Impact August 2017

UTMB NEWSLETTER • AUGUST 2017

Volunteers: Adding a dose of compassion at League City Campus

Best Care in Action: MICU protects patients against infection UTMB team takes extreme medical mission trip to Mount Everest Spotlight on Annette Macias-Hoag, associate chief nursing officer, Angleton

UTMB employees Sarah Burnett, Brenda Lundy and Betty Shipp received President’s Way to Go Awards at the July Town Hall meeting. Burnett, a medical lab specialist with Blood Bank Transfusion Operations, was recognized for a “long list” of accomplishments, including initiating several innovative projects to improve patient care and ensure blood products are used safely and efficiently, and for her volunteer work in the community. Lundy, a clerk with Clinics Administration and Support, was recognized for always going the extra mile to make sure patients receive special assistance, and for her brave actions during the John Sealy Hospital fire in January. Shipp, a nurse and care manager with UTMB’s Community Health Network, was recognized for making a difference in the lives of many patients. Speaking about Shipp, Dr. David Callender said, “I’ve heard several stories about patients who had been to the ER multiple times and had incredible social barriers that nobody else could help them overcome, but in every case, you did that and you helped them improve their social status, their health and their lives. Thank you for your brilliant work.”

UTMB’s media relations team won two regional awards for their efforts in educating and explaining the Zika virus to the public. The team was awarded first place in the “Crisis Communications” category at the Houston American Marketing Association’s Crystal Awards and at the Houston Public Relations Society of America Excalibur Awards. When the Zika crisis began, UTMB scientists were some of the few well-respected researchers who had actually worked on the virus. The media relations team made the news media aware of the UTMB faculty’s expertise on Zika.

Dr. Joseph Penn, director of Mental Health Services with UTMB Correctional Managed Care, co-authored the book chapter, “Correctional Psychiatry,” in Kaplan and Sadock’s Comprehensive Textbook of Psychiatry, 10th Edition. This was the 50th anniversary edition— and is the cornerstone text in psychiatry. Penn is board-certified in general, child and adolescent, and forensic psychiatry. He is a clinical professor in the UTMB Department of Psychiatry and Behavioral Sciences, and has served as a consultant regarding correctional and non-correctional mental health care delivery and standards of care.

Dr. Tian Wang, associate professor in the Department of Microbiology and Immunology, was awarded $2.9 million from the National Institutes of Health to further develop a vaccine against chikungunya, a mosquito-borne virus which was recently ranked the No. 2 priority for global vaccine needs. Along with UTMB’s Dr. Scott Weaver, and

other researchers, Wang recently helped develop the first vaccine for chikungunya fever made from an insect-specific virus that doesn’t have any effect on people, making the vaccine safe and effective. The findings are detailed in Nature Medicine.

Dr. Thomas Geisbert, professor in the Department of Microbiology and Immunology, was awarded $6 million from the National Institutes of Health to develop a potential medical therapy to be used in the fight against Crimean-Congo hemorrhagic fever virus, a tick-borne disease that is often fatal. Focused on emerging viruses—with a particular emphasis on viruses causing hemorrhagic fever including Ebola virus, Marburg virus and Lassa virus—Geisbert has nearly three decades of experience working in Biosafety Level-4 containment.

The University of Texas System Board of Regents recognized five UTMB faculty members with the system’s top teaching prize, the 2017 Regents’ Outstanding Teaching Award: Dr. S. Lynn Knox, professor, vice chair for education and residency program director, Anesthesiology; Dr. Ronald S. Levy, professor, Anesthesiology; Dr. Anita Mercado, associate professor, Internal Medicine, Dr. Joan Nichols, professor, Internal Medicine and Microbiology and Immunology, and associate director of research and operations at the Galveston National Laboratory; and Dr. Mary O’Keefe, professor, School of Nursing. This award is given annually in recognition of faculty members who have demonstrated extraordinary classroom performance and innovation in undergraduate instruction.

Knox

Levy

Mercado

Nichols

O’Keefe

Eleven Frontera de Salud student members and faculty advisor Dr. Norma A. Pérez recently returned from their second mission trip to Presidio County in West Texas, a rural area that lies in the Chihuahuan desert and is adjacent to Mexico. Working with the area hospital district and the Presidio-Brewster County Indigent Healthcare Program, the students helped organize a health fair that included blood pressure, diabetes and BMI screenings, as well as information about immunizations and the Zika virus. Students also hosted a nutrition and healthy eating booth with a live demonstration on making a cactus salad. The arid region makes growing fruits and vegetables difficult, so the students built five hydroponic gardens that will grow broccoli, cabbage and spinach. These gardens are being adopted as a model by the Texas Department of State Health Services-Family and Community Health Services Program.

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impact

From the President Can you believe we are nearing the end of another fiscal year? It sure has been an eventful one!

A UGUS T 2 0 1 7

From the extraordinary bravery our employees showed during the John Sealy Hospital fire in January to the launch of our “UTMB Wonders” awareness campaign and Innovations in Mind Fundraising initiative, to the new Health Education Center groundbreaking on our Galveston Campus in April, the heart and commitment of our employees have been nothing short of inspiring.

Best Care in Action: Protecting patients against infection

Through your hard work, we’ve continued to rise in the rankings among academic medical centers as part of the Best Care initiative and we fared as well as could be expected during the 85th Regular Session of the Texas Legislature. This summer, we watched students graduate from all four of UTMB’s schools, marking 126 years of excellence in education, research and patient care. Look for coverage of the School of Health Professions commencement in the next issue of Impact.

There’s so much to celebrate, and I’d like to thank you for making this year so special.

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This edition highlights one of our very own volunteers, Jessica Norris. If you visit the League City Campus, you may have seen her providing refreshments to patients and visitors—always with a smile.

Ms. Norris is one of nearly 400 active volunteers in Galveston, League City and the Angleton Danbury Campus Auxiliary who donate their time and energy to serving UTMB’s patients and families.

Medical mission trip to Mount Everest

You can learn more about Ms. Norris and the amazing services our volunteers provide in this latest edition of Impact, along with other stories highlighting our people. Among them:

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• A profile of Annette Macias-Hoag, associate vice president, Health System Operations and associate chief nursing officer, Angleton Danbury Campus • A Best Care in Action spotlight featuring an initiative in the MICU to protect patients against infections • A research study that discovered a new vaccine can protect female mice and their developing fetuses from Zika virus infection and related birth defects • A team of UTMB physicians and employees taking an extreme medical mission trip to Mount Everest • Summer programs offered by the Office of Educational Outreach that enable teacher and student success • UTMB’s Employee Advisory Council’s visit to CMC in Huntsville • Tips for recognizing and acknowledging the warning signs of suicide, by Dr. Jeff Temple and Lauren Scott, Behavioral Health and Research Department of Ob/Gyn • Numerous accomplishments and kudos in the Working Wonders column and throughout the newsletter

Day in the Life: UTMB volunteer Page 8

Spotlight on Annette Macias-Hoag, associate chief nursing officer, Angleton

I hope you enjoy this issue, and please contact the Impact team if you have ideas for future stories.

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Dr. David L. Callender UTMB President

Impact is for and about the people who fulfill UTMB’s mission to improve health in Texas and around the world.

We hope you enjoy reading this issue. Let us know what you think!

ON THE COVER: UTMB volunteer Jessica Norris pushes a beverage cart to clinic waiting areas on UTMB’s League City Campus.

UTMB has about 400 active volunteers, including those in Galveston, League City and members of the Angleton Danbury Campus Auxiliary who are passionate about serving patients and their families.

P R INT E D B Y U T MB G R A P H IC D ES IG N & P RIN TIN G S ERVICES

Vice President Marketing & Communications Steve Campbell

CONTACT US Email: impact.newsletter@utmb.edu Phone: (409) 772-2618

Associate Vice President Marketing & Communications Mary Havard

Campus mail route: 0144 U.S. Postal address: UTMB Marketing & Communications

301 University Boulevard

Galveston, TX 77555-0144

Editors KirstiAnn Clifford Stephen Hadley Art Director Mark Navarro

B EST CA R E I N AC T I O N

BY KIRSTIANN CLIFFORD

Keeping patients safe is the No. 1 priority for nursing staff in the Medical Intensive “We’ve hit some major records in the MICU for reducing infections,” said Hastedt.

Care Unit at UTMB’s Jennie Sealy Hospital in Galveston.

“We used to average at least one CAUTI infection per month—and now we’ve gone For the past two years, they have been working to reduce health care-asso- five months in a row without a single infection. We produce data on a monthly basis that shows our rate of incidences are steadily declining and it really provides a ciated infections (HAIs), which patients can lot of motivation and pride among our staff.” get while receiving medical treatment in the hospital. HAIs are among the leading threats to patient safety, affecting about one out of every 25 hospital patients at any given time, according to the Centers for Disease Control and Prevention.

Robert Starkweather, an RN business analyst at UTMB who works with epidemiology, assists the MICU in determining if an infection qualifies as an HAI and ensures the correct data is submitted to the CDC. By reducing the cases of CAUTI and CLABSI, Starkweather said it also decreases the likelihood patients will acquire other infections, as well.

“Every hospital unit has unique challenges,” said Robert Hastedt, MICU nurse manager.

“In the MICU, where we tend to have frail patients who need to be admitted longer, it’s combatting two types of infections: CLABSIs and CAUTIs.”

“A lot of these infections are connected to each other,” said Starkweather. “For example, reducing the number of CLABSI infec“CLABSI” stands for central line-associated tions also lessens the risk of infections like Nurse manager Robert Hastedt (center) and the MICU nursing team bloodstream infections, which occur when the MRSA (methicillin-resistant Staphylococcus intravenous tubes used to supply medication, aureus) bacteremia, because that usually nutrients and fluids to patients become host goes through the central line, as well.” to bacteria, pumping germs straight into the patient’s bloodstream. “CAUTI,” or catheter-associated urinary tract infections, occur when germs enter the urinary tract through a urinary catheter and cause infection. Both types of infections have been associated with increased length of stay, mortality and health care costs. But both are largely preventable.

What this means for patients is improved safety and outcomes, as well as a better overall hospital experience. Without the inconvenience of a central line or urinary catheter, patients are more comfortable and are able to ambulate much easier—the MICU has even introduced a new mobility project to get more ICU patients up and moving around.

The MICU formed the Healthcare-Associated Infection Prevention Team, made up of nurses and epidemiologists, to tackle the issue head-on. The group performed “It’s been a team effort that really took the bedside nurses and physicians to make an evidence-based review and found that the most important aspect to infection this work,” said Hastedt. “They’ve done a phenomenal job and I think we’ve passed prevention was identifying patients who did not need a central line or urinary the biggest test, which is making sure these changes stick. We knew it wouldn’t catheter. Fewer catheters means fewer chances for hospital-acquired infections. be easy and would take a lot of hard work, but we did it.” n “We developed a program that used evidence-based criteria to assess patients and determine whether they needed a central line or urinary catheter,” said Rachel Taylor, an MICU nurse. “It’s been a big culture change. Before this initiative, almost every patient in the ICU had a urinary catheter at all times—it was like one of the boxes nurses checked when a patient was admitted. Now, we do a true assessment of each individual’s needs.”

If a patient meets the criteria to get a urinary catheter, the nurses have been trained to follow specific interventions for infection prevention and collaborate with physicians to get the device removed as soon as it is no longer necessary.

In addition, the charge nurse performs a rounding audit at the beginning of each shift to ensure staff have adhered to safety protocols and review whether any devices can be removed.

Once having the highest rates of CLABSIs and CAUTIs in the hospital, the MICU has made significant improvements over the last several months and is now one of the top performers in preventing device-associated infections. In fact, the unit has reduced their rate of the two infections to zero by decreasing its number of urinary catheter days by 24 percent and the number of central line days by 18 percent.

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Best Care Update: Quarter 3 Rankings In July, UTMB received its third-quarter performance report for the Vizient Quality & Accountability Study. Our overall ranking has improved to 8th place among the study’s participating 107 academic medical centers. This is a testament to everyone’s commitment to providing Best Care to our patients. The final ranking will be available at the end of September. As we close the year strong and maintain our rank, we must continue to focus on making UTMB a high-value practicing organization.

DOMAIN

Overall Mortality Safety Effectiveness Patient Centeredness Efficiency Equity

2016 RANKING

2017 MID-YEAR RANKING

76

19

8

94

78

61

2017 3RD QUARTER RANKING

23

4

7

47

17

13

21

13

12

98

53

34

1

1

1

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PAT IENT CARE

Team from UTMB takes medical mission trip to Mount Everest

BY KIRSTIANN CLIFFORD

Five minutes after landing in Nepal in 2015, Dr. Harold Pine and his UTMB medical mission team experienced a catastrophic earthquake that devastated the region.

In addition to medical care, the team also built an entire computer classroom for the village school, donating 20 brand new fully loaded Dell computers with software.

Their carefully planned three-week trek to hold ear, nose and throat clinics in remote villages was turned upside down. Instead, they worked around the clock in Kathmandu to provide basic first aid to the injured, as the death toll reached into the thousands.

The medical mission was followed by the physically demanding hike to Everest Base Camp, which stands at more than 17,500 feet. While the air was thinner, the team bonded over the challenges they overcame and successes they experienced.

Since then, Pine, a pediatric otolaryngologist, vowed to return to the region to finish what his team started.

“It’s not an easy place to be; it’s not an easy place to work,” said Pine. “At one point, we were high enough that oxygen is half what it is at sea level. But we still managed to provide medical care to those we met along the way, including a climber who was suffering from altitude sickness. It’s a once-in-a-lifetime kind of crucible to do this trek. It was really a memorable and rewarding experience.”

“I wanted to do something special,” said Pine, who recruited old and new team members for another trip. “I wanted our team to experience a trip that was part humanitarian, part personal challenge.”

In April 2017, the team landed in Nepal once again. Joined by a UTMB medical student, surgical intensive care unit nurse and faculty members representing otolaryngology, pediatrics, urology, dermatology, radiology and plastic surgery, the team trekked to the village of Deusa, handing out 40 pounds of toothbrushes, providing medications, and offering free head and neck cancer screenings, skin evaluations and other medical care.

“In one day, we saw more than 300 people. It was amazing,” said Pine. “Deusa is located in a remote area that is completely off the beaten track—it’s where a lot of the porters live who support the big Everest climbing expeditions. These porters travel great distances, leave their families and do a lot of the hard work, so we wanted to support them. People walked for hours to be seen by us and we didn’t turn anyone away.” impact

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Dr. Dayton Young, a fellow otolaryngologist who was part of the team, said the bond between team members has stuck, even after returning to this side of the world.

“I think the mission trip helped break down silos,” he explained. “There were all types of people on this trip who work at UTMB and who I wouldn’t have gotten to know otherwise. For example, I didn’t know the breadth of expertise we have in dermatology—and they were unaware of all the subspecialties in otolaryngology.

Since we got back, I have already referred several patients to colleagues I met on the trip and am much more aware of what’s going on across the university.”

Pine is already planning his next trip to Nepal—this time in 2019. If you’re interested in joining the next UTMB Mount Everest Medical Mission team or would like more information, contact him at hspine@utmb.edu. n 5

RESEARCH

New Zika vaccine protects fetus against infection and birth defects

BY DONNA RAMIREZ

Immunizing female mice with a Zika vaccine can protect their developing fetus from infection and birth defects during pregnancy, according to new UTMB research. The findings of the study were recently published in Cell, a medical journal.

Although rapid and promising progress on developing vaccines has been made with animal models, the UTMB study is the first to demonstrate that potential vaccines could protect a fetus from the Zika virus.

“We were the first to show that two different potential vaccines given to the mother prevent the Zika virus from infecting the fetus during pregnancy in a mouse model,” said UTMB’s Dr. Pei-Yong Shi, senior author and the I.H. Kempner Professor at the Department of Biochemistry and Molecular Biology.

“Based on these data, we believe that evaluating the vaccines’ ability to prevent birth defects in humans is warranted.”

RES EARC H B R I E F S

While a Zika infection typically results in mild or symptomfree infections in healthy adults and children, the risk of microcephaly—a neurological condition in which a baby’s head is abnormally small because its brain did not develop correctly—and other diseases in a developing fetus is an alarming consequence that has created a worldwide health threat. Pregnant women who are infected with the Zika virus but never display any disease symptoms may still give birth to a baby with microcephaly.

Researchers vaccinated female mice against Zika with one of the two developing vaccines before they became pregnant and then exposed the mice to the virus during their pregnancies. Shi and colleagues found little or no evidence of the virus in the vaccinated pregnant mice or in the fetuses’ bodies.

Compiled from press releases written by Donna Ramirez and Christopher Smith Gonzalez. Find out more at www.utmb.edu/newsroom.

Managing asthma in adults can be tricky because the condition can stem from several causes and treatment often depends on what is triggering the asthma. A team of experts from UTMB, including Department of Internal Medicine professor Dr. William Calhoun and assistant professor Dr. Jennifer McCracken, examined and summarized the current information available from many different sources on diagnosing and managing mild to moderate asthma in adults.

They determined that essential, effective treatment must involve a physical and breathing exam, along with a comprehensive health history of the patient that includes questions about an individual’s possible triggers. The study authors noted that a key part of asthma management is a written action plan that details the signs and symptoms of worsening asthma and the steps needed to combat it in layman’s terms. The findings are now available in the Journal of the American Medical Association. Asthma affects nearly 8

percent of adults and leads to 1.8 million hospitalizations and 10.5 million visits to the health care provider’s office each year in the U.S. Other authors include UTMB Drs. Sreenivas Veeranki and Bill Ameredes. The study was supported by The National Institutes of Health.

Dr. Krishna M. Bhat, a professor in the Department of Neuroscience and Cell Biology, and his lab have shed light on how the developing brain ensures that connections between brain cells reach their intended destination and are also maintained during their life-span. The findings have been published in the journal Science Signaling. Like other networks, the brain contains regions that serve specific functions such as interpreting sensory information, controlling bodily movement or forming memory, among others. In order for regions to interact with one another to perform complex tasks, the brain has a web of interconnecting pathways. The study showed that a protein called Slit is required for maintaining the interconnecting pathways in

RESEARCH

“Having a Zika vaccine that can protect pregnant women and their unborn babies would improve public health efforts to avoid birth defects and other effects of the disease in regions where Zika is circulating,” Shi said.

UTMB is working with the Brazilian Ministry of Health to develop a vaccine for Zika virus, which became a worldwide health threat last year, showing up in more than 70 countries and infecting more than 5,000 people in the U.S. last year.

Other authors include UTMB’s Dr. Chao Shan, Camila Fontes, Bruno Nunes, Dr. Daniele Medeiros, Antonio Muruato, Dr. Huanle Luo, Dr. Tian Wang, Dr. Alan Barrett, Dr. Scott Weaver and Dr. Shannan Rossi; Drs. Justin Richner, Brett Jagger, Bin Cao, Elizabeth Caine and Indira Mysorekar from Washington University School of

the nervous system. Without continual guidance from Slit, the pathways drift off course. The study found that Slit keeps brain cells on their paths in partnership with receptor proteins called Robo. The study also revealed that Slit-Robo signaling is controlled by an enzyme called Mummy. Mummy modifies Slit in such a way that it could be secreted outside the cell where it is made, and also maintains correct amounts and spatial distribution of Robo during early and late nervous system development. This has implications for studying loss of cognition and other brain functions as people age or in many neuro-diseases. Other authors include UTMB Drs. Mary Ann Manavalan, Vatsala Ruvini Jayasinghe and Rickinder Grewal.

Scientists at UTMB have unraveled how certain proteins work together to regulate the formation of connections between neurons. The human brain contains an estimated 100 billion neurons that communicate with each other through hundreds of trillions of synapses, the contact and communication points between connected neurons. In a study published in the journal Neuron, Dr. Gabby Rudenko, associate professor in the Department of Pharmacology and Toxicology, and other researchers at UTMB focused on proteins that reach out across and bridge the cleft between two neurons.

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Medicine; Dr. Kimberly Dowd, Bryant Foreman and Dr. Theodore Pierson from the National Institutes of Health; Sunny Himansu and Dr. Giuseppe Ciaramella from Valera LLC, a Moderna Venture, as well as Dr. Pedro Vasconcelos from Evandro Chagas Institute, Ministry of Health, Parå State University, Brazil.

This work was supported by the National Institutes of Health, the Defense Advanced Research Projects Agency, the Burroughs Wellcome Fund, the March of Dimes, Moderna, UTMB, The University of Texas System, the Pan American Health Organization, the Ministry of Health of Brazil, the Brazilian Agency for Scientific and Technological Development, and the Coordination of Professionals of High Level Degree of the Ministry of Education of Brazil. n

The traditional school of thought has been that one protein from each side of the synaptic cleft combine to form a trans-synaptic bridge that helps form and/ or stabilize a synapse. However, sometimes a third molecule can block this connection by getting in between the two proteins. By determining their three-dimensional structures, Rudenko and her colleagues revealed how trans-synaptic bridges formed by the proteins neuroligins and neurexins can be blocked by a third competing protein known as MDGA, regulating the synapse development. Understanding these synaptic connections is critically important work that could have an impact on designing new treatments for neurological diseases. Other authors include Dr. Shanti Pal Gangway, Xiaoying Zhong, Suchithra Seshadrinathan, Dr. Hui Chen and Dr. Mischa Machius. n

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impact

BY KIRSTIANN CLIFFORD

If you’re an employee or patient who frequents UTMB’s League City Campus, chances are you’ve met Jessica Norris.

For the past year, she’s donated her time and energy to pushing a beverage cart around all League City Campus clinics—making sure no patient, family member or employee is overlooked. Her reason for putting in nearly 600 volunteer hours over the past year is plain and simple.

“My favorite thing to do is help people,” she says as we meet on a Tuesday morning.

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I’m excited to finally meet Norris in person, as I had been contacted by several employees and patients who said she has a special way of brightening every room she walks into. I immediately understand what they mean as I spot Norris walking through the front door of the LCC clinics—she has a genuine smile and gracious demeanor. Numerous employees smile, wave and call out, “Good morning, Jessica!”

Norris greets me with a warm welcome and we walk to a breakroom where she starts her day preparing a beverage cart of water, coffee and lemonade. As she fills a drink dispenser, she explains how her mother’s work as a pediatric nurse at UTMB inspired her to start volunteering last August.

“I went to work with my mom one day at the Pediatric Specialty Center at Bay Colony and liked helping her out, so I asked how to volunteer for UTMB,” she says. “She printed out a packet and I filled it out and they (UTMB Volunteer Services) called me the next week—I was really excited. I usually volunteer four days a week and I love it.”

Norris is one of nearly 400 active volunteers, including those in Galveston, League City and members of the Angleton Danbury Campus Auxiliary who are passionate about serving UTMB’s patients and their families. In 2016 alone, volunteers donated about 35,000 hours in various capacities, including delivering beverages to waiting areas, providing emotional and spiritual support to patients receiving infusions, greeting and guiding patients and visitors throughout UTMB’s hospitals and clinics, and much more.

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“Good morning, my name is Jessica. Would you like something to drink?” Norris asks a patient in the waiting area of the first stop of the day: Surgical Specialties. “We have pink lemonade, coffee and water… Would you like cream or sugar in your coffee?”

After stopping at all the clinics and waiting rooms, including Women’s Health, Breast Health, Radiology, Orthopedics and Day Surgery, Norris runs out of coffee.

Norris gives each person her full attention, asking if they’d like ice in their water, whether they would like a stir stick for their coffee and stopping to give directions if a person looks lost.

We head back upstairs to the breakroom to make a fresh pot, but not before running into another patient who knows Norris well. The woman asks for a cup of coffee and Norris promises to bring a fresh cup to the patient’s waiting room.

“I enjoy meeting a lot of people here, it’s fun,” she says. “I’m not shy—you can’t be shy to go up to people every day.”

Our second stop is at the infusion clinic, where Norris recognizes several patients. She doesn’t even have to ask some people what they would like, she already knows “their drink” and gets to work mixing creamer into a cup of coffee.

Jerry Gutierrez, a patient who has been coming to the infusion clinic several times a week for the past six months, says he has come to look forward to seeing Norris visit the clinic on her daily rounds.

“We like her a lot,” says Gutierrez, who often brings his grandson with him for the three-hour infusions. “She is very kind, very polite, and my grandson loves her lemonade!”

Norris smiles in appreciation and says she enjoys customer service and providing an additional level of compassionate support that enhances the overall patient experience. In fact, her customer service skills are so good, she’s been training young adults in UTMB’s Junior Volunteer Program.

“I like to make people happy because if they aren’t happy, then we aren’t representing the clinics well,” says Norris. “It’s not just the medical staff that represent UTMB, it’s everybody, including the volunteers.”

“People ask for lemonade a lot, but people LOVE coffee,” she says matter-of-factly.

By noon, it’s safe to say all thirsts have been quenched—Norris has completed three full rounds of the clinics with the beverage cart. Even in the Day Surgery waiting area, where family members anxiously await important information regarding their loved ones, children and adults look content. It’s obvious she enjoys every minute of her routine—she says hello to countless employees, calling them by their first names, and even shares an enthusiastic high-five with a patient named Jessica, as well.

“It’s always nice to be greeted by someone who remembers your name,” says Kelly Douglas, nursing supervisor for the Women’s Health clinic. “She is very friendly and helpful and our patients love her and the work that she does.”

Lauren Davis, a patient service specialist in the Women’s Health clinic, added, “I have seen Jessica’s generosity and kind spirit transform a patient’s anxious demeanor into a warm and genuine smile. She really is an important part of the UTMB team.”

Norris has no plans on slowing down. She continues to take on more duties, such as restocking breakroom supplies, delivering mail to all areas of LCC, and cutting patient care cards. When she’s not volunteering, she’s active in her church choir, is a self-confessed “selfie” addict, and likes to spend time with her younger sister, who is training to become a physician assistant.

“Jessica’s positivity and genuine concern about every person is refreshing,” says Debra Grant, a patient affairs specialist who oversees League City Campus volunteers. “She’s a huge asset. She started out just volunteering Tuesdays and Thursday mornings, but she keeps adding on shifts. I think she would volunteer every day if she could.”

I say goodbye to Norris as she heads to lunch with her mom, who says she’s proud of her daughter. Norris will be back in the afternoon for another four-hour volunteer shift—she doesn’t want to miss any patients who may need a helping hand or friendly smile.

“I’m going to volunteer as long as I can,” she says. “I like helping patients and showing them my kindness—it’s what I do best.” n For more information about volunteering at UTMB, contact Carol Arvie-Gooden, manager of Volunteer Services, at clarvieg@utmb.edu or visit https://utmb.us/2k.

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LEA D E R S POT L I GH T

Spotlight on Annette Macias-Hoag, associate vice president, Health System Operations and associate chief nursing officer, Angleton Danbury Campus

Annette Macias-Hoag joined UTMB in 2011 and currently serves as associate vice president for Health System Operations, as well as associate chief nursing officer for UTMB’s Angleton Danbury Campus. While at UTMB, she has led the Level 1 Trauma reverification and The Joint Commission certifications for Ventricular Assist Device and Primary Stroke Center and has implemented new services such as the Epilepsy Monitoring Unit. Macias-Hoag has operational responsibilities for Invasive and Non-Invasive Cardiology, Neurodiagnostic, Respiratory Care and Vascular Services. She also leads the Patient Placement Center and programs such as Trauma, Stroke and Congestive Heart Failure.

Prior to UTMB, Macias-Hoag was the director of patient care for the Heart and Vascular Institute at Memorial Hermann–Texas Medical Center. She has also served as director of clinical services at Baylor College of Medicine.

Annette Macias-Hoag (right) enjoys spending time with her family, which includes her husband, Dan; son, Nick; his partner, Jennifer; and her grandson, Jaxson.

What does Best Care mean to you and how do you contribute?

To me, Best Care means that all of us work together to ensure our patients receive evidence-based care and an excellent patient care experience every single time.

I contribute to Best Care by: • collaborating with staff to provide timely and effective care, • asking for input on how we can achieve the best possible outcomes, • collaborating with other departments to provide continuity of care and coordination, • collaborating with staff in assessing safety concerns and helping in the implementation of systems or processes that will eliminate such concerns, and • establishing open and honest communication with teams to enable transparency and comfort in escalating issues or concerns.

It’s been three years since the Angleton Danbury Campus joined UTMB. What are some of the challenging aspects of your role as associate chief nursing officer for UTMB’s Angleton Danbury Campus? The most rewarding?

Having the opportunity to lead nursing at ADC has been a huge honor and a rewarding experience. The staff is welcoming and engaged in learning. At ADC, our team has made significant changes such as implementing bedside shift reports, “Progression of Care” rounds, an Acuity-Adaptable Unit to minimize the amount of patient transfers, leadership rounds with patients and staff, and a Correctional Managed Care discharge lounge. These changes have allowed ADC to see more patients in our hospital, improved patient throughput and satisfaction, and decreased length of stay.

I am most proud of the staff’s willingness to develop and implement the ADC Nursing Council structure, which is similar to the one developed on the Galveston Campus and ensures nurses have a voice. We have had excellent participation from all ADC departments. Our nurses are on the frontlines and need to be involved in decision making regarding nursing practice and patient care—it’s imperative to the success of our hospital.

The most rewarding part of my job at ADC is to see our staff and managers grow professionally as they work together.

Why did you decide to pursue a career in nursing?

When I was in high school, I volunteered at the Veteran’s Hospital in Rio Piedras, Puerto Rico. I was assigned to the operating room and my job was to take 12

Macias-Hoag received an associate’s degree in nursing from Madison Area Technical College in Wisconsin, a bachelor’s degree in nursing from the University of Wisconsin and a master’s degree in health care administration from the University of Phoenix. all specimens, including amputations (which were many), to the appropriate department. While I had limited interaction with patients when I was a volunteer, I saw what nurses did for patients and it was inspiring.

I took the long way to be a nurse. I was going to be a teacher with a second major in chemistry, so I had classes with nursing students. After three years of college, I knew I had to change career paths as I have always enjoyed taking care of people.

What’s the best advice anyone’s ever given you?

My dad told me, “Wealth comes and goes, but your education is always with you.

Find every opportunity to learn.” My parents were not educated but very wise.

Neither of them was able to finish grade school, so it was important for them to ensure their children had a solid education. My father was an accomplished chef and an avid reader. I remember my father purchasing every new edition of the Britannica Encyclopedia. He would read every volume and encourage us to do the same. Lifelong learning has been important to me since I was young and I just wish my father was alive to see that all his daughters took his advice to heart.

What do you like to do outside of work?

Spend time with my family: my husband, Dan, who without his support I could not do what I do; our son, Nick, who is a radiology technologist at UTMB; his partner, Jennifer, who is a registered nurse in UTMB’s Emergency Department; and our precious grandson, Jaxson, who is now 6 months old.

I also like to go out on the boat in the afternoon with my husband. However, I have not had much time lately because I’m studying to complete a doctorate in nursing practice from Texas Tech in Lubbock. When I finish my doctorate, I plan to do several things: take piano lessons, learn to fish in salt water, volunteer at a high school (or any local agency that works with youth), and take a long trip— hopefully to Australia.

Do you have any hidden talents?

I can dance Sevillanas, a type of folk music and dance of Seville and its region in Spain influenced by Flamenco. I can also play castañuelas, a percussion instrument consisting of a pair of wood shells joined on one edge by a string.

They can produce a clicking sound when tapped together with your fingers. My father was from Cadiz, Spain, and we had to learn starting at an early age. My 74-year-old mother still dances Sevillanas every Wednesday for about two hours.

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EDU CATI ON

UTMB’s Office of Educational Outreach enables teachers and students to succeed

BY KIRSTIANN CLIFFORD

The importance of a good teacher is no secret. There’s long-standing research confirming that the most influential factor in student achievement is teacher effectiveness.

That’s why UTMB’s Office of Educational Outreach provides programs not only for students but also for teachers.

“One teacher will impact hundreds of students during the academic year, and thousands over the course of their career,” said Dr. Clifford Houston, UTMB’s associate vice president for Educational Outreach and Herman Barnett Distinguished Professor in Microbiology and Immunology. “As educators of our future workforce, we want to enhance teachers’ professional development so they can give students the best tools for a bright future. The more a teacher’s background is supplemented with math and science, the more effective they will be in the classroom.”

dent,” said Kacey Sommers, an eighth grade science teacher at Lomax Junior High in La Porte. “I’ve participated in several summer trainings at UTMB and always leave with resources and activities to incorporate into the curriculum.

I’ve implemented a lot of engineering design and STEM (science, technology, engineering and mathematics) activities and have seen tremendous growth in students—they have become better critical thinkers and problem solvers.”

Teachers were able to keep the equipment used in the program and have access to the Office of Educational Outreach’s resource center, which provides all types of math, science and other supplies for teachers to borrow and use in their classrooms.

“Many times, teachers have to pay out of pocket for anything above and beyond what’s in a traditional classroom,” said Houston. “So we want to empower teachers further by giving them the materials they need to be more effective. They may not have a gel electrophoresis device, but after we’ve taught them how to use it, we’ll let them borrow it to use in the classroom.”

This summer, the Office of Educational Outreach held a high-intensity The computer science program is just one professional development program Dr. Marguerite Sognier (right) of many professional development opporprovides encouragement as teacher for teachers focused on computer Kacey Sommers works on programming tunities offered to teachers by the Office science to help address the critia robot. of Educational Outreach. As one of seven cal shortage of computer science Texas Science, Technology, Engineering teachers in the state. By the end of and Mathematics (T-STEM) Centers across the course in July, the 21 teachers the state designated by the Texas Education Agency, UTMB also offers profesfrom Galveston County and beyond were prepared to take an exam to become sional development in mathematics, science, project-based learning, robotics certified computer science teachers for grades 6-12. and technology. In addition, workshops are available throughout the academic “So much of medicine, research—and everyday life for that matter—is inteyear to provide educators with STEM content, best practices and instructional grated with computers,” said Dr. Marguerite Sognier, director of the Office strategies, and to help them connect academic content to real-world career of Educational Outreach. “We are helping teachers enable their students to experiences. In one year, more than 1,200 teachers and 72,000 students are develop critical and innovative thinking skills to meet the rapidly developing directly or indirectly impacted by these programs. technological changes in all fields. As a university, we have an important role to play in supporting and fostering the kind of biomedical and health Sognier added that the teacher programs help recruit students for the various Educational Outreach pre-college student pipeline programs such as the High care workforce we know will be essential in the future.”

School Biomedical Research Program, Biomedical Health Careers Academy During part of the professional development program, each teacher built and Summer STEM Camps. their own computers from scratch. Using a “Raspberry Pi,” which is a small, “Teachers go back to the classroom with a new confidence and excitement and affordable, single board computer used to help teach programming, teachers they pass it on to their students—and that’s very significant,” she said. “We get used their critical-thinking skills to program robots to do different functions. many pre-college students who previously were not interested in science, but They were all excited to share their newly acquired skills with students. who sign up for one of our programs after hearing about it from their teachers.

“This is the first time I’ve done anything like this—it was out of my comfort Just one program experience can be life changing for these students and can zone but this program has helped us grow as teachers and be more confi- give them the skills and confidence to succeed.” n

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CORRECTIONAL MANAGED CARE

Gwendolyn Williams, an LVN at the Telford Unit in New Boston, Texas, smiles for the camera as she receives her 20-year service pin.

Headed to Huntsville

Employee Advisory Council visits CMC employees at Estelle Unit, attends Employee Service Awards ceremony

BY KIRSTIANN CLIFFORD

Employee Advisory Council members had the opportunity to meet hundreds of UTMB Correctional Managed Care employees during a July 13 trip to the Huntsville area.

The crowd cheered for each employee as they received their 5, 10, 15, 20 or 20-plus year service pins. Many said they enjoyed their job because the CMC community is like “one big family.”

The day began with a tour of the Estelle Unit, which houses more than 3,000 male “My department is my family,” said Lisa Lopez, a senior manager of health offenders of various custody levels and offers an extensive array of health care information management, who received a 20-year pin. “I’m not from here and services. More than 200 UTMB CMC employees work at Estelle, providing medical I don’t have family here, so this is my family. We see people come and go, but care 24 hours a day. EAC members toured several areas including the 120-bed the ones that stay, we are diehards!” inpatient infirmary, dialysis clinic, physical therapy clinic and geriatric facility.

Gwendolyn Williams, an LVN at the Telford Unit and 20-year pin recipient, added, The tour was followed by a trip to the Texas Prison Museum, where more than “It’s been a journey with ups and downs and I’m glad I stuck with it. I love what 170 CMC employees from units in the Huntsville and Palestine regions were I do, love the people and am grateful to make a positive impact.” celebrated for reaching important milestones in their careers. Collectively, the EAC Chair Tilly Clark said it was a joy to see the service pin recipients celebrate employees represented more than 2,000 years of service to UTMB CMC and their milestones together. its mission.

“Their level of dedication to UTMB CMC is inspiring to all,” she said. “It was “Two thousand years of prison is hard time,” joked Dr. Owen Murray, UTMB obvious there is sense of community with not only each other, but with their vice president for Offender Health Services. “But it really speaks to everyone’s leaders, as well, which directly contributes to their success as a team. After dedication and it’s one of the reasons why we have been very successful over hearing the personal stories Dr. Murray told about so many of the employees, the last 25 years. When you work in this unique environment, it really becomes it was easy to see how they truly ‘work together to work wonders.’” part of who you are—whether you see this as enjoyable work, mission work or both. There are a total of 3,000 UTMB CMC employees around the state and I To see more photos from the EAC tour and service pin ceremony, visit UTMB’s want to thank everyone for their commitment to our patients and to the university.” Flickr page at www.flickr.com/photos/utmb/albums. n

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EAC members with CMC Dialysis employees at the Estelle Unit.

Twenty-year UTMB CMC service pin recipients

A U G U AS UT G2U0S1T7 2 0 impact 17 impact

CON STRUCTI ON

UTMB’s three campuses continue to experience growth and expansion.

The following are some of the projects currently underway across the institution: JOHN SEALY HOSPITAL MODERNIZATION

Phase II Expansion: Construction of the five-story South Tower—which includes 60 additional patient beds on two floors—will begin in March 2018 with the expansion set to be operational by 2020.

The renovations to the façade on the north side of John Sealy Hospital’s AB wing are 90 percent completed. When both wings are finished at the Galveston Campus hospital, the façade will resemble the exterior of Jennie Sealy Hospital with glass running the building’s length and new brick to match Jennie Sealy’s. In addition, the interior of John Sealy Hospital is being renovated with larger and updated patient rooms. The renovated hospital is expected to be operational by 2020.

HEALTH EDUCATION CENTER

LEAGUE CITY CAMPUS EXPANSION PROJECTS Utilities: Crews are nearly 80 percent finished with expanding the site utilities across the campus to support the new MD Anderson Cancer Center outpatient treatment center, which is expected to open next year, as well as future building expansion. Completion is set for October.

UTMB Clinic: Construction of the UTMB Clinic on the second level of the MD Anderson Cancer Center facility is expected to start this fall and features 9,100 square feet of multi-purpose clinic space, 12 flex examination rooms and two treatment rooms. Activation is set for next summer with the first patient anticipated in fall 2018.

Parking Garage and Bridge: The new, seven-story parking garage with an attached 33,000 square foot multi-use building and connecting bridge will begin construction this summer and is expected to reach substantial completion by May 2018.

Structural top-out of the Health Education Center on the Galveston Campus will take place this winter. Current work taking place on the site, located just south of the School of Nursing/School of Health Professions Building, includes completion of below-grade structural components such as pier caps and elevator pits. In addition, column mock-ups for the building’s structure have been approved for workmanship, quality and finish and exterior column placement is now taking place (see photo at right). The Health Education Center is expected to be operational by spring 2019.

RESEARCH BUILDING 17 EXPANSION Current work at Research Building 17E on the Galveston Campus includes installation of exterior metal wall panels and painting on the interior on the first three levels. Facility will be operational in September.

Did you know UTMB has a Facebook page just for employees?

The I Am UTMB Facebook page features news, information, photos and event coverage in a friendly and engaging community for employees and students at our three campuses and locations throughout the state. More than 1,200 people have "liked" the page so far. Join the conversation— and tell a friend.

Visit www.facebook.com/IamUTMB. impact

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Know the signs: Suicide warning signs and prevention tips

By Dr. Jeff Temple and Lauren Scott, MSW, Behavioral Health and Research Department of Ob/Gyn While shows like the Netflix series “13 Reasons Why” have been criticized for glamorizing or romanticizing suicide, they have also stirred important conversations about suicide and depression among teens. The fact that about half a million teens every year have thoughts of suicide means that we should be talking about it more. And we need to be more proactive—talking about it in schools and in our communities before a suicide happens. The following tips for recognizing and acknowledging the warning signs of suicide were adapted from classroommentalhealth.org.

For more information, visit their website.

• Recognize the warning signs, which include: —— Talking about thoughts or urges to hurt or kill oneself —— Looking for a way to kill oneself, such as searching online or seeking pills —— Talking or writing about death, dying or suicide —— Talking or writing about feeling hopeless, feeling trapped, or being a burden on others —— Talking or writing about the loss of a reason for living or lacking a purpose in life —— Exhibiting rage, anger or the desire to seek revenge —— Acting anxious or agitated; behaving recklessly —— Increasing use of alcohol or drugs —— Sleeping too little or too much —— Withdrawing or isolating oneself from friends, family or society —— Experiencing extreme mood swings or dramatic changes in mood • Don’t be afraid to ask. If you think someone might be having suicidal thoughts, ask them directly if they are thinking about hurting or killing

themselves. Asking someone about suicide does not cause suicide or put the idea in someone’s head.

• Be confident. Address the issue without dread, negativity or judgment. Your openness and confidence can be reassuring.

• Listen. Allow the person to talk about their feelings. A suicidal person may feel relief to be able to discuss freely their feelings and experiences.

• Take all thoughts of or comments about suicide seriously.

It’s not just a warning sign that the person is thinking about suicide— it’s a cry for help.

• Connect with professionals. Depending on your level of comfort, either engage in a conversation with her/him or connect them to a mental health professional. Do everything in your power to get a suicidal person the help he or she needs.

—— The National Suicide Prevention Lifeline is available 24/7 at 1-800-273-8255.

—— The Crisis Text Line provides free crisis intervention via SMS message.

Text HOME to 741741.

—— Local resources include the Family Service Center of Galveston County (www.fsc-galveston.org) and the Teen Health Center (www.teenhealthcenter.org).

• Disregard confidentiality at times of suicide risk.

—— If it’s an emergency, address immediately! If someone is suicidal, confidentiality is no longer a consideration.

—— Inform school administration when any student confides a suicide plan or attempt.

PARTING SHOT

A sneak peek The first phase of renovations to the R. Waverley Smith Pavilion on the Galveston Campus will wrap up in October. The redesigned space will create a more direct, indoor route between Jennie Sealy Hospital and the Clinical Services Wing, John Sealy Hospital, John Sealy Annex, Café on the Court and the Hospital Parking Garage. This photo shows a section of the first floor of Waverley Smith, which will connect to Café on the Court and will include a counterheight bar with additional seating and vending machines. For more construction updates, check out page 15.