January 2019

UTMB NEWSLETTER • JANUARY 2019

Pivotal role in patient care: Point-of-care-testing technical supervisor

Reducing re-admissions with UTMB Discover Researchers develop single-dose Ebola vaccine Construction update across UTMB

Congratulations to this year’s recipients of the Martin Luther King Jr. Community Service Awards at UTMB. The winners, who were announced at the annual awards luncheon on Jan. 9, are Dr. Ike C. Okereke, associate professor in the Department of Surgery; Sareema Adnan, medical student; and Linda Venzke, compliance nurse auditor in the Office of Institutional Compliance. The annual program honors and recognizes the contributions of UTMB faculty, students and staff who promote diversity, inclusion, community partnership, philanthropy and civic engagement.

This year’s recipients of the John P. McGovern Academy of Oslerian Medicine Thayer Awards for Excellence in Teaching are Dr. Nastassia de Souza, Department of Internal Medicine/ Endocrinology; Dr. Thanh-Truc Le, Department of Internal Medicine/Gastroenterology; Dr. Aammar Khan, Department of Pediatrics; and Dr. Rosemary Beavers, Department of Obstetrics and Gynecology. Selected by Osler Student Scholars, these residents exemplify sound scientific knowledge, compassion toward patients and dedication to learning and teaching.

Dr. Randall J. Urban has been named principal investigator of UTMB’s Clinical and Translational Science Award (CTSA) program. UTMB is one of 62 institutions funded via a National Institutes of Health CTSA. Funded since 2009, UTMB’s CTSA program includes multiple collaborative teams that investigate a range of conditions from heart disease and cancer

to asthma. In addition, the CTSA helps train young scientists in translational research.

Dr. Gulshan Sharma, UTMB’s Chief Medical and Clinical Innovation Officer, has been named a PrimeMover of 2018 by HealthLeaders, a multi-platform media company dedicated to meeting the business information needs of health care executives and professionals. PrimeMovers are defined as executives who are transforming health care financially, clinically and operationally.

Cheryl A. Sadro, UTMB’s chief financial officer, has recently been named to Becker’s Hospital Review 2018 list of “143 Women Hospital and Health System Leaders to Know.” The women on the list are executives at hospitals and health systems across the nation who have established themselves as successful leaders within the ever-evolving health care industry.

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From the President Welcome to the latest edition of the Impact newsletter!

Thanks to your hard work and dedication, UTMB is continuing to broaden its geographic footprint as we pursue our mission to care for the people of Texas and beyond. Following months of planning and preparation, UTMB will open the new UTMB Health Clear Lake Campus in Webster on March 30.

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Researchers develop single-dose medication to treat Ebola

The Clear Lake Campus immediately increases our inpatient bed capacity and our ability to deliver complex care to this growing region.

In addition, the campus will expand opportunities to educate students and residents and increase our clinical research.

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During my Town Hall on Jan. 18, I discussed our latest financial performance and provided an update on the various construction projects taking place across UTMB. I also touched on our efforts related to Best Care and the latest information about our follow-up efforts on the You Count Employee Survey. If you were unable to attend or watch Town Hall online, you can access the full presentation at www.utmb.edu/president/town-hall/.

Day in the Life of a point-of-care-testing technical supervisor

This latest issue of Impact features a “Day in the Life” of Rina Kalariya, a point-of-care-testing technical supervisor in UTMB’s Laboratory Services department, and highlights what she and her team do to enhance clinical care across the institution.

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Other stories in this latest issue include: • A Best Care in Action article about how UTMB uses its Discover tool to reduce re-admissions • Researchers develop a single-dose medication to treat all strains of Ebola • A collection of great news in the Working Wonders section • Tips to help combat the winter blues • This month’s trivia question and more

Construction Update Page 10

As always, if you have a story idea or would like to see something featured in this newsletter, please send an email to the Impact team.

Health Tips: Combating the winter blues

Dr. David L. Callender UTMB President

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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!

Vice President Marketing & Communications Steve Campbell

ON THE COVER:

Editors Stephen Hadley Shannon Porter Jessica Wyble

Rina Kalariya point-of-care-testing technical supervisor in the Department of Laboratory Services, checks the equipment she helps maintain and manage.

P R I N T E D B Y U T MB G RAPHIC D ESIG N & PRIN TIN G SERVICES

Associate Vice President Marketing & Communications Mary Havard

Art Director Mark Navarro

CONTACT US Email: impact.newsletter@utmb.edu Phone: (409) 772-2618 Campus mail route: 0144 U.S. Postal address: UTMB Marketing & Communications

301 University Boulevard

Galveston, TX 77555-0144

B E S T C A R E I N AC T IO N

BY JESSICA WYBLE

When Amy Smith, assistant vice president for the Care Transitions Group, and Josette Armendariz, assistant chief nursing officer and director for Patient Care at UTMB, sit down with the UTMB CARE (Controlling Avoidable Readmissions Effectively) collaborative group each month, the mission of the meeting is simple—discuss and explore ways UTMB can continue to reduce the number of 30-day all-cause hospital readmissions.

Defined as patients who return to the hospital within 30 days of their most recent discharge, 30-day readmissions at UTMB have been on the decline recently—boasting a 14.5 percent drop over the last two years. This trend is indicative of the shift taking place in how care is approached and delivered not just at UTMB, but at health care institutions across the industry.

“The focus is on keeping people well and keeping people out of the hospital,” said Smith.

Complementing and enabling this evolving approach to health care is UTMB Discover— an enterprise data warehouse and analytical toolkit that, through the use of various applications within it, aggregates real-time, accurate data generated by UTMB’s mission areas.

Launched in December 2016, the data-mining tool presents a wide variety of information in an easy-to-understand way that helps data analysts like Ruth Russell with the Care Management Administration team more quickly develop reports and spot trends or anomalies occurring within UTMB’s operations.

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Care Management team have already implemented some operational changes, including offering video visits as an option to patients who have questions or concerns following their discharge. The remote visit saves the patient time and money by eliminating the need for a physical trip to the hospital. She and her team have also worked to streamline and centralize the process for patient follow-up phone calls.

“Previously, there were a lot of different areas making these calls for the same patient,” said Smith. “To keep the process consistent and reduce confusion, we’ve streamlined that so it now is exclusively under the care management umbrella.”

It’s critical that post-discharge conversations are given special attention, because they give care managers a chance to reiterate any special instructions patients need for their recovery and also gives individuals a chance to ask any questions they may have. Plus, by centralizing the process, there’s less chance a patient will receive conflicting directions or unclear messages, which ultimately leads to an overall better care experience while saving time and money.

These are just a few examples of the work and initiatives resulting from the increased availability of shared data, made possible by UTMB Discover and the Readmissions Explorer Application. In addition to directly improving the patient experience and furthering UTMB’s efforts to provide Best Care, the reduction in readmissions work is also garnering attention at the UT System level, as health institutions are beginning to compare performance in some of these areas.

“Before UTMB Discover, data analysts like me would run monthly reports and send those out for care managers, clinicians and others to retroactively review and assess their operations,” said Russell, a senior business systems analyst. “But now, thanks to this system, it’s all automatic and live data anyone with access can see at any time. So, it’s become a much more immediate and proactive process, and we are now free to focus our energy on looking for trends, opportunities or anomalies that may need special attention.”

Dustin Thomas, vice president for UTMB Decision Support, has been integrally involved with the UTMB Discover initiative since joining the university in 2016. He is pleased with the results the tools have delivered thus far, noting that the recent reduction in UTMB’s readmissions rate alone has saved the organization nearly $2 million in related costs.

The reports and trends members of the CARE collaborative group are most interested in are generated by the Readmissions Explorer, an application within UTMB Discover built to specifically address and examine factors that may bring a patient back to the hospital in that 30-day window of being discharged. Comprising UTMB nurses, physicians, pharmacists, care managers, social workers and others, the multidisciplinary CARE team uses these custom findings to explore potential solutions and make quicker, better-informed decisions when it comes to the care they deliver each day.

“It really has been a two-year journey and we’re at a good spot right now where we’ve seen some good returns,” says Thomas. “UTMB Discover makes it possible to see that our institution is making statistically significant changes in the way we are providing care.”

Thanks to the Readmissions Explorer findings and these regular discussions, Smith—who’s been on board with UTMB for just over a year now—and the

“It all comes back to better patient care,” said Smith. “That’s what it all boils down to.” n

Just two years into UTMB’s transformation into a more data-driven institution, there’s no telling where this journey may lead, but one thing’s for sure: providing the best care possible to every patient, every time will remain at the forefront of the organization’s mission.

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RESEARCH

BY DONNA RAMIREZ

UTMB RESEARCHERS HAVE DEVELOPED a single-dose medication that protects non-human primates from all strains of the deadly Ebola virus.

Sudan strains as well as the deadliest Zaire strain that caused the 2013-16 epidemic in West Africa and the current outbreak in the Democratic Republic of Congo.

UTMB’s Dr. Thomas Geisbert, a world-re“We were able to protect the non-human prinowned Ebola researcher, said that previous mates against all the Ebola species plagutherapeutics typically were of the “one ing people at a single, low dose,” said “Our experimental drug bug, one drug” variety. But because Larry Zeitlin, president of Mapp of the unpredictable nature and Biopharmaceutical Inc. “Further can protect against all variety of the Ebola virus, scienstudies exploring even lower tists have been seeking a way to doses could open the door to forms of Ebola known to protect against different strains treatment via auto-injectors of the virus. like the kind used for allergic harm people, suggesting reactions. The ability to quick“Our experimental drug can proly and efficiently provide protect against all forms of Ebola that it will continue to tection against all Ebola viruses known to harm people, suggestin a single dose would reduce ing that it will continue to protect protect people if the Ebola the burden on health care workpeople if the Ebola viruses evolve ers in the field during outbreaks, over time,” said Geisbert, who is a viruses evolve over time.” especially in regions that have a professor of microbiology and immuless-developed infrastructure. ” nology.

The team of scientists working to develop the medication demonstrated that a two-antibody cocktail could fully protect non-human primates and ferrets against lethal Ebola virus infections caused by the Bundibugyo and

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Other authors of this paper from UTMB include Dr. Chad Mire, Dr. Robert Cross, Dr. Joan Geisbert, Dr. Viktoriya Borisevich and Dr. Krystle Agans. n

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BY JESSICA WYBLE

At the start of every day, Rina Kalariya sits at her desk checking the latest performance reports for the point-of-care-testing (POCT) equipment she helps maintain and manage. It’s just one part of her role as technical supervisor for the POCT group within UTMB’s Laboratory Services department, but it’s an important one.

“It’s my job to do this initial review every day to ensure there are no outliers [out-of-the-ordinary figures] and that the machines are producing accurate results,” says Kalariya.

Producing rapid results and taking place as the patient is receiving care, POCT allows patients to receive faster diagnoses. This means they can more quickly receive the appropriate care they need. To perform this type of diagnostic screening, UTMB has specialized equipment that receives routine quality control checks and maintenance.

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That’s where Kalariya and her four-person team

come into play. Although they do not conduct tests at the patient bedside, the team ensures the POCT equipment—which includes instruments that can detect pregnancies, diagnose the flu virus, monitor blood glucose levels and more—is maintained and produces reliable data for the providers making decisions based on the test results. The team also trains providers on how to use the specialized equipment effectively.

As team lead, Kalariya, who has been in her current role for three years, oversees the equipment validation process. With hundreds of POCT instruments in use across the organization, data review and documentation are a big part of her job.

She and her team of coordinators—the majority of whom have a laboratory background similar to hers—have a shared understanding of the precision required for POCT. To share best practices and the importance of approaching POCT with that same precision, Kalariya’s group regularly offers two different trainings—one designed specifically for nurses and the other designed for medical students. The classes cover how to use and maintain various POCT instruments, following Joint Commission Standards for POCT, specimen collection, charting results and more. Attendees even have a chance to gain hands-on experience in simulation labs.

Pathology faculty member Dr. Christopher Zahner serves as the POCT laboratory director and works closely with Kalariya, approving the monthly quality control (QC) reports she runs for each POCT instrument. He commends her for the thorough way she approaches such a meticulous task.

These trainings are critical, as they emphasize the sensitive nature of POCT and offer tips on how to avoid common pitfalls that may lead to inaccurate or unusable results.

“She’s the kind of person who’s focused on details,” says Zahner.

“Someone who’s willing to get into the nitty gritty. That’s exactly what we need in that role.”

Given the benefits of the practice, point-of-care testing continues to increase throughout the health care industry, and UTMB’s campuses are no exception.

Gabriel Diaz, a point-of-care coordinator on Kalariya’s team, echoes Zahner’s sentiment.

Responsible for servicing the POCT needs of the entire institution, members of Kalariya’s team frequently visit Angleton and League City to ensure equipment there is working as it should and providers have what they need.

“Rina adds a strong sense of organization to our department,” he says. “She is able to see everyone’s strengths and skills and uses that to guide our work without micromanaging.”

Originally from India, Kalariya got her start at UTMB in 2006

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as a bench tech in the Chemistry lab, where she honed that ability to focus, organize information and attend to details to ensure the integrity of the samples and specimens she handled.

POCT has changed quite a bit from when Kalariya started a one-person operation focused solely on John Sealy Hospital.

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“When Jennie Sealy came up, we expanded,

And, there’s always the chance she or one of her team members followed quickly by the League City Campus, while we simul- will be called to scrub in and assist with a liver transplant, as taneously worked to integrate POCT in Angleton,” she says. they did for each of the 19 such surgeries performed at UTMB in fiscal year 2018.

With the soon-to-open Clear Lake Campus on the horizon “The POCT instrument we use for liver transplants is very critical for UTMB, the POCT team will remain busy. because it monitors how the blood is clotting and whether or not “We are bringing in lots of new instruments for the campus, so a patient is at risk for bleeding out during surgery,” says Kalariya. we have to make sure they are compatible with any existing The machine used for this specific equipment we’ll be using,” says procedure is known as a real-time Kalariya. “We’ve been performTEG (thromboelastography) and ing lots of tests and comparisons anesthesiologists use the results to ensure we’re acquiring tools from it to determine whether or that produce accurate, reliable not the patient needs blood prodresults for our providers and their Producing rapid results, POCT ucts during the procedure. patients.”

allows patients to receive faster

“Rina and her team are integral When she’s not working on the diagnoses, which in turn means in transplant services, getting Clear Lake venture, documenting they can more quickly receive patients properly assessed and equipment QC reports or leadcared for,” said Zahner. “Our team the appropriate care they need. ing a training, Kalariya makes is very well aware of how lucky we a point to check in with her are to have her.” team, POCT manufacturers and At the end of the day, Kalariya enjoys vendors, and key POCT equipwhat she does and knows she’s ment users, dubbed “super users” making a difference along the way. within the institution. Responsible for POCT in a particular group or area, super users “Every day is a different challenge, which is why I love my job,” serve as liaisons between their specific unit or department says Kalariya. “I’m so glad I play a role in taking care of the patients. That’s what I enjoy.” n and Kalariya’s team.

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Over the past decade, UTMB has experienced unprecedented growth as we’ve added campuses in League City and Angleton Danbury and continued to expand our Galveston Campus. This year, we will add a fourth campus—UTMB Health Clear Lake Campus in Webster.

In addition, UTMB is in the midst of building numerous facilities that will support our patient care, education and research missions well into the future. Here’s a closer look at construction taking place on the Galveston and League City campuses.

G A LV E S TO N C A M P U S

Research Building 17E

John Sealy Hospital modernization

New six-story building opened late last year enables UTMB to increase our research capacity and provides ample space to expand our research enterprise in the future.

John Sealy Hospital, which was built in 1978 and served as our hub for inpatient care for nearly four decades, is undergoing a complete interior and exterior renovation. When complete in 2020, John Sealy Hospital’s exterior will look much like our Jennie Sealy Hospital—which opened in 2016—and will include spacious patient rooms and all new equipment and furnishings.

• The current work is focused on the hospital’s AB Wing, which includes spaces for C-Section operating rooms, Labor & Delivery rooms and Neonatal Intensive Care unit. This will allow UTMB to relocate all inpatient care from the older John Sealy Annex.

• Once the AB wing renovations are complete, all patient care from the CD wing will be relocated to allow renovation of that zone to begin.

• The initial building scope and the buildout of sixth-floor research area, along with a skybridge between Research Building 17E and the Mary Moody Northen Pavilion, is now complete.

LEAG U E C ITY C AMPUS League City Campus Hospital Construction is underway at the League City Campus Hospital as we’re adding a five-story South Tower that will eventually expand our patient bed count from 37 to 97. When the $156 million expansion is complete in 2020, the expanded hospital will help us meet a need for inpatient care in one of the fastest growing regions in the United States.

• All Labor & Delivery operations are being moved from the League City Campus to the new Clear Lake Campus. Once that move is complete, UTMB will construct 17 Intensive Care Unit (ICU) rooms where the Labor Delivery Recovery and Postpartum (LDRP) rooms are currently located.

Health Education Center UTMB’s new Health Education Center will add much-needed classroom space and a new auditorium, as well as education and conference space, to accommodate our growing student population. When it becomes operational this summer, the HEC will provide interprofessional education opportunities to students and include simulation centers where they can practice a wide range of skills in a low-risk, high-realism environment.

• In addition, academic meeting space, clinical trial support areas and clinic space is currently under construction at Medical Plaza 1, which is adjacent to the parking garage that opened last year on the League City Campus.

• The current activities in progress includes terrazzo flooring, wall finishes and exterior paving.

• Construction in the pedestrian plaza between HEC and the existing Schools of Nursing and Health Professions Building will continue with completion in the fall.

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President David Callender launched his “Pulse” video update series last year to keep the UTMB family upto-date on issues affecting the organization.

January 18 Dr. Callender provided a recap of his Town Hall presentation that included an information on financial results, news on the UTMB Health Clear Lake Campus and mission-area updates. In addition to watching his Pulse video, you can review the Town Hall materials at https://www.utmb.edu/president/town-hall.

addition to the recap in Weekly Relays, you can watch and listen to the videos from https://www.utmb.edu/president/pulse. Please use a modern web browser for the best experience. If you are at a PC without audio or speakers, closed captioning on the videos can be turned “On” and “Off” by clicking the “CC” symbol in the video player tool bar (the symbol displays once you hit “play,” on the right side of the tool bar). Closed captioning is now on by default.

You can also access the transcripts on the Pulse website to read the messages; a transcript accompanies each video. If you are a social media user, the videos (with subtitles) are posted to the UTMB employee Facebook page, I Am UTMB. Facebook will display captions if you mute the sound. n

There are multiple ways to access Dr. Callender’s video updates. In

Names: Nicole Mendell and Christopher Smith Gonzalez UTMB Talent: Research Associate, Pathology and Senior Communications Specialist, Media Relations Hidden Talent: Gulf Coast musicians Life partners for nearly a decade, Nicole Mendell and Christopher Smith Gonzalez share many things—a house, a car, a daughter. The list goes on, as the duo even shares an employer, UTMB. But what seems to bring them together the most is a passion for music—a passion they feed by performing together regularly in the local band Kevin Anthony & G-Town.

With Nicole on drums and Christopher on the upright bass or on bass guitar, the two make up the rhythm section of the five-piece band that prides itself on mixing country, Cajun, blues, Mexican and swamp pop musical styles to make what they call the “Gulf Coast Sound.”

The troupe, which is slated to record its next album this March, can typically be found playing a variety of venues in and around Galveston and the Greater Houston area, although it’s not uncommon for them to venture to Louisiana or the Texas Hill Country for a show or two each year. n impact

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Tips for battling the winter blues

By Dr. Derek Neal, assistant professor, associate training director of Department of Psychiatry and Behavioral Sciences

increase in sleep, increase in restlessness or slowed movements and slowed speech, feeling worthless or guilty, trouble concentrating or making decisions, and thoughts of death or suicide.

The combination of fewer daylight hours and colder temperatures can cause many people to experience symptoms that can resemble depression. For some, the symptoms are relatively brief, such as a shorter temper or increased sense of lethargy that can accompany a dreary winter day.

For others, the winter months can bring on Seasonal Affective Disorder, also known as SAD. This disorder is a type of depression that lasts for a season, typically in the winter months, and retreats during the rest of the year. About 5 percent of adults in the U.S. experience SAD and it has been linked to a biochemical imbalance in the brain prompted by shorter daylight hours and less sunlight in winter.

The APA offers these tips to manage SAD: • Experience as much daylight as possible since lack of sun exposure is part of what causes the disorder.

Some patients benefit from a light therapy box that emits very bright light (and filters out harmful ultraviolet (UV) rays). It usually requires 20 minutes or more a day, typically first thing in the morning, during the winter.

• Focus on healthy eating, especially avoiding foods that are loaded with extra calories and sugar.

According to the American Psychiatric Association (APA), the symptoms are similar to depression, vary from mild to severe, and include feeling of sadness or depressed mood, loss of interest or pleasure in activities once enjoyed, changes in appetite (usually craving and eating more starches and sweets) with corresponding weight gain, changes in sleep (typically sleeping too much), fatigue despite

• Staying connected, either through volunteering, group activities or spending time with family and friends.

• Stay physically active as much as possible. Research indicates that exercise can be effective in combating the impacts of SAD. • Seek help from a mental health professional if you continue to struggle with feelings of depression. With the right treatment, SAD can be a manageable condition.

UTMB TRIVIA The Health Education Center, under construction now on UTMB’s Galveston Campus, will provide students with myriad interprofessional educational opportunities when it opens this fall. The HEC includes simulation rooms where students can practice skills in a highly realistic but low-risk environment.

What is the estimated total square footage of the new HEC? Answer to the November-December trivia question: Dr. Truman Blocker was the future leader of UTMB who served his country.

Congrats to Melissa Lockhart, nurse practitioner in the Department of Internal Medicine-Geriatrics, who won the November-December trivia!