MMC U Connections
news for the University of Maryland Medical Center
One of the Country’s 2 Top Hospitals – for 7 Years in a Row
“Change is the law of life and those who look only to the past or present are certain to miss the future.” – John F. Kennedy
Message from the CEO The year 2012 was a great one, on which we hope to build. We earned recognition for specific achievements as well
UMMC Recognized for exemplary performance in Quality of Care and Patient Safety
The University of Maryland Medical Center (UMMC) ranks among the nation’s top hospitals for the seventh year in a row, according to the annual Leapfrog Group survey. The survey is an analysis of patient safety and quality performance measurements from nearly 1,200 hospitals. UMMC is one of only two hospitals in the country – and the only hospital on the East Coast – to make the list every year since its inception in 2006.
as high scores on a comprehensive set of criteria, such as The Leapfrog Group and US News & World Report use when naming top hospitals. It’s what happens when we really care, in every sense of the word. The Beacon Award (page 6) recognizes our Cardiac Care Unit for its level of specialization, skill and technology, while patients from the unit tell us our nurses and technicians also have the compassion to help them through the stages of healing. Our staff reaches across disciplines in imaging (pages 2-3), where professionals use the latest technology to look inside the body to diagnose and heal patients. This issue also includes one of our “Great Stories” events, in which
“The Leapfrog Group’s recognition of UMMC as a Top Hospital for seven continuous years is a testament to our employees who work together every day to give the very best care for our patients. Our amazing teams of health care providers – physicians, nurses, pharmacists, therapists, technicians and support staff – remain committed to providing quality and compassionate care to all of our patients and their families,” says Jeffrey A. Rivest, president and chief executive officer of the University of Maryland Medical Center. Leapfrog’s standards include computerized ordering of medications, which has been found to reduce medication errors, and ICU staffing by physicians who specialize in critical care. Research has shown that in ICUs where intensivists manage or co-manage all patients, there is a 40 percent reduction in patient deaths. UMMC has more intensive care units than most hospitals in the country. The 10 ICUs specialize in specific areas of critical care, such as surgical, medical, neurological, cardiac surgery, multitrauma and pediatric ICUs.
The 2012 Leapfrog Hospital Survey results are available at www.leapfroggroup.org/cp featured inside
The Big Picture
we highlight a few of the grateful
notes from former patients to staff (pages 4-5). We also share a celebration
maging technologies can confirm a diagnosis, or help guide a catheter to a coronary artery, or even map the brain of a patient in preparation for neurosurgery. Across the Medical Center, the latest imaging methods offer physicians a view of what’s going on beneath the surface. It may feel like magic to the patient, but the professionals who work the scanners and other equipment explain the art and science of capturing these images, which radiologists and other physicians analyze to determine what each patient needs. >>>> Story and pictures on pages 2-3
by our Community Psychiatry program, which teaches stable patients how to take the next steps toward living and working independently in the community (page 7). Local businesses that generously contributed to these events deserve a big “thank you” for welcoming the new graduates.
page 3 page 5 page 7
As we manage through the winter, we look forward to a year
of even greater service to our
Event Reunites Grateful Patients and Caregivers pages 4-5
blustery (and balmy) days of
patients and our community. Sincerely,
UMMC also fulfills Leapfrog’s criteria for high-risk surgeries and procedures including heart bypass, angioplasty, aortic valve replacement, abdominal aortic aneurysm repair, bariatric surgery, esophagectomy, pancreatectomy and high-risk newborn deliveries, and has met Leapfrog’s robust volume, processes of care and outcomes standards. In 2010, the Leapfrog Group named the University of Maryland Medical Center a Top Hospital of the Decade because of its consistently high performance in the annual survey. “The Leapfrog Top Hospital distinction is by far the most competitive award a hospital can receive. By achieving the Top Hospital accolade, the University of Maryland Medical Center has demonstrated exemplary performance across all areas of quality and patient safety. This hospital stands out as one consistently providing safe, high-quality care, and I would be comfortable sending my family to the University of Maryland Medical Center for care,” said Leah Binder, president and chief executive officer of the Leapfrog Group.
Best Valentine’s Day Gift Ever page 6 Cardiac Care Unit Earns Beacon Award for Excellence
Life Lessons for Independence – Within a Community page 7 Redwood Pharmacy Opens to Serve Public JEFFREY A. RIVEST President & Chief Executive Officer
UMMC and UMB Join Forces for Heart Walk page 8 UMMC Websites Win National Awards page 8
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fe a t u r e s t o r y
2 UMMC Connections
the big pictur
From the 13-second full-body Statscan x-ray that Shock Trauma staff pioneered
for assessing patients with multiple injuries, to a precise view inside a baby’s heart, imaging is often central to diagnosis and treatment. • “Multiple recent physician surveys have identified advanced imaging technologies as among the most important innovations in medicine – with the greatest impact on patient care – over the last 25 years,” said Elias R. Melhem, MD, PhD, professor and chairman of the Department of Diagnostic Radiology and Nuclear Medicine. “At the Medical Center, expert radiologists and highly trained technologists collaborate to provide the most accurate diagnoses for our patients and improve the safety and efficiency of lifesaving treatments by applying real-time image guidance.” • Physicians rely on the radiologists – whom patients often don’t see – to analyze and interpret the images for them, and on technologists who are highly trained in a range of specialty areas to capture the images using the latest equipment. Here are just a few of the professionals and the modalities they are trained in.
UMMC Connections is produced by the Ofﬁce of Corporate Communications and Public Affairs for the UMMC community. 22 South Greene Street Baltimore, Maryland 21201 410-328-6776 www.umm.edu Jeffrey A. Rivest President and Chief Executive Ofﬁcer Mary Lynn Carver Senior Vice President Communications and Public Affairs Anne Haddad Editor and Publications Manager Chris Lindsley Director, Communication Services Frank B. Moorman Director, Strategic Internal Communications Linda Praley Creative Director Linda J. Lynch Staff Assistant Sharon Boston Taylor Hebden Amanda Donohue Michelle Murray Meghan Scalea Kathy Schuetz Bill Seiler Karen Warmkessel Contributors Email news and story ideas to firstname.lastname@example.org.
hen doctors believe a minimally invasive procedure will be as effective as surgery, they might refer patients to the branch of radiology that goes beyond diagnosis to actual treatment. Physicians who specialize in interventional radiology collaborate with departments such as nephrology, oncology and radiation oncology. Compared to surgery, interventional radiology procedures are less invasive, cause less pain and scarring and typically offer a speedier recovery. Most procedures can be performed on an outpatient basis. Fluoroscopy, a type of moving-picture X-ray that captures real-time images of internal structures, guides a radiologist through various procedures. An interventional radiologic technologist, such as Ashley Hester, RT(R)(VI), controls the image intensifier, which is located above the patients while they are lying down, and focuses it on the treatment area. Some patients require general anesthesia, but the majority need only moderate sedation. “The real-time guidance helps the radiologists insert a catheter into a vein to deliver chemotherapy treatments for cancer patients, or to insert a tube in the kidney to assist with drainage for a patient with hydronephrosis – swelling of the kidney,” Hester said. These procedures vary in duration from 30 minutes to several hours. Doctors also rely on ultrasound guidance to assist them with many interventional procedures. “We use ultrasound when we’re placing nephrostomy tubes to get access into the kidney, and then we verify with fluoroscopy,” Hester said. nuclear medicine
Nuclear medicine is a branch of diagnostic imaging and includes positron emission tomography (PET) combined with computerized tomography (CT) – called PET/CT scanning – as well as general nuclear imaging. Patients whose doctors refer them to nuclear medicine will be guided through the process by Jason Jenkins, BS, CNMT, senior nuclear medicine technologist and student education clinical coordinator, or another technologist certified in this modality. Most of the patients who require PET/CT scans are also being treated by an oncologist for some type of malignancy. Patients are administered a radiopharmaceutical called FDG (fludeoxyglucose 18) intravenously and then relax in a quiet room while the FDG circulates. The PET scan will detect the FDG in a way that indicates to the physician whether a lesion is malignant. The concurrent CT scan shows the exact location, size and shape of the lesion. Together, the technologies allow doctors to see a lesion on a more microscopic and cellular level, combining anatomy and physiology.
A PET/CT scan takes about 40 minutes to an hour to complete. However, UMMC is in the middle of a project to install a new PET/ CT scanner that will shorten that time. General nuclear imaging uses a scintillation or gamma camera with the injection of a radiopharmaceutical in the patient, to record how an organ is functioning. Oncologists are among the specialists who might refer patients for a nuclear medicine scan. Cardiologists also order this type of imaging as part of a stress work-up in patients with suspected heart disease. Nuclear medicine staff at UMMC perform about 10 stress tests per day, administering radiopharmaceutical injections while a patient is in resting condition and again under exertion, usually from exercise on a treadmill. The doctor can monitor how blood flows to all areas of the heart during resting and stress conditions and compare images to detect any abnormalities. “Nuclear medicine allows a comprehensive array of diagnostic tests,” said Jenkins. With imaging, a doctor can detect a lesion or disorder in its early stages so that treatment can begin promptly, perhaps averting a heart attack or other damage. pediatric echocardiography
Pediatric echocardiography is essential in detecting congenital heart disease in young patients, many of whom are being cared for in the Pediatric Intensive Care Unit, the Neonatal Intensive Care Unit or the Mother/Baby Unit. Other patients have no need for echocardiography until an unexpected event causes physicians to look closely for preexisting heart conditions that lie dormant for years. Sonographers, such as Andrew Bickel, RDCS, AE, PE, registered diagnostic cardiac sonographer, perform cardiac ultrasound, assisting doctors in manipulating a camera to create images of the heart. The images can be two- or three-dimensional or Doppler ultrasound, which measures the speed and direction of blood flow. “Patients come to see our cardiologists with issues such as chest pain or heart murmurs, and the doctors have us perform an ultrasound to test for congenital heart diseases,” Bickel said. About 40 young patients a day come in for this test, which takes about an hour. The imaging can allow a pediatric cardiologist to decide whether surgery or medical treatment is the next appropriate step. “Complicated issues like a hole in the heart or obstruction of blood vessels may be reasons for immediate surgery,” Bickel said. Patients can be sent to the Pediatric Hybrid Catheterization Suite for catheterization procedures or heart surgery.
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PET/CT images from before (left) treatment show cancerous lesions. After treatment, a follow-up scan shows good news – no lesions.
Interventional radiology can shrink uterine fibroids through uterine fibroid embolization (UFE), as an alternative to surgical removal. Above, the image on the right shows where the two fibroids have been reduced compared to before treatment (left).
Pediatric sonographers and cardiologists care for patients from prenatal stages through childhood, and for adults with congenital heart disease. To ease nervous pediatric patients, Bickel likes to explain everything he’s doing and reassures the patient that he or she doesn’t need to worry during the procedure, which is conducted just like an ultrasound on a pregnant woman, except on the chest area, not the abdomen. The sonographers put gel on the cameras and on the patient’s chest before they move the camera around on the skin of the chest to obtain the picture. The sonographer will write a preliminary report about his or her findings, working closely with the cardiologist, who interprets the study. With the use of echocardiograms, the sonographers were able to help physicians detect an anomalous coronary artery in a 12-year-old athletic patient who had chest pain and syncope (fainting) during a field hockey match. “The quality of the non-invasive imaging was so precise that the Children’s Heart Program team was able to quickly act to get the patient in for surgery and save her life,” said Geoffrey Rosenthal, MD, PhD, professor and director of the Pediatric and Congenital Heart Program.
Ashley Hester, RT(R)(VI)
Jason Jenkins, BS, CNMT
Elias Melhem, MD, PhD
pediatric cardiac catheterization
Cardiac catheterization works in conjunction with echocardiography – for both pediatric and adult patients, although pediatric patients are different enough to require physicians, technologists and nurses who are sub-specialists in treating infants and children. “If a pediatrician hears a murmur in a patient’s heart, then the child would be sent to us for evaluation. If we find a hole in a wall in the heart, an abnormal blood vessel, or a valve that may be too small, we can often treat the problem in the hybrid suite,” says Theresa Furrow, RT, CVT, senior cardiovascular radiology technologist.
As part of the University of Maryland Children’s Heart Program, cardiac catheterization on pediatric patients allows for both diagnostic evaluation of the heart and interventional treatment, if necessary. Pediatric anesthesiologists ensure the infants and children are safely sedated or anesthetized. The Children’s Heart Program also treats adult patients who have grown up with congenital disorders. Patients are usually referred from area hospitals or clinics, although some have been born at UMMC. In some cases, the infant’s condition has been diagnosed while still in the womb through the University of Maryland Center for Advanced Fetal Care. Angiograms (pictures of blood vessels and the chambers of the heart) are used with fluoroscopy (X-ray moving images) to show internal structures of the body. Together, they provide pediatric cardiologists and heart surgeons with the information needed to more precisely treat even the tiniest of patients.
<<<<<<< High-school athlete Colleen Houck, 17, of Bel Air, had no idea she had a heart disorder until she went into cardiac arrest while playing in a basketball game in January. At the University of Maryland Children’s Hospital, where she was brought after being resuscitated, the Children’s Heart Program team used minimally invasive techniques to diagnose what caused her arrest, and to implant an automatic intracardiac defibrillator that would prevent it from happening again. To perform such procedures, physicians work with cardiovascular radiology technologists, such as Theresa Furrow (right), to provide a virtual window into the heart.
functional magnetic resonance imaging (fmri)
One of the most highly specialized imaging modalities in medicine is functional magnetic resonance imaging, or fMRI. In fMRI, physicians can see and analyze changes in blood flow to specific parts of the brain, revealing a change in energy use by those cells. The patient remains awake and answers questions. The image can detect – through a bloodoxygen-level-dependent (BOLD) contrast agent – which parts of the brain are activated by various stimuli. It’s as close to mind-reading as science has been able to achieve so far. Although fMRI is used primarily in brain research, it is helpful in some clinical situations for patients. For example, a neurosurgeon might request an fMRI study before operating on a patient’s brain, in order to operate as precisely as possible to avoid centers of function. Just scheduling an fMRI is a challenge, as it requires coordination of the schedules of several specialist physicians and an MRI physicist. While it can take weeks for some other academic medical centers to schedule an fMRI study, UMMC can usually bring the right people together within a day or two. “Sometimes, the same day,” said S. Umran Ashruf, MD, assistant professor of diagnostic radiology and nuclear medicine, and section chief of neuroradiology, because Erma Owens, MS, RT(R)(MR), the magnetic resonance imaging manager, is continually focused on improving the patient experience. “For people who have complex tumors, they need to get this done in a certain time frame, and she makes that happen,” Ashruf said. “Other hospitals send their patients here because we can accommodate them sooner.”
While it can take weeks for some other academic medical centers to schedule an fMRI study, UMMC can usually bring the right people together within a day or two.
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4 UMMC Connections
very day, patients and their families express gratitude to
Medical Center staff members for the care and service they provide.
Staff members notice when one of their own does something extraor-
dinary, too. Four times a year, the Great Stories program selects from
among the many e-mails and letters about staff members or teams that exceed standards and expectations to enhance a patient’s experience. Patients, patients’ families and staff are encouraged to submit examples to email@example.com.
Our daughter, Kimberly Littlefield, had cancer surgery on Feb. 2 with Dr. Alexander. Prior to the surgery she had had a Reiki treatment. Imagine how pleasantly surprised she was to discover that your wonderful hospital provided not only Reiki, but music as well. Kim was able to have three Reiki [treatments] after surgery. We had the opportunity also to enjoy harpist Carol Loeb twice while visiting our daughter. Honorees:
We commend you highly for realizing how to help the whole patient in their recovery.
Perioperative Waiting Area team: H. Richard Alexander Jr., MD; David Wong, RN; Lolly Forsythe-Chisolm, BA; Donna Audia, RN; Matt Peroutka, BA, CMP; Carol Joy Loeb, BSN, RN, CMP; Gladys
Thank you very much,
George and Laudine (Liz) Creighton
October employee of the month
November employee of the month
Bradley Lansinger, CPCS, joined the Department of Medical Staff Services in 2001 as a medical staff coordinator responsible only for credentialing. But over the years he’s become the department’s Midas Credentialing database expert as well. “Brad used his natural interest in computers to learn all he could about the department’s software systems,” says Allison Andrus, CPMSM, director of medical staff services. “While other institutions have had to rely on the vendor or facility-wide IT personnel, we are lucky enough to have someone within our own department who quickly learned how to get the most out of our software.”
During the course of a busy day, Paula Sanders can answer as many as 400 phone calls. But no matter how many callers she greets, she remains upbeat and ready to assist. Sanders’ dedication has impressed her peers, who recently voted her the “unsung hero” of the Call Center. “Paula always does whatever is needed to help a caller, the department or her team,” said Dion Long, referring physicians and Call Center manager. “She’s very focused on her job.” Sanders is one of nine telephone communications attendants who serve as the voices of the hospital.
Bradley Lansinger, CPCS Midas Database Analyst Department of Medical Staff Services
Paula Sanders Telephone Communications Attendant | Call Center
Abound @ UMMC Great
When the Cure Comes with a Price
Dear Sir, On Jan. 5, 2012, I entered UMMC for extensive oral surgery to remove a squamous tumor on my tongue. The surgery, performed by Dr. Lubek and staff, lasted over 10 hours and required that I receive a tracheotomy, a feeding tube placed into my stomach, as well as re-construction of my tongue. I spent 7 days in the ICU recovering. The oral surgery left me without an ability to speak or breathe on my own and this gave me a strong fear of choking and suffocating. The Surgical ICU nursing staff assigned to me each day was extremely sensitive to my fears and attentive to all of my medical needs. They were the most professional and caring group of people I could have asked for. Each time there was a shift change, my apprehension and fear level increased dramatically as I believed that the next shift would not know or understand my personal fears and needs beyond my medical treatment. I know that patient statistics are exchanged between each new shift, but I quickly learned that your entire staff took caring and sensitivity to an even higher level. Each person made it a point to fully explain my physical as well as my psychological state with the new shift. This had a very positive effect on increasing my level of trust and comfort while minimizing my fears. In addition, each change in the nursing staff worked as a seamless unit with a single goal: To make sure my overall well-being was the best they could render. No request was treated as an effort or a problem. I congratulate your entire staff of superstars for their outstanding service. Moreover, I want to express my sincere appreciation for the extra level of attention provided by Teri, Nichole, Laura, Kylee, Jessica, Patricia and Nishia, just to name a few. Learning that I had cancer and the terror of anticipating the extensive surgery I was to receive became all-consuming until I awoke in the ICU. Now that the surgery is behind me, I find every day brings a new beginning and a bright future.
Geoffrey Rosenthal, MD, PhD; Sunjay Kaushal, MD, PhD; Sudhir Vashist, MBBS, MD; Peter Gaskin, MBBS; Stacy Fisher, MD; Donna Nance, RN; Tiffany Ryer,
Dear Dr. Rosenthal, Dr. Kaushal and
BSN, RN; Carolyn Wirth, BSN, RN, CCRN;
the Pediatric Cardiology Team,
Elizabeth Dillard, RN, RCCS, RDCS, sonographer; Marisa Ruby, MS, CCLS,
Our family wanted to thank you for
child life specialist; David Harness, MDIV,
all you did for Collin and all that you
continue to do for his heart. When we first came to University of Maryland, we were not certain of what Collin’s situation was or even what his outlook would be. Kenny and I will never forget the night we met with Dr. Rosenthal and finally had a sense of what was wrong with Collin’s heart. In fact, we still have the picture hanging above our sink to remind us. And then the following morning when we talked with Dr. Kaushal, and he used the words “hope” and “optimistic” when talking about Collin. I will never forget the
To your wonderful staff I would like to say Thank You Very Much.
sense of relief I had when I asked Dr. Kaushal if Collin would ever come home. He laughed and said, “Of course he will!”
It is so absolutely wonderful to have our four kids together and under one roof. Collin is our little hero, our little Superman. We are forever grateful to your team. We know you spent long hours and an enormous amount of effort on treating Collin. You have saved Collin’s life and we have no doubt that he is with the best of
the best when it comes to Pediatric Cardiology.
Joshua E. Lubek, MD; Tera Martin, RRT, respiratory therapist; Nicole
We know the future may not always be easy and that Collin may require additional
Storck, BSN, RN; Laura (Coyer)
treatment, but we are confident in your team and medical staff. In fact, that gives
Paetow, BSN, RN, CCRN; Jessica
us peace of mind. You are all part of Collin’s family and each and every one of you
Murry, BSN, RN; and Patricia
will hold a special place in his heart. Because of you, Collin has a strong heart that
Bautista, RN; and others in the
is ready to grow and be filled with happiness and joy.
Surgical Intensive Care Unit
Our sincere appreciation, The Ripple Family (Kenny, Suzie, Kayla, Ryan, Owen and Collin)
December employee of the month
January employee of the month
In only her first year working at UMMC, Cynthia Jarrett, CNA, has made a long-lasting impression on patients and coworkers alike. “Since joining our staff in November 2011, Cynthia has been recognized throughout the organization as awesome,” said Tonja Bell, MSN, RN, manager of the Supplemental Staffing Department. “She prides herself on providing exceptional holistic care and has received numerous cards of gratitude from patients and their families.” The husband of one patient called Jarrett “a true beacon of hope for my wife.” A fellow staff member said that “with her kind, caring and beautiful spirit she brightens your day.”
Outstanding technical skills and a consistently positive attitude have made Kristin Spaeth, BS, CMD, a key member of the Radiation Oncology Department’s dosimetry/physics team. “Kristin has exceptional technical expertise and she takes the initiative when we are introducing new technologies,” said Bin Zhang, BS, CMD, chief dosimetrist. Spaeth said she loves being part of a team whose members care deeply for patients. “Although we don’t work directly with the patients — the radiation oncologists, radiation therapists, and nurses do that — we think of them on a personal level. I try to look at each CT scan as if it were my sister’s, my mother’s or my best friend’s,” Spaeth said.
Cynthia Jarrett, CNA Certified Nursing Assistant Department of Supplemental Staffing
Kristin Spaeth, BS, CMD Staff Dosimetrist Radiation Oncology Department
6 UMMC Connections Best Valentine’s Day Gift Ever Feb. 18 will mark one year of humdrum daily activities and normal life for Jennifer Dietrick of Baltimore and Robert Hopkins of Essex, MD. And that in itself is a miracle.
Jennifer Dietrick and Robert Hopkins
ne year ago, in February of 2012, Dietrick went into acute liver failure. Doctors believe her acute liver failure may have been caused by the prolonged use of acetominophen, in combination with prescription pain medicine for injuries resulting from Dietrick’s recent car accident. Within hours of falling ill, she was transferred to the University of Maryland Medical Center, where it became clear that an urgent liver transplant was her only option for survival. However, no deceased donor livers were available anywhere within the entire region, and Dietrick was growing weaker by the minute. A living-donor liver transplant was the last resort. Fortunately, she already was at the only hospital in Maryland to perform adult living-donor liver transplants. The living-donor liver transplant team, lead by Rolf Barth, MD, associate professor of surgery and director of liver transplantation, and John LaMattina, MD, assistant professor of surgery, approached Dietrick’s family about the possibility of living-donor liver transplantation. They explained that someone from her family or close circle of friends could donate 60 percent of their own liver and give her a chance at survival. Dietrick’s boyfriend, Robert Hopkins, stepped forward immediately. Within hours, he proved to be a match for Dietrick, and the donor and transplant surgeries were performed the next day. Today, after more than three years together, Dietrick said, “Our relationship is healthier than before. I re-evaluated what’s important in our relationship – and in my whole life.”
After her lifesaving surgery, Dietrick moved back in with her parents while she recovered. She returned to work as an accountant in April. Now as a wiser 25-year-old, she has a greater appreciation for the little things, like how her dad makes her coffee every morning before work. She has taken an active role in the UMMS Liver Transplant Facebook Community, where she talks with other patients and family members who are working through the befores and afters of liver transplantation. Patients seek her out in this Facebook community, and she enjoys the opportunity to help others and give back. “My biggest struggle has been trying to help people understand what I’ve been through. I look healthy on the outside, but I wake up feeling exhausted. During the first three months of recovery, I saw rapid improvement, but then the recovery hit a plateau. They say patients usually don’t start feeling totally back to normal until about one year after surgery.” Hopkins returned to school just a few weeks after his donation surgery. He plans to graduate from George Washington University Law School in December 2013. He says he wouldn’t do anything differently if faced with the same scenario again. This Valentine’s Day, Dietrick and Hopkins are happy to celebrate another normal year together. Dietrick says they talk about the future, but there is no rush to get married. Hopkins has shown his commitment to her in an even greater way through the gift of life.
A Beacon of Hope for Cardiac Care
Cardiac Care Unit Earns National Recognition Beacon Award for Excellence – for Exceptional Patient Care
T Dennis and Luray Rill
The Cardiac Care Unit at UMMC has again been awarded a Beacon Award for Excellence, at the silver level. Lesli Bennett, MSN, MBA, RN, is the nurse manager of the unit and David Hunt, MSN, RN, is the director of nursing and patient care services for cardiac care.
he nurses on the Cardiac Care Unit (CCU) are accustomed to seeing patients who might be at the most critical stage of their heart diseases, before they improve enough to go to the next step in their recovery on another unit. So it’s always a treat when Dennis Rill, 68, stops in to say hello to them after an outpatient visit with his cardiologist. Just over a year ago, Rill’s heart was failing and his chances of survival were slim. On Nov. 23, 2011, he received a ventricular assist device (VAD) that keeps his heart pumping until he’s strong enough for a heart transplant, which he is still awaiting. He was in the CCU for seven months before he became strong enough to go home. Now, he’s able to go shopping with his wife, Luray, and hang out in the back yard with her. “He comes back to see other patients, to give them hope and show them how their life could be with these devices,” said Karen Cossentino, MS, RN, CCRN, senior clinical nurse II in the CCU. The Rills say it is the CCU nursing staff that is closest to their hearts. “I can’t say enough about them,” Luray Rill said. “We went through a lot together,” Dennis Rill said. “They know their skills, they know what they’re doing, and they were always there for us. They didn’t just take care of me, they took care of my wife. They reminded her to go home and rest.” Before the technological advances of the last five to 10 years, Rill might not have survived to go home. The nurses in the CCU have extensive experience caring for patients with these devices. That depth of experience has contributed to the excellent patient outcomes that are among the reasons the CCU has again won renewal of its Beacon Award for Excellence.
The University of Maryland Medical Center’s CCU was recognized this fall with a silver-level Beacon Award for Excellence by The American Association of Critical-Care Nurses (AACN). Any intensive care or critical care unit – not just cardiac – can apply for a Beacon Award, but less than 1 percent of all hospitals in the United States have a unit that has achieved the distinction. Only one other hospital in Maryland has a unit that has a current Beacon Award. To maintain the award, a unit must reapply at certain intervals. “It’s remarkable, really, for a unit to be selected for the Beacon Award,” said Lisa Rowen, DNSc, RN, FAAN, senior vice president and chief nursing officer for UMMC. “So it’s even more impressive that our Cardiac Care Unit achieved a Beacon Award the first time it applied, in 2009, and that it has maintained its Beacon Award status continually since then.” Rowen added, “The unit has fostered a culture of exceptional teamwork that allows them to achieve not only great outcomes for patients, but also to enjoy an enriching professional environment.” Patients in the CCU are critically ill with a wide range of heart disorders. Many of them need a transplant. The unit also has a high proportion of patients who have a rare heart-lung disorder called pulmonary hypertension, because the unit’s medical director is an expert in that field and physicians throughout the region refer patients to her. Myung H. Park, MD, associate professor of medicine at the UM School of Medicine and director of the Pulmonary Vascular Diseases Program, is widely known for her research in pulmonary hypertension, which occurs when blood pressure in the pulmonary artery rises far above normal levels, causing the small arteries of the lung to narrow. When it comes to caring for patients who are living with an artificial device, such as an artificial heart or a ventricular assist device, Rowen said, “You would be hard-pressed to find a cardiac care unit in any other hospital with as much experience as our CCU.” “The forward movement of the technology has been brisk,” said Cynthia Bauer, MS, BSN, senior clinical nurse II in the CCU. “We’re seeing improved survival rates with the new devices.”
in the community
Life Lessons for Independence
Within a Community
brass ensemble played “Pomp and Circumstance” as the 14 graduates proceeded up the aisle. Family and friends wiped away tears of joy. One graduate, Richard Turnage, 31, spotted his mother, Tangera Keene, and stopped just long enough for her to snap a picture. The proud moment was the culmination of a unique community mental health program that Turnage and his fellow graduates completed – a nine-semester curriculum focused on the skills and experience they need to make the transition from a group home to independent living. Bryan Baird, the student speaker at the graduation, reminded his fellow graduates of all they had done. “We learned how to interview for a job,” he said. “We learned how to cook meals [and] how to open a bank account. We went to the library and took public transportation.” “Most of these patients were very young at the onset of their illnesses, which include mood and cognitive disorders. That greatly interfered with daily life,” said Jill RachBeisel, MD, associate professor of psychiatry at the University of Maryland School of Medicine and director of community psychiatry at UMMC. “In their teen years, at a stage when most of us learn our social skills, they were just hanging on for dear life,” RachBeisel said. “We wanted to develop a holistic, structured program to teach these skills that the majority of adults take for granted.”
reaching stability, then gaining skills
Before members of the academy progressed to residential rehabilitation, mental health treatment had allowed them to achieve stability. But even with this stability, the patients still had gaps in their experience and knowledge that might thwart their attempts to land a job, get their own apartment, get along with their neighbors and bosses or even to emotionally navigate a large family gettogether. Keene said she sees a big improvement in her oldest son, Richard Turnage, who was in the academy’s first graduation class this year. “He is much better with his cousins, nieces and nephews when we all get together now,” Keene said. “There’s a big difference.” “I’ve learned to manage my anger,” Turnage said. RachBeisel developed the Academy of Independent Living three years ago. The learning and living both happen within each of the 19 single-family homes UMMC owns or rents in West Baltimore neighborhoods. The homes are run by the UMMC Community Psychiatry’s residential rehabilitation program, Harbor City Unlimited. Presentations are made in a classroom setting, and students then go out into the community to practice what
they have been taught, and in some cases, even rehearsed, such as ordering food in a restaurant. a real graduation
In some respects, the first-ever commencement ceremony of the Academy of Independent Living felt like that of any school, which is what the graduates wanted. Most had never had the opportunity to wear a cap and gown. In their teen years, when they might have gone to the prom and finished high school, the struggle with severe psychiatric disorders consumed their emotional and physical energy. Their keynote speaker, scholar Kay Redfield Jamison, PhD, professor of psychiatry at Johns Hopkins University, is internationally known for her books on managing life with severe mental illness. The graduates wanted as much of the pomp and circumstance as they could get, starting with a formal dance a month before the graduation at the University of Maryland, Baltimore. Stella’s Bridal Fashions and Value Village donated elegant gowns that retail for hundreds of dollars and Horton’s House of Tuxedos donated rental tuxedos or suits for the men. Elegant catered appetizers, cheeses, fruits and desserts were set on lovely tables. Everyone danced and celebrated. Staff noticed the students, in their formal attire, were standing taller and more poised than ever. “Most programs have bits and pieces of this. But none that I know of is as comprehensive and organized as ours,” RachBeisel said. “Everyone would agree with the concept, but it is having the skill sets available in the staff to execute all of it. Our use of occupational therapists in the program has brought a skill set that can help train the existing staff to carry out this program moving forward.” “Her collaborations with all staff have made it possible for members to participate in transformational opportunities for a population that is so frequently left in the shadows,” said Lila Nappi, OTR/L, director of occupational therapy in the Psychiatry Department. In addition to teaching skills, the program allows the residents to develop relationships with neighbors and supports their transition back into the community. The academy embraces the mission of “recovery in mental health treatment,” RachBeisel said. Individuals learn to manage their illnesses so they can recover their lives. “I’d like to get a job as a truck driver,” said one graduate. His mother said her son has grown mindful in his personal interactions with others in the community, which she has noticed when she goes shopping with him. She smiled and added, “The fact that I see him in a suit is great thing.”
Richard Turnage and his mother, Tangera Keene
Academy of Independent Living students and staff at the formal dance.
To read a moving letter that Lila Nappi, OTR/L, wrote to her colleagues who collaborated with her over the Academy of Independent Living, go to the UMMC blog, Life in a Medical Center, at MedCenterblog.org.
UMMC’s Redwood Pharmacy Serves Outpatients and the Public The UMMC Pharmacy at Redwood has moved to a new storefront at 11 S. Paca St. – at the corner of Paca and Redwood streets and across from the Redwood Building and University Plaza Park. Hours are 9 a.m. to 5 p.m. Monday through Friday. Hospital staff, patients and visitors should continue to use the Outpatient Pharmacy in the Weinberg Atrium of the Medical Center. The new Redwood location, however, may be more convenient for the nearby community and for patients who are coming from appointments in the Redwood physician office building. The new Redwood pharmacy has an expanded selection of over-the-counter products, as well as prescription processing.
8 UMMC Connections people spotlight
UMMC/UMGCC Websites Win Awards in Prestigious Competition
UMMC and UMB Join Forces for Heart Walk
Every year, the American Heart and Stroke Association Heart/Stroke Walk celebrates health and
raises awareness and funds to combat the No. 1 and No. 3 causes of sickness and death in Maryland – cardiovascular disease and stroke. The University of Maryland Medical Center has been a partner in this effort for years, but the 2012 Heart Walk in October was the first time the Medical Center partnered with the University of Maryland, Baltimore, and with other hospitals in the University of Maryland Medical System (UMMS) – Upper Chesapeake Health, Baltimore Washington Medical Center and Kernan Orthopaedics and Rehabilitation. The total 500 walkers raised a record $65,000 for the AHSA, which provides grants to University of Maryland and other organizations. The association is committed to research that will treat and reduce the incidence of diabetes, congenital defects in children and heart attack, brain attack (stroke) and heart failure. “We receive research funding from the AHSA that helps us discover new ways to treat and prevent cardiovascular disease, and we are making a difference in the opportunities for people who live in our region,” said David Hunt, MSN, RN, director of nursing for cardiac care and radiology at UMMC The mission is simple – educate people to eat more healthy foods, enjoy regular exercise, understand how to control their weight, manage their stress and quit smoking.
UMGCC Sponsors half marathon for the 5th year
The 5th annual Maryland Half Marathon to benefit the University of Maryland Marlene and Stewart Greenebaum Cancer Center will be held on Saturday, May 11, 2013, on a redesigned, faster course in the Maple Lawn community of Howard County. Registration for the 13.1-mile race is now open at www.mdhalfmarathon.com. The 2013 event will feature Dozer’s Kids Fun Run, named in honor of the dog that jumped into the half marathon at Mile 5 and finished the 2010 race. Fundraising on behalf of the goldendoodle added more than $32,000 to the net proceeds from the race the past two years. There will also be a Kids Zone as well as live music. The half marathon starts at 8 a.m., and the kids’ race at 8:30 a.m. Registration for the half marathon is $85 for those who register by Feb. 28, and $90 from March 1 through race day (May 11, 2013). Dozer’s Kids Fun Run is $15, and the Kids Zone is free. UMMC Honored for Environmental Health
The Medical Center received a Trailblazer Award from Maryland
Denise Choiniere, MS, RN, director of Sustainability and Facilities Services at UMMC, and Caryn Zolotorow, MS, RNC-OB, the nurse manager of the Mother/ Baby Unit were among UMMC staff who accepted the award.
Hospitals for a Healthy Environment (MD H2E) for a first-ofits-kind program to educate new mothers about the health risks associated with pesticides. UMMC was among five hospitals and a nurse honored at MD H2E’s fifth annual conference Nov. 14 at the University of Maryland School of Nursing. Nurses on UMMC’s Mother/Baby Unit launched the program for new mothers in partnership with the Integrated Pest Management in Health Care Facilities Project. The nurses provide new mothers with information about safe alternatives to using pesticides in the home. UMMC also was honored at the MD H2E meeting for adopting a “green” pest management approach that eliminates the use of toxic chemicals.
The University of Maryland Medical Center (www. umm.edu) and University of Maryland Marlene and Stewart Greenebaum Cancer Center (www.umgcc.org) websites won a combined three eHealthcare Leadership Awards at the 16th Annual Healthcare Internet Conference in Las Vegas on Nov. 14. The websites contain helpful information and moving firsthand accounts from patients who tell their stories. The sites allow patients and the public to submit questions to physicians using the “Ask the Expert” feature, learn the latest about medical conditions and the best treatments for them, view informative videos of physicians and other UMMC health care providers, and use the “Find a Doctor” tool. This prestigious eHealthcare Leadership Awards – considered the top competition for hospital websites – received nearly 1,100 entries from more than 240 health care organizations, including the Cleveland Clinic, Mayo Clinic, Johns Hopkins Medicine, Brigham and Women’s Hospital, New York Presbyterian and others. The UMMC site won a gold award, the top level award given, for Best Health/Healthcare Content, which is judged by “how extensive, balanced, up-todate, well-organized, and readable” the Web content is. UMMC also won a gold award for Best Rich Media, which focuses on video, audio podcasts, virtual tours and multimedia content. The UMMC website hosts more than 600 videos, which receive about 100,000 views a month. The UMGCC (cancer center) website received a silver award for Best Health/Healthcare Content in the hospital subsite/center of excellence category.
Ed Bennett Inducted into Healthcare Internet Hall of Fame Ed Bennett, director of Web and communications technology for UMMS, was inducted into the Healthcare Internet Hall of Fame Nov. 13, becoming one of just three professionals nationwide to receive this honor since the Hall of Fame was established in 2011. Bennett, who is known throughout the health care industry as an innovator and leader, has worked for 12 years in the Corporate Communications and Public Affairs Department at UMMS. His most important and enduring contribution is an understanding of what patients and caregivers want, including use of original content, attracting visitors to a hospital’s website, ways for visitors to ask questions of experts, and a successful mobile app for hospitals. Bennett continues to be a sought-after conference speaker and serves as an adviser to the Mayo Clinic Center for Social Media, where he’s currently focusing on employee-access issues. Bennett received the award during the 16th Annual Healthcare Internet Conference in Las Vegas.
Kristin Seidl, PhD, RN, is the new director of quality and patient safety officer for UMMC. She will lead patient-safety and qualityimprovement strategies, pulling together multidisciplinary teams to plan, implement and monitor progress across the organization. She first joined UMMC in 2005 as a clinical practice coordinator in surgical critical care, and has moved into greater leadership roles in nursing practice, development and research. In addition to her work at the Medical Center, she is an assistant professor at the UM School of Nursing. I N V O LV E D
Beth H. Rodgers, BSN, RN, CNOR, operating room clinical educator at University of Maryland Medical Center, was elected president of the Baltimore Chapter of the Association of PeriOperative Registered Nurses.
Five UMMC Pharmacists Take Honors and Leadership Roles in the Maryland Society of Hospital Pharmacists.
Adrienne Shepardson, PharmD, central production manager, received the Pharmacist of the Year Award. Kristine Parbuoni, PharmD, BCPS, was installed as the new president. Brian Grover, PharmD, BCPS, was installed as the new president-elect. Asha Tata, PharmD, BCPS, received the Jeffrey Ensor Leadership Award and was installed as secretary for the society. Mehrnaz Pajoumand, PharmD, BCPS, was installed as a new member of the society’s board of directors.
You can follow @EdBennett on Twitter.
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