The clinic stays open late so patients can come in toward the end of their workday.

The clinic also ensures that patients’ time is well spent. Adkins says she asks

THE TEAM AT THE ENDOCRINOLOGY CLINIC PLAYED A MAJOR ROLE IN SHC EARNING A NO. 7 NATIONAL RANKING BY U.S. NEWS FOR DIABETES AND ENDOCRINOLOGY CARE.

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FOCUS ON… ELIZABETH QUADROS (LEFT) AND LETICIA WILKE DISCUSS PLANNING HEALTHY MEALS FOR THEIR PATIENTS.

“We have to provide a lot of education, because diabetes patients need to do so much of the management themselves.” patients if they have any last questions so they don’t need to call once they get home. She also ensures that lab work is completed and the results are ready before patients see the physicians.

“I try to get everything done in one day so the patient doesn’t have to come back,” she said. “We try to make it easy for them.”

In addition, Adkins and her coworkers at the front desk are all cross-trained so they can take over each other’s job when there’s a need, such as a long line to check in for appointments.

“The medical assistants keep our busy clinic running smoothly,” said Leticia Wilke, RN, MSN, clinical nurse specialist.

Of course, user-friendly care can help a clinic earn the No. 7 spot only if the care is excellent to begin with.

Many on the nursing staff have specialty training in diabetes care to complement the physicians’ knowledge.

Wilke, who is board certified in advanced diabetes management, often takes on the role of life coach, talking to patients about ways they can add exercise to their routine and change their eating habits.

“Our goal is to empower patients and for them to feel confident in their self-management of diabetes,” she said.

Stanford Blood Center It’s not easy, getting people to take a needle in the arm and give up a pint of blood. And before they even get to that point, they have to undergo a barrage of personal questions.

But blood and blood products save lives every day, so the staff at Stanford Blood Center have to find creative ways to ensure that they always have enough to serve the hospitals of Stanford Health Care. They’ve offered movie tickets and T-shirts—even a college scholarship—to persuade community members to help strangers.

“It’s very challenging to get people to take the time to donate,” said Karen Hendryk, donor recruitment manager at the center. “We’re always coming up with ways to make it as convenient as possible.”

The blood center became part of Stanford Health Care a year ago. For 40 years, it was part of the School of Medicine, but as it grew, it made more sense to become part of SHC, as the center supplies blood to SHC hospitals.

The new ownership has changed little about the center’s operations, but it may help the center collect blood: Hendryk plans to tap SHC employees for donations.

“We’re looking toward the SHC community and to grow that partnership in the coming year,” Hendryk said.

To encourage donations, the center staff try to make donating blood easy by providing the donors with a pleasant experience. “We love our donors,” said

BLOOD CENTER TEAM MEMBERS (L TO R): CLAYTON TOLLER, BETHANY OWEN, EILEEN TELLERIA, TIM GILMORE, ROMMEL SANGALANG. AT RIGHT, DONOR FRANCIS DE LEON IS ASSISTED BY SHC’S ANTERO ABELLERA DURING A RECENT BLOOD DRIVE.

Cat Layson, RN, senior blood bank nurse and collections team supervisor, “and we want them to be comfortable while they’re here.”

The blood center’s goal is to tap 150 arms daily, so to find enough donors the center nurses hit the road. Their specially equipped buses park at about two places each day: churches, high schools, community colleges and workplaces—any organization or event that can guarantee at least 30 donors.

When the center is short on a certain type of blood, the staff will reach out to previous donors who have that blood type (O negative and O positive are always in demand) and ask them to come in. They also educate and inspire donors by telling them how they’re helping others.

Whether they step on a bloodmobile bus or arrive at one of three donation centers in Palo Alto, Menlo Park and Mountain View, donors have to answer a series of questions about their medical and personal history, including recent travel, medications, past illnesses and even if they have a tattoo. If they’re deemed good to go, they can donate whole blood, platelets (the cells in blood that stop bleeding), red blood cells or plasma (the fluid without the blood cells).

The blood is always tested for infectious diseases, said David Lancaster, the center’s inventory management supervisor, even when it’s from a repeat donor. When they receive blood from the donor site, center staff process it, label it and send it to the hospitals based on need. Managing the inventory is critical: While plasma can be frozen and stored for a year, platelets’ shelf life is only five days.

When Lancaster has an excess or a shortage of one blood type or blood product, he’ll swap with other nearby blood centers—that way, all the hospitals in the area have a full inventory, or as close to it as possible.

“I’m happy just to know that we are ensuring the hospitals have enough blood to do their job,” he said.

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The New Stanford Hospital A Year in Review

Since the final beam was set in place last year, a massive amount of work—more than 1.1 million man-hours in 2016 alone—has transformed what looked like an elaborate erector set into the nearly completed exterior of the new Stanford Hospital. In a year of milestones, Bert Hurlbut, Vice President, New Hospital Construction, highlighted his crew’s biggest achievements.

Structure Is Built. Since the topping-off ceremony in March 2015, when the skeleton of the hospital was just taking shape, the construction crew has completed the structure. That means, all of the steel is up and welded, and all of the metal decking and concrete are in place. “That’s 18,000 tons of structural steel, the same as 36 million pounds of steel, and over 800,000 square feet of metal deck,” said Hurlbut.

“Those are two pretty impressive numbers.”

Structure Is Sound. Unlike a fixed-base building, which is built directly on the ground, the new hospital is a baseisolated building. It is separated from the ground by flexible pads and will move with earthquakes to prevent or minimize damage.

This past year, the base isolation bearings were unlocked and put to work, said Hurlbut, “so the structure is now protected from an earthquake.”

Glass Dome Is Complete. The glass dome, a lattice structure with a view to the sky above, has been built, welded and painted. Ninety tons of steel tubes cross north, south, east and west, forming open squares, which are clad with 50 tons of glass.

Connecting Link Is In Place. The pedestrian bridge, which connects the new facility to the existing hospital at 300 Pasteur, has been erected and is now being welded, according to Hurlbut. “This was the last structure to be put into place.”

THE PEDESTRIAN BRIDGE (TOP PHOTO) AND GLASS DOME (CENTER PHOTO) MARK TWO SIGNIFICANT MILESTONES IN 2016, ALONG WITH THE NEARLY COMPLETED EXTERIOR (BOTTOM PHOTO) OF THE NEW STANFORD HOSPITAL.

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Exterior Glass Is Installed. The construction team began installing exterior glass last November. In all, over 800 glass window panels have been placed. “It all goes in one piece at a time and all by tower crane,” said Hurlbut, “so it takes a long time.”

Interiors Are Built. The interior walls of the hospital are up, and all mechanical, electrical and plumbing equipment is in place. Crews are now painting walls on the bottom floors and finishing up drywall on the top floors.

Permanent Power Is On. The hospital has been slowly weaning off its temporary power source and is now completely on its own permanent power system. The emergency generator system, which runs on five V-16 diesel engines and two 40,000-gallon fuel tanks, has been put in place and will be activated in the next three to four months. The system will be able to operate the hospital for four days without refueling, or a week if conservation efforts are used.

Safe Job Site. At the peak of construction, there were as many as 900 tradespeople onsite on any given day. Today, that number hovers around 700 workers. The project set a safety goal of working one million man-hours without a job-site accident that resulted in lost time at work. The construction team surpassed this milestone in early August and has now worked in excess of 1.1 million hours without a lost-time accident. “That’s a nice accomplishment,” said Hurlbut. “For a job of this magnitude and complexity, it has been a smooth build.”

What’s Next? In the coming year, the team will construct the helicopter-landing pad, build out the 28 operating rooms and finish the radiology rooms. It will also add the hard and soft landscaping, such as streets, sidewalks, curbs and gutters, and plants, bushes, trees and grass.

“There’s a little pin light at the end of the tunnel, but I can see it,” said Hurlbut with a slight chuckle. “The end is in sight.”

KUDOS

attention in a timely manner. Sidhu went above and beyond standard best practice to ensure the well-being of a patient.

September C-I-CARE Service Spotlight Award

August C-I-CARE Service Spotlight Award

On a Friday before a holiday weekend, SHC discharge pharmacist Noah Fang stayed late to help a physician with discharging a patient. This patient also happened to have a new prescription, so Fang sat with the patient to go over the new medication details and possible side effects. When Fang realized this patient would not be able to receive his new medication for another four days due to the holiday weekend, he spent the extra time to find alternative pharmacies to ensure that the patient received his proper dosage in a timely manner. Fang’s commitment to his patient’s needs illustrated his dedication to the principles of C-I-CARE.

August Patient Safety Star Award

MARISSA GOODGER

KIRANJEET SIDHU

Earlier this summer, Juno Vega received a text message from his son regarding a shooting on his college campus. Feeling helpless, Vega notified his Director, Marissa Goodger, that he would not be able to attend their upcoming meeting. Goodger sensed something was wrong and offered her undivided attention to help in any way she could.

She stayed with Vega for two hours, helping him coach his son through the tragic series of events at UCLA that fateful day.

Goodger showed care and compassion in Vega’s hour of need and exemplified the true spirit of C-I-CARE.

Kiranjeet Sidhu, RN, Nurse Coordinator, grew concerned about a patient’s welfare after not hearing back from her for some time. Because she remembered that this patient lived alone, Sidhu reached out to the patient’s emergency contacts and later discovered that no one had heard from her for two weeks. Following her intuition, Sidhu decided to do a welfare check on the patient and contacted a social worker. The patient was found down in her home, and had been down for days. Fortunately, Sidhu intervened in time for the patient to receive medical

45 Years at SHC GLORIA BROWN, CLINICAL LABORATORY SCIENTIST When Gloria Brown started working in Stanford Hospital’s clinic laboratory, she was pouring chemicals from 1-liter containers and weighing out chemicals on scales—“just like a mad scientist in a movie.”

Now, she says, “you put a little drop of blood on a wafer … and the analyzer prints out a result.”

This year, Brown celebrates 45 years of working at Stanford Health Care, a tenure that has seen the clinical lab modernize, automate, computerize and expand. Today, the center

that tests blood, urine and other body fluids is a warehouse-sized room filled with analyzers, centrifuges, test tubes, computers, lab techs and clinical laboratory scientists dressed in white coats—150 of them, working three shifts.

After graduating from Texas Southern University with degrees in biology and chemistry, Brown found herself in the Bay Area, looking to start a career. O’Connor Hospital in San Jose accepted her into its clinical laboratory scientist internship program, and when the year was up and she passed her exams, she landed a job at Stanford.

She now supervises the coagulation section of the clinical labs at Stanford, the satellite labs at Lucile Packard Children’s Hospital Stanford, and the Redwood City center laboratory.

Working out of an office crammed with paper reports, charts and graphs, Brown oversees quality control, validating new

NOAH FANG

tests, updating procedures, training new staff members, scheduling, day-to-day operations and hiring.

She never left because she never had reason to: “It’s been a great opportunity for learning,” she said. “Stanford gets some really interesting cases.”

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HEALING HUMANITY

There are no patients.

Just dancers.

When dancing, all movement is graceful. That is the very clear lesson learned when witnessing a Dance for Parkinson’s (Dance for PD) class at Stanford’s Neuroscience Health Center.

Each week, a group of 15 to 20 individuals with Parkinson’s disease and some family members make their way to Stanford and find a seat in the first-floor dance studio. Parked along the edges of the room are walkers, motorized scooters, jackets and shoes. In the center is a circle of chairs where participants sit, eyes focused on a petite woman who greets each of them warmly with a smile and a hug. Professional dancer Damara Ganley (pictured above, right) leads the group through a series of movements, guiding them with descriptive commands to bow to the sun, tap their toes, gather and toss flowers in the air, and flame an imaginary fire. The group moves in unison, smiling and encouraging each other through each song.

At the end of an hour, no one is in a hurry to leave.

“Dance has benefits for everyone,” said Ganley, who leads classes at Stanford every Friday afternoon at 12:30 pm. “It’s a way to use your body in an artful way,” which is of particular interest to people with Parkinson’s, a progressive disorder of the nervous system that affects movement. “Dance allows them a way to move consciously. It is a massage for weary shoulders.”

Dance for PD started in 2001 as a collaboration between the Mark Morris Dance Group in New York and the Brooklyn Parkinson’s Group. Today, the program is offered in 100 communities across the U.S. and in 16 countries. Helen BronteStewart, MD, MSE, who directs the Stanford Comprehensive Movement Disorders Center, was determined to bring the program to Stanford.

A dancer herself, she helped design the first-floor studio of the Stanford Neuroscience Health Center to accommodate movement classes for patients and, with Ganley, received a grant from the National Parkinson’s Foundation to offer the class for free.

“As physicians, we stress the importance of physical activity, social interaction and mental stimulation to our patients with Parkinson’s disease,” said Bronte-Stewart, who is also codirector of the Stanford Balance Center. “Dance for PD gives them all three. But it is much more than a possible therapy or treatment; the PD dancers have told us that this type of dance restores their self image and brings them joy.”

For Juan Bulnes, who was diagnosed with Parkinson’s disease eight years ago, the Dance for Parkinson’s class is a way to stay active and live as best he can with his condition.

“Damara has taught me graceful movement,” he said. “This is a complex condition and dancing helps. It makes me more optimistic. It informs some of my steps.”

Dance for PD’s instructors are professionally trained dancers whose knowledge about balance, sequencing, rhythm and aesthetic awareness is useful to people with Parkinson’s disease. In class, teachers engage participants’ minds and bodies and create an enjoyable, social environment for artistic exploration.

“I wouldn’t miss class,” said Faye Wiggins, who as a caregiver enjoys the class as much as her husband, Lyle. Each week, the couple travels from their Sunnyvale home and for an hour shares their love of music and dance. Lyle, who’s had Parkinson’s for 24 years, is limited in his speech, his movements now are slow and delayed, and his body is no longer as tall and straight as it once was. But when the music starts, Lyle turns to his wife, arms outstretched, and sways to the music.