Impact March 2017

UTMB Newsletter • March 2017

Bringing UTMB’s voice to Austin Best Care in Action: Getting to the heart of blood pressure control Spotlight on David Marshall, Health System UTMB employee breaks powerlifting records

Ryan Scott, a research associate in UTMB’s Department of Anesthesiology, Translational Intensive Care Unit, received President Callender’s Way to Go Award for helping a pregnant woman who was having complications and needed medical attention quickly. While walking on the Galveston Campus, he observed the woman in distress and jumped into action, assessing the situation and ensuring that she made it to the Emergency Department—he even parked her car and returned the keys to the patient. “This really exemplifies going above and beyond, and helping UTMB provide Best Care by putting our best face forward to every patient, no matter what our position is,” said Christina Nelson, laboratory supervisor in the Department of Anesthesiology. “Mr. Scott may not be involved in patient care, but he really went out of his way to assist. We are all very proud to have him as part of our lab.”

Souby George, a nurse with UTMB’s Mother-Baby Unit, has been selected to serve on the American Nurses Association’s (ANA) Moral Resilience Panel Advisory Committee. This committee provides feedback and advice to ANA and to a steering committee regarding policy development and strategies to strengthen moral resilience for practicing nurses.

Seven Correctional Managed Care employees received annual awards at the UTMB CMC Winter Conference on Feb. 2 in Galveston. Congratulations to Eric Johnson (Mental Health Manager of the Year), Elizabeth Moore (Support Person of the Year), Eleut Vincent Ong (Nurse Manager of the Year), Tanya Lawson (Operations Manager of the Year), Debra Dean (Texas Juvenile Justice Department Manager of the Year), Kenneth Vandewalle, DDS, (Dentist of the Year) and Dr. Tere Drogin (Medical Provider of the Year).

Twenty-four UTMB Angleton Danbury Campus staff members including nurses, respiratory therapists and medical assistants, were recently recognized for receiving specialty certification in their respective fields by demonstrating to patients, peers and the community that they have the knowledge, skills and abilities that meet rigorous national standards and reflect a deep commitment to patient safety. Annette Macias-Hoag, ADC associate chief nursing officer and associate vice president, Health System Operations, provided each newly certified employee a “Golden Stethoscope Award” to recognize this great professional achievement.

UTMB Health was recently honored with the United Way of Galveston’s Legend Award for the 2016 SECC Campaign. Led by 2016 chairman Dr. James Graham, a very creative steering committee and more than 60 “SECC Ambassadors,” the campaign raised $590,000 for charitable agencies and causes in communities where staff live and work—well beyond the $525,000 goal. The SECC has been around for more than two decades and is the only statutorily authorized workplace campaign for state agency and higher education employees throughout Texas. UTMB’s large and generous workforce has always been among the leaders statewide in giving. Thanks to each member of the UTMB family for making this campaign a huge success.

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From the President Welcome to the latest issue of Impact! This edition highlights several people and initiatives that make UTMB a vibrant institution focused on defining the future of health care in Texas and around the world.

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It’s an exciting time to be a member of the UTMB family. Next month, we’ll break ground on the new Health Education Center on our Galveston Campus, a state-of-the-art facility that will be one of the leading venues for health education in Texas. The HEC will enable us to expand our infrastructure to meet the needs of a student body that has grown by 40 percent over the past decade. The HEC will also allow us to continue our legacy of educating health care professionals to serve our state and nation.

Best Care in Action: Getting to the heart of blood pressure control

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The HEC is just one of several construction projects planned or underway on our campuses. You can read more about these activities in this edition of Impact. Among the many additional stories you’ll find in this issue: • A Day in the Life of Lauren Sheer, assistant vice president of Legislative Affairs in our Austin office

Day in the Life of Legislative Affairs

• A profile of David Marshall, chief nursing and patient services officer • A closer look at Best Care in Action as UTMB’s ambulatory clinics tackle hypertension

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• A smart system, developed by a UTMB anesthesiologist, to monitor patient oxygen levels and improve lung function • The Southeast Texas Poison Center at UTMB, which is available 24 hours a day, seven days a week • A guide to determining when you should head to an emergency room instead of an urgent care clinic

Spotlight on David Marshall

• Numerous accomplishments and kudos in the Working Wonders column and throughout the newsletter

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If you have a suggestion for articles you’d like to see in future issues of this publication, please reach out to the Impact team to let them know.

As always, I hope you’ll take some time to enjoy this issue as we share these stories that exemplify who we are and where we’re headed as an institution. Thank you for everything you do each and every day in service to our communities and UTMB’s mission.

UTMB employee breaks powerlifting records

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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: Lauren Sheer, assistant vice president of Legislative Affairs at UTMB, stands in front of the Texas State Capitol in Austin. She is constantly on her feet during Texas’ biennial legislative sessions, advocating on behalf of UTMB regarding various topics—from funding priorities to proposed legislation that could impact the institution.

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 Simone Parker Art Director Mark Navarro

P rinted by U T MB graphic design & P rinting S ervices

Bes t c ar e

B y K irsti A nn C lifford

In less than a year, UTMB’s ambulatory clinics have gotten to the heart of a big health issue: hypertension. It’s often symptomless, but can be a dangerous disease—leading to stroke, heart attack, heart failure and kidney disease.

With that in mind, UTMB’s system of ambulatory clinics committed themselves to increase the percentage of hypertension patients whose blood pressure (BP) is under control from 65 to 70 percent. (“Under control” means having a blood pressure reading less than 140/90.)

“It was no easy task, but we took a team approach and developed a clinical education program to make sure we were successful,” said Michelle Millard, clinical nurse educator. “UTMB has more than 90 clinics that extend from McAllen to Orange, so this was a huge initiative.”

importance of monitoring their blood pressure and keeping an updated log to bring to medical appointments.”

If the first blood pressure reading produces a high measurement, clinicians now make it routine to take a second blood pressure manually five minutes later and alert the physician if either reading is outside of the 140/90 parameter.

In addition, staff has been trained to properly document blood pressure in Epic.

By standardizing documentation, Information Services can pull data from Epic and run quality assessment reports that ensure internal standards are being met—and if not, help clinics pinpoint what areas need to be improved.

Marivic Dimaano, a nurse supervisor at UTMB’s cardiology clinic in Texas City, said the educational initiative has empowered nurses to take a larger role in co-managing patients with high blood pressure.

Starting on World Hypertension Day in May last year, the ambulatory team kicked off the initiative, encouraging all staff to review an article on best practices in “With this program in place, physicians are more comfortable having patients hypertension. come in for a nurse visit for blood pressure follow-up checks,” said Dimaano.

“We followed up by asking everyone in ambulatory to have their blood pressure “We have established patients who call to say their BP is 180 and they don’t taken—and not just clinical staff, but also patient service specialists, our clerical want to go to the ER or urgent care. So we tell them to come in for a nurse personnel and physicians—so everyone would have their own measurement as a visit and we manage their blood pressure in consultation with the physician personal baseline and recognize the importance in the clinic. Most of the time, they just need of knowing their blood pressure,” said Katherto adjust their medicine. That way, patients are ine Golden Beck, professional practice director saved a trip to the ER and physicians are able for ambulatory clinics. “When we did that, we to focus on treating those who need a higher actually found a significant number of employees level of care. It’s led to better access to care who were potentially hypertensive. That really and improved health outcomes for patients.” highlighted the need for everyone to pay attenMoving forward, Millard and Golden Beck are tion to it and understand the consequences if focused on maintaining improvements and left untreated.” recently appointed about 50 “blood pressure The next critical step was to educate all clinical champions” representing various clinics. The staff to ensure everyone knew how to correctgroup will hold a teleconference each month and ly and consistently measure a patient’s blood will report back on any suggested best practices pressure. In addition to holding mandatory skill or observations to improve the program. UTMB’s fairs and providing communications such as Health Maintenance Team also has reached out Nurse Supervisor Marivic Dimaano takes a hypertension posters and handouts, Millard and to more than 1,000 patients with chronic unconpatient’s blood pressure.

Cheryl Lynch, a project development manager, trolled hypertension to schedule appointments visited clinics to support the blood pressure with a nurse or physician. So far, more than 140 monitoring training. appointments have been completed.

“It’s crucial to get the most accurate BP reading so we treat patients appropriately and provide them with the best care possible,” said Millard.

“For example, it’s important to use the appropriate-sized cuff with the patient’s arm supported at heart level, as well as make sure the patient has both feet on the floor and hasn’t exercised, ingested caffeine or smoked for 30 minutes before the BP assessment. I coach staff to engage the patient, so they too understand the 4

Keys to success: • Making high blood pressure control a priority • Using evidence-based treatment guidelines and protocols • Using health care teams to increase frequency of contact with patients • Implementing consistent, strategic use of electronic health records • Providing patient outreach through use of Health Maintenance Team

Ann O’Connell, vice president of Ambulatory Operations, said she’s proud of the clinics’ accomplishments.

“Clinicians are our first line of defense against the hundreds of thousands of deaths caused by high blood pressure each year,” said O’Connell.

“We applaud our hardworking UTMB clinicians and care teams and hope other health care teams can learn from our successes with hypertension control.”

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e ducat i o n

Inspiring others to give Husband and wife team up in support of Innovations in Mind Faculty and Staff Campaign

B y S imone P arker

UTMB holds a special place in the hearts

of Drs. Michael Ainsworth and Karen Szauter. It’s where the couple met and married while working as faculty members.

And it’s where they continue to fulfill a mission to train the health care work force of the future.

“I have been at UTMB my entire career,” said Ainsworth. “It gives me a pretty healthy perspective about the challenges and demands of a medical student, an intern, a resident and a faculty member.”

simply ask our entire UTMB family to look inside and consider what’s important to them.”

The $50 million Innovations in Mind initiative will partially support construction of the new Health Education Center on the Galveston Campus, help create faculty endowments and student scholarships, and bolster neurodegenerative disorders research.

Szauter is excited the Health Education Center will provide more space for patient simulation and other types of health sciences student training, while accommodating the growing student population.

Ainsworth is a proud member of the School of Medicine class of 1981. He also is associate dean in the School of Medicine and oversees clinical skills development programs for medical students. Szauter is medical director of the Office of Clinical Simulation in the School of Medicine. She joined UTMB as a faculty member in 1990.

“The majority of my time is spent preparing activities related to patient simulation programs in the School of Medicine, the School of Nursing and the School of Health Professions,” she said. “That’s been my career focus for almost 20 years.”

“To see something built that will provide a better opportunity for education of students in all four UTMB schools—that’s something we feel pretty strongly about,” she said.

“To see something built that will provide a better opportunity for education of students in all four UTMB schools—that’s something we feel pretty strongly about.”

Ainsworth also has joined a committee that meets monthly to discuss architectural design plans and construction updates for the center. He’s looking forward to the groundbreaking ceremony April 7 and the opening scheduled for 2019.

“You want to talk about getting in on the It’s obvious the couple enjoys talking ground floor,” he said. “This is a good about their work and the passion opportunity for people to get involved, they share for giving back to UTMB. be generous and help support someThey have joined hundreds of their thing that will serve all students.” colleagues to raise awareness and support for the Innovations in Mind Faculty and Staff fund- The campaign is striving to encourage the broad-based support raising initiative, which launched Feb. 2. Ainsworth said it’s of the UTMB community for some of the university’s highest a great opportunity for employees to get involved and invest priorities. Ainsworth and Szauter are making a leadership gift in the growth and continued success of the institution and and hope their commitment will inspire others to give. its mission.

For more information about the Innovations in Mind Faculty “We have hundreds of faculty who are involved across the and Staff Campaign and to make your gift, please visit four schools in the Academic Enterprise,” said Ainsworth. “I https://innovationsinmind.utmb.edu/employee.

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R ES EAR C H

UTMB anesthesiologist develops smart system to monitor patient oxygen levels, improve lung function Dr. Michael Kinsky points at the Smart-Oxygenation-System (SOS), a device he developed that can monitor a patient’s oxygen levels and alert medical staff when the levels drop and the patient is at risk for pulmonary distress.

B y C hristopher S mith G on z ale z

Sometimes, it’s the algorithm that knows best.

Kinsky said an example of a smart system could be something such as a thermostat in a house. When the temperature outside Dr. Michael Kinsky, a professor in UTMB’s Department of Anesgoes down, the thermostat kicks on the heat and then shuts off thesiology, has developed a device that can monitor a patient’s when the house reaches a designated temperature. oxygen levels and alert medical staff when levels drop and the Likewise, when oxygen in the body is low, the system increases patient is at risk for pulmonary distress. the amount of oxygen to the body, Kinsky said.

Kinsky developed the device, called the Smart-Oxygenation-System or SOS, as part of a larger body of work, funded by the “It is the amount of oxygen or the rate of increase that we look Department of Defense, looking into creating smart or auton- at, which determines how sick the lungs are,” he said. omous systems to help care for patients.

“Medicine is still far behind other industries in adopting and using smart systems,” Kinsky said.

There are already systems that can measure the amount of oxygen in a patient’s blood. Ideally, blood should be 99 to 100 percent saturated with oxygen. If it dips below 92 percent, an oxygen control system using a ventilator can kick on and bring the saturation level back up, Kinsky said.

RESEARCH B R I E F S Compiled from press releases written by Donna Ramirez. Find out more at www.utmb.edu/newsroom.

Dr. Ping Wu, PhD, professor of Neuroscience and Cell Biology, and Nikos Vasilakis, PhD, associate professor of Pathology, have uncovered the mechanisms that the Zika virus uses to alter brain development. While a Zika infection typically results in mild or symptom-free infections in healthy adults and children, the risk of microcephaly in the developing fetus is an alarming consequence that has created a worldwide health threat.

Since a normal brain develops from stem cells that are able to develop into various types of cells, the UTMB team deduced that microcephaly is most likely linked to abnormal function of stem cells. The researchers established a method of investigating how Zika alters the production, survival and maturation of brain stem cells using cells donated from three human fetal brains.

“We discovered that the Zika virus halted the production of brain stem cells and hindered their ability to develop into brain nerve cells,” said Wu. “However, the effect of the virus on the ability of stem cells to develop into specialized cells differed between donors. This difference seems to be linked to a Zika-induced change in global gene expression pattern however, it remains to be seen which genes are

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responsible. Wu added, “The unique system containing stem cells from three donors will allow us to dissect molecular mechanisms underlying Zika virus-induced brain malformation.” Two weeks after the cells had developed into a certain type, Vasilakis said they discovered that the Zika infection was mainly found in glial cells, which provide support and insulation for the brain. This study was published in Stem Cell Reports.

Wenbo Zhang, PhD, associate professor of Ophthalmology and Visual Sciences, has shed new light on what causes permanent vision loss following a head injury. When someone suffers a head trauma, there can be damage to the optic nerve, which is responsible for passing information between the eyes and the brain. When the optic nerve is injured, there are tears and swelling in the affected area that causes the nerve cells to die. This type of injury is called traumatic optic neuropathy, or TON, and results in irreversible vision loss. At this point, there is no effective treatment for TON and the mechanisms of the optic nerve cell death have been largely unclear. Zhang and his team found that inflammation brought on by white blood cells play a role in head trauma-induced vision loss.

Limiting inflammation could decrease nerve damage and preserve

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RE SE A R CH Similar devices are available to monitor and respond to oxygen is being provided to a patient and can alert medical blood pressure and IV fluids. Kinsky, along with Dr. George personnel when that amount crosses a certain threshold.

Kramer, director of the Resuscitation Research Laboratory “The system can actually improve lung function and care by in the Department of Anesthesiology, have been working reducing the reaction time to a bad situation,” Kinsky said. on these types of systems for the past 15 years. A few years He added that the device can be much more effective and ago, he worked on an IV system that could monitor and pro- efficacious than current monitoring practices and could vide needed fluids for a patient until the patient was back to lead to more efficient use of oxygen and better outcomes normal. for patients.

The various military branches are interested in these types of autonomous care, Kinsky said.

These systems reduce the number of personnel needed to treat each patient and patient health does better with these systems.

The SOS device still needs further testing and development— Kinsky is in the process of applying for a Department of Defense grant to finish that work.

“These types of systems can be of great “You don’t need a clinician help to military and or responder dialing a nob civilian medicine,” to make sure a patient is Kinsky said. “They getting the right amount can free up doctors of oxygen,” Kinsky said.

Kinsky explains how doctors and nurses will be able to monitor patients on the and nurses to care “They could be somewhere Smart-Oxygenation-System remotely on devices such as their smart phone. for other patients else saving lives.” and can even let The new SOS device will build upon already-in-use autono- doctors monitor their patients remotely on devices such mous oxygen systems. It is designed to monitor how much as their phone.”

cell function, researchers discovered.

Inflammation is part of the body’s defense system against injury and infection and is an important component of wound healing. White blood cells travel to injured areas to help repair the damaged tissue, causing inflammation in the process. Excessive or uncontrolled inflammation can actually make injuries worse and contribute to disease.“Our data clearly showed that a certain protein receptor on white blood cells brings them to the optic nerve when it has been damaged,” said Zhang.

“When we deleted this receptor or gave mice a drug that blocks the receptors after optic nerve damage, we saw fewer white blood cells on the scene.” Thus, nerve damage was decreased and nerve cell function was preserved compared with mice that did not receive any intervention following injury.” The findings are detailed in The American Journal of Pathology.

Kathryn Cunningham, PhD, director of the UTMB Center for Addiction Research and professor of Pharmacology and Toxicology, has confirmed that lorcaserin, a commercially available weight-loss medication, reduces drug-seeking behavior in rats that had been self-administering oxycodone, an opiod pain killer. According to

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the US Centers for Disease Control and Prevention, the number of deaths in the US from opioid overdose has quadrupled since 1999.

Most of the treatments available to reduce drug use work by occupying opioid receptors, so that if someone were to take an opioid while on the medication, they would not feel the signature euphoria as strongly. However, a person’s drug-taking environment is a powerful cue that can elicit drug craving. People who have tried the currently available medications often relapse when they are around the people, places or paraphernalia they associate with opioid use.

Cunningham and her team trained rats to self-administer oxycodone while exposed to specific lights and sounds, creating a drug-taking environment. Once the drug-seeking behavior was well established, some of the rats were given lorcaserin and the rest were given a placebo. The lorcaserin rats self-administered less oxycodone and reacted less strongly to cues associated with taking the drug. “These results highlight the therapeutic potential for lorcaserin in the treatment of opioid use disorder,” said Cunningham. The study is currently available in ACS Chemical Neuroscience.

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B y K irsti A nn C lifford

Wearing comfortable shoes should be a job requirement for Lauren Sheer.

For the last 10 years, Sheer has helped bring UTMB’s voice to Austin—walking, and sometimes running, back and forth between her office on Congress Avenue and the capitol building. As Assistant Vice President of Legislative Affairs, she’s on her feet constantly during Texas’ biennial legislative sessions, advocating on behalf of UTMB regarding various topics—from funding priorities to proposed legislation that could impact the institution.

“It’s a marathon, not a sprint,” says Lauren, as I meet up with her mid-week in February.

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Texas’ 85th legislative session began in January and is limited to 140 days; however, the

unique programs at higher education institutions. If fully enacted, it would cut $42.9 million in funding for UTMB over the biennium. Sheer pulls out a handout she created with funding priorities to discuss with legislators. It lists vital programs such as the planned Biocontainment Critical Care Unit that would be impacted if funds were not restored.

governor may call additional special sessions if needed. Although the state budget is the only bill the legislature is constitutionally required to pass each session, thousands of additional bills are usually filed for consideration. Sheer and the small team in UTMB’s Health Policy and Legislative Affairs office monitor “It’s important to remember that it’s still very early in the prothem all for potential impacts. cess,” says Sheer. “This is a starting point. What the House and She quickly brings me up to speed on a few bills her office is Senate eventually agree upon and send to the governor for his tracking as we walk underneath the impressive 300-foot-tall signature will look different from what has just been introduced. dome in the capitol rotunda, on our way to the Senate chambers. But where it will end up, we won’t know until the end of sesA Senate committee has just introduced proposed legislation sion—and that’s the hard part for everyone back at UTMB who dealing with research, and Sheer wants to hear the discussion. is trying to plan for the upcoming fiscal year.”

“I send bills like this one to our faculty, staff and adminis- When the meeting adjourns, we meet up with Dr. Ben Raimer trators, who can take a look at it and let me know what the for lunch in the capitol cafeteria. It’s crammed with people, so Sheer scouts out an empty table as Raimer takes the opportunity implications would be for UTMB—it’s very helpful,” she says as we take a seat in the public gallery overlooking the meeting. “I’ve been working with some of our research staff as well as our legal department to get feedback on the bill. I also collaborate with UT System on bills, because other health-related institutions often share similar concerns.”

Sheer points out a few committee members who are also UTMB alumni before we head to the House Appropriations C ommittee meeting.

The chair is expected to announce subcommittees that will take a “deep dive” into specific portions of the budget, such as health care, criminal justice and education. Sheer explains that the House and Senate recently released their proposed appropriations bills.

to highlight the vital role Sheer fills. As senior vice president of Health Policy and Legislative Affairs at UTMB, he first hired Sheer to be a legislative coordinator nearly a decade ago. The “This session, the House and Senate proposed budgets are fairly two have adjoining offices and have forged a close working far apart,” she says. “So we’ve taken a look at what each legisla- relationship since then. tive body has done, learned what the differences are and have “We are so lucky to have Lauren,” says Raimer. “She knows put together materials to go around and meet with members everyone around the capitol and always puts the university’s to discuss the impact of proposed reductions. We want them to best face forward everywhere she goes—and that’s a really big have all the information they need to make decisions and ensure help around here. That means doors get opened for meetings that they know what our programs do and how important they and it also means that she’s presenting accurate information. are to the university’s mission.”

She knows our budget as well as anyone at the university—and She points specifically to the Senate’s budget proposal for FY18 she knows what articles our items are in and what laws govern and 19, which essentially eliminates all “Special Items”—that’s each item. It’s a remarkable task and not everyone can balance a budget bill category that contains funding for specific and that many different things, but she does it extraordinarily well.”

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Sheer smiles, mentioning that she originally went to UT Austin to become a dentist, but decided to switch career paths after taking a summer job in then-State Representative Craig Eiland’s office during college.

employees work, such as offering the 47th lowest price per inmate for health care in the nation—at $11.50 per inmate per day—without sacrificing quality.

Each day during the legislative session, Sheer engages in dozens, if not hundreds of conversations with elected officials and their staff. And she’s just as busy between sessions, attending hearings and reporting back to UTMB leadership on all the issues regarding research, hospital regulations, graduate education, formula funding for programs… the list goes on and on.

“It fascinated me—all the subjects the legislature addresses and discusses that impact people’s daily lives,” says Sheer. “That’s what drew me in and I’ve been involved ever since. And it’s an honor to work for UTMB. I was born on the island and my family owns a business on 35th and Broadway, so it’s nice to work for an institution where you have a history and connection.” “During the interim, I’m also inviting legislators and their staff Her passion about UTMB is evident as she meets with several down to our campuses for site visits,” she says. “You might see legislators in the afternoon, including Rep. James White, who is us walking the halls of Jennie Sealy Hospital, the Galveston the chair of the House Corrections Committee and has several National Lab or a prison—it’s really helpful for them to get a prison units in the counties he represents. Sheer has to con- firsthand look at what we are telling them about all session long.” stantly be on her toes. As she works with his staff to schedule a I say goodbye to Sheer after walking across the capitol grounds back to her office. She will spend the last few hours of her day preparing talking points for Dr. Callender, as he will be testifying in front of a House appropriations subcommittee the following week. Sheer’s days will get longer as the session progresses—she’ll often work from 7 a.m. to well past midnight. It takes endurance and stamina, but if anyone can do it, she can. When she’s not running from chamber to chamber, she’s chasing after her twin sons, who turn 5 this year.

“It’s tiring, that’s for sure,” says Sheer. “Everybody who works in this world jokes, ‘So what vacation are you taking after session?’

But I don’t take my job for future meeting regarding correctional health care, White steps granted. It’s a big responsibility—there’s not much that happens out of his office and says, “Come on back!” in Austin that doesn’t impact UTMB’s 12,000-plus employees in “Meetings get moved around all the time and sometimes legis- some way, and I’m humbled to work with a great team and tell lators pop out of their office and are able to meet right then, so the institution’s story to anyone who will listen.”

I have to be ready at all times,” says Sheer. “Other times, I have Sheer knows the legislative session marathon doesn’t end until the to be ready to sit around and wait, which can be frustrating, but final gavel drops. At the finish, she will have have worn through it’s important to be respectful of legislators’ schedules and meet a few pair of shoes—but the UTMB community can rest assured with them whenever I can.” that their interests have been supported every step of the way.

It’s not uncommon for Dr. Owen Murray, UTMB vice president for Offender Health Services, to join Sheer for meetings with For updates on Texas’s 85th legislative session, check out Ben’s Blog legislators and their staff. In fact, that afternoon, Murray and at www.utmb.edu/hpla/ben-g-raimer-md/bens-blog, written by Sheer meet with Senate staff to discuss critical funding issues UTMB’s Dr. Ben Raimer. for Correctional Managed Care. I get to sit in on the meeting, where I learn some incredible facts about the wonders CMC impact

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l e a d er s potlight

David Marshall, chief nursing and patient care services officer David Marshall, JD, DNP, RN,

first joined the UTMB family in 1983 as a staff nurse, advancing to the positions of assistant head nurse, nurse manager, nursing supervisor, nurse administrator and director of nursing. In 2001, he assumed the role of chief nursing officer.

David Marshall with his daughter, Reagan, at a recent volleyball tournament in Corpus Christi.

During Marshall’s tenure at UTMB, he has been instrumental in numerous initiatives, particularly UTMB’s successful efforts to regain magnet status after Hurricane Ike. The Magnet Recognition Program by the American Nurses Credentialing Center recognizes health care organizations that provide the very best in nursing care.

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

Best Care is what our patients deserve and what our providers and staff strive to deliver. As a leader in the UTMB Health System, part of my role is to ensure that the talented people we have working here have what they need to deliver the very best care to all patients and their families.

What are the biggest challenges you face as UTMB’s chief nursing and patient care services officer?

I think the biggest challenges I face are related to recruiting and retaining sufficient staff. The market for health care workers is highly competitive, especially in the Galveston/Houston area. When UTMB’s exciting and rapid growth is added to the already stiff competition, the quest to attract and retain talented individuals becomes a bigger challenge. In a recent document outlining his vision and “Quantum Leaps,” UT System Chancellor William H. McRaven said, “There is a war for talent, and we intend to win it.” I agree with him, and that is what we are trying to do here at UTMB.

What was your first job?

My first job was picking peaches in Northeast Texas. My dad received a call from one of his friends who owned an orchard on Memorial Day in 1975, and I was picking peaches that afternoon. The peach pickers wore harvesting bags that strapped around their shoulders and rested about mid-chest level. Once the bag was filled with peaches, there was a release at the bottom, and the pickers would drop their peaches into crates stacked on a trailer. I made $750 that summer and bought my first car—a slightly used Ford Pinto.

What do you like to do outside of work?

My hobbies are fishing and traveling. I grew up fishing in freshwater lakes and ponds in Northeast Texas, but I fell in love with saltwater fishing when I moved to Galveston. In fact, the largest fish I have ever caught was a 52-pound ling about 60 miles off the Galveston shore in July 2014.

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Marshall has served on the American Nurses Association Congress on Nursing Practice and Economics, the American Nurses Credentialing Center’s Commission on Accreditation and the Committee on Practice Issues for the Texas Nurses Association. He also served on the Board of Directors of American Organization of Nurse Executives and is a past chair of the Galveston County Branch of the Greater Houston Area Chapter of the American Red Cross.

Marshall received a bachelor’s degree in nursing from UT Austin, a law degree from South Texas College of Law and a doctor of nursing practice degree from Texas Tech University Health Sciences Center.

In addition to fishing, I like to travel. Any international destination is my favorite, and I have been fortunate enough to travel to Belize, Cambodia, Costa Rica, Germany, Honduras, India, Mexico, Mozambique, South Africa, Venezuela and Vietnam.

My 15-year-old daughter, Reagan, plays club and high school volleyball, so over the past three years I have become quite a volleyball fan. She is a defensive specialist position on her indoor volleyball teams.

Do you have any hidden talents?

I guess they’re still hidden! On a recent cruise, I completed my first scuba dive in Cozumel, Mexico. Most of the dive sites are within the Cozumel Reefs National Marine Park, which protects much of the second largest barrier reef system in the world.

If you could have only one meal for the rest of your life, what would it be and why?

My maternal grandmother made the best fried chicken and homemade rolls I have ever had. If I could have one meal for the rest of my life, I would want her fried chicken with homemade rolls.

What’s something you always wanted to do but have not done yet?

I have always wanted to go whitewater rafting, but that’s still something that is on my bucket list that I have not gotten to.

If you could travel anywhere in the world, where would you go and why?

I would go back to Mozambique in southeast Africa. The country’s history and its people were fascinating to me. It was a Portuguese colony for 500 years, and the Portuguese influence combined with local traditions were what fascinated me. Their primary language is Portuguese and their food is heavily influenced by Portuguese cuisine.

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C ONS T R U CT I O N

Construction continues to transform UTMB campuses The waves of construction activity that have punctuated the post-Hurricane Ike era on UTMB’s Galveston Campus—as well as new building on the growing League City Campus—are continuing to transform the institution for current and future generations of health care professionals in Southeast Texas.

“It’s an exciting time to be on UTMB’s campuses,” said Jake Wolf, UTMB’s program director for capital projects.

“Following on the success of the new Jennie Sealy Hospital and Clinical Services Wing, we are continuing to support the vision of the Best Care initiatives and institutional goals of delivering high-quality projects that improve research, education and health care delivery across UTMB.” Here’s a closer look at some of the construction projects taking place across UTMB as of March 2017:

John Sealy Hospital modernization

Health Education Center

Galveston Campus 1. Health Education Center: The site for the new HEC, at 11th and Market streets, is currently being readied for construction of the five story, 162,000-square-foot facility that will serve as the centerpiece of UTMB’s educational future. It represents the largest and most dramatic addition to the institution’s educational infrastructure in many years and is slated for occupancy in May 2019.

2. Building 17E: This 90,500 square-foot facility will further ensure UTMB’s standing as a world-class research enterprise and provides the organization with state-of-the-art facilities that are resilient and support the university’s strategic mission. Expected completion is August 2017.

3. John Sealy Hospital modernization: The second phase of the hospital’s modernization includes updating the façade of the towers to make them look similar to Jennie Sealy Hospital, complete with gleaming glass running the building’s length and new brick to match the hue of the newest arrival to the Galveston campus. In addition to a revamped appearance, patient rooms in the two towers will be expanded to 345 square feet and will be completely remodeled—from the

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MARCH 2017

Building 17E

League City Campus floors to the ceilings and wall coverings—and the infrastructure updated to support the latest technological advances. The modernization project is slated for completion in early 2020.

4. Waverley Smith Pavilion Renovation: The project that will connect Jennie Sealy Hospital and the Clinical Services Wing (CSW) to John Sealy Hospital, Café on the Court and the Hospital Parking Garage is scheduled for completion in July.

5. Heart and Vascular Center: Construction of a new family-centered Cardiac Catheterization and Electrophysiology suite is slated to open on the sixth floor of UTMB’s Jennie Sealy Hospital in July 2018.

1. Collaboration with MD Anderson Cancer Center: MD Anderson is leasing property on the League City Campus, where it is constructing a $110 million, 190,000-square-foot full-service outpatient cancer center. This collaborative effort will allow both institutions to expand access to advanced health care services by taking full advantage of MD Anderson’s internationally recognized expertise in cancer care and clinical research; the investments UTMB has made in its League City Campus and surrounding clinics; and UTMB’s extensive network of primary and specialty care providers throughout the region.

The center is set to open in May 2018.

2. Parking structure and multi-use building: A new 700-car parking garage and 33,000-square-foot clinical building to further support the growth of the League City Campus is set for completion in May 2018.

3. League City Campus Hospital Phase 2 expansion: As part of the master plan for the hospital, which opened in June 2016, an additional 123,000 square feet will be added to the facility to accommodate new patient rooms and related services to continue to serve the fastest-growing population center in Galveston County.

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PAT IEN T C A RE

Help—Just a phone call away Southeast Texas Poison Center at UTMB available 24/7 to educate and save lives B y S imone P arker

The Southeast Texas Poison Center at UTMB is a bustling place.

The center receives about 120 calls each day about poisonings and toxic exposures from the public and medical health professionals.

“We are proud to have an amazing staff here at UTMB,” said Jean Cleary, Southeast Texas Poison Center director. “Our specialists are trained professionals such as nurses, pharmacists, nurse practitioners and toxicologists.”

The poison center, located near the Emergency Department on UTMB’s Galveston Campus, is one of a network of six regional centers established by the Texas Legislature to provide prevention and emergency treatment information to residents and health care providers.

Specialists respond to calls through the Poison Helpline at 1-800-222-1222, 24 hours a day, seven days a week. They answer questions about drugs, chemicals, natural poisons, environmental toxins and public health matters.

Tally Calvert is a certified poison information specialist and has worked at the center for 10 years.

She answered more than 5,000 calls in 2016 alone.

Wilcken said that being informed about patient fatalities is the toughest part of her job. It’s one of the main reasons why she and all of her colleagues are working every day to educate people about poison prevention, while also raising awareness about the center’s location in Galveston.

The poison center serves as an emergency treatment resource for people in Texas and all over the world. All calls are toll-free, and each one is recorded. Callers are not required to provide personal information, such as names, ages or addresses, but the recordings can help advance knowledge in the field.

(L-R) Pamela Lansinger, Robert Case, Sai Ni, Carol Whatley, Misty Wilcken, Serena Frederick, Jean Cleary and Mark Morrow.

“It’s not unusual for me to start the day talking to the emergency room about a patient in a coma or a mom whose child ate non-silica gel,” she said.

Calvert said the types of calls can vary depending on the time of day or season of the year.

“We see a peak in calls in the morning and at night from people who have made medication errors, as well as from people who have attempted suicide by ingesting a poisonous substance,” said Calvert. “Around the holidays, we typically see more children getting into medications because more people, such as grandparents and relatives, are visiting.”

Poisoning is a leading cause of injury-related death in the U.S., according to the Centers for Disease Control and Prevention (CDC). CDC research reveals that drugs—both pharmaceutical and illicit—cause the vast majority of poisoning deaths.

Misty Wilcken also is a poison information specialist. She said some calls are quite unique. One memorable call involved an elderly gentleman who had eaten what he thought were peanuts.

“We were able to discern that he had actually eaten a full container of tree nuts his wife had ordered off the internet as an appetite suppressant for weight loss,” she said.

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Unfortunately, the call came to the poison center too late; the gentleman did not survive.

“If needed, we can go back to the information for research and study purposes,” said Wilcken.

“For example, if someone takes an overdose of a particular drug, we can review the type and severity of side effects that are expected, which can help determine the best treatments.”

If necessary, specialists can contact trained professionals within the poison center network and physicians for phone consultations to help determine the best treatment for callers. Their top priorities are educating people about poison prevention and helping to save lives every day.

Southeast Texas Poison Center at a glance: • In 2016, STPC received more than 44,000 calls.

• Of those calls, at least 27 (each day) were from emergency medical services, clinics, emergency rooms and other health care providers who needed assistance with diagnosis, monitoring and treatment of poisoned patients.

• About 66 percent of calls about poisoning exposure are managed at the site of the call, which is usually at home.

• For every dollar invested in the poison center system, $13.39 is saved in medical costs.

• To learn more, call 1-800-222-1222 or visit www.poisoncontrol.org.

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HI DDE N TA L E N T S

by K irsti A nn C lifford

Lucy McMahon may be pint-sized, but she packs a powerful punch.

It wasn’t until her late 40s that McMahon first discovered a passion for bodybuilding. After hurting her lower back while lifting a patient on a stretcher, she had six months of physical therapy. Part of her rehabilitation involved lifting weights. Soon, she was hooked.

Standing at 4 feet 10 inches, the 74-year-old UTMB medical interpreter has been traveling across the globe breaking world records in powerlifting.

“On my 46th birthday, I went to the gym and started to train for “I’ve always been competitive,” she said. “You could say I’m bodybuilding,” she said. “I trained hard, following the advice my father gave me when I was young—‘If you’re going to do someaddicted to breaking world records.” thing, give 100 percent or According to McMahon, she don’t do it.’” holds more than 20 records McMahon placed well in in various age and weight many competitions both divisions. Most recently, nationally and internashe traveled to Russia in tionally.

But when she December to compete in reached her mid-60s, her the Global Powerlifting Allipassion for bodybuilding ance/International Powermorphed into a love for lifting Organization World powerlifting.

Championships, where she took home a gold medal She’s become just as wellin her division. Although known for her weightliftshe weighs 97 pounds, she ing ability as she has for can deadlift 180 pounds, her trademark scream— bench press more than 80 which is part of her roupounds and squat nearly tine before and during 130 pounds. each lift.

Lucy McMahon competes in the deadlift at the 2013 Global Powerlifting Alliance

“I look like a toothpick next World Championship in Finland.

“If I don’t scream, I can’t lift,” to many of the competitors,” she said. “I mean, I’m not she laughed, pointing to a lifting peanuts! I’ve tried photo of herself with two large Grecian powerlifters. “But I like not to scream, but I couldn’t even move the bar from the floor. to challenge myself to see how far I can go. The harder the goal, Before I lift, I put chalk on my hands, rub them together while the more proud I am when I achieve it. It sets an example for my pacing back and forth and give myself a pep talk—then I start son, daughter and grandkids—if I can do it, you can do it, too.” screaming. I don’t mind putting on a show—I love the audience.”

McMahon knows a thing or two about hard work and determination. Moving from Mexico to the U.S. when she was 19, she held various jobs around the country while learning English— from dancing in musicals in New Orleans to working as a salon beautician—before landing in Galveston.

Her routine works. Many countries visited and world records later, McMahon hasn’t slowed down. She’s now working toward a goal of deadlifting 190 pounds and trains several times a week at a gym along the seawall. And she brings that same hard-working mentality to her job as a medical interpreter, where she helps hundreds of Spanish-speaking patients and their families navigate the health care system.

“I moved to Texas to study and work,” said McMahon. “In this country, we have opportunities, so I studied as many things as I could. I’ve always liked to help people, so I attended nursing “I’ve always believed in myself and that’s helped me get where assistant school while working at a gas station and cleaning I am today both professionally and personally,” she said. “Size beach homes. I worked in the ER at UTMB for several years doesn’t matter and age is just a state of mind. I still have many and was also an EMT in Galveston County.” more things I want to do and people I want to help.”

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Urgent Care

or ER?

A guide to the right care in the right place

Urgent Care

Emergency Room

Seek urgent care for: • Abdominal pain—mild

Go to your nearest ER for: • Bleeding that will not stop

• Allergic reactions—mild to moderate

• Bone breaks, compound fracture

• Asthma attacks—mild to moderate

• Chest pains or stroke

• Colds, coughs and flu

• Fever in babies (under 8 weeks)

• Dehydration or heat exhaustion

• Loss or change of vision

• Ear and eye infections

• Major cuts, lacerations

• Fever

• Motor vehicle accidents

• Minor burns

• Seizure without existing condition

• Minor eye injuries

• Serious burn

• Minor fractures

• Snake bite

• Scrapes, minor cuts and bruises

• Head, spine and serious neck or back injury

• Sinus infections

• Sudden difficulty breathing

• Skin infections and rashes

• Sudden loss of consciousness

• Sore throat

• Suicidal thoughts

• Sports injuries, falls, sprains and strains

• Unable to urinate

• Urinary tract infections

• Vaginal bleeding if pregnant

• Vomiting and diarrhea

• Vomiting or coughing up blood

These tips are only a general guide. If you are unsure whether you (or your child) needs urgent care or emergency care, go to the nearest ER or call 9-1-1.

ALSO CONSIDER...

• Patient charges and co-pays are usually lower in an urgent care clinic. The ER offers specialized care for more complex cases.

• UTMB ERs are open 24 hours a day, every day. Urgent Care hours vary by site, most are open after hours and on holidays and weekends.

• Waits in ERs can be highly variable—and long at times. Depending on complexity of cases being treated, waits for urgent care are often shorter than ER waits.

• The ER offers a full range of advanced technology. At this time, Urgent Care does not offer ultrasounds, CT scans or MRIs. UTMB has full service ERs at the Galveston, League City and Angleton Danbury campuses.

You can also access our growing network of urgent care clinics in Alvin, Galveston, League City, Texas City, and now, Angleton—which opened to patients on March 6.

Visit utmbhealth.com/urgentcare for more information or call the nurse-staffed Access Center 24/7 at (800) 917-8906.

Pa rting Sh ot

Early blooms Roses started blooming early this year at the Gleaves T. James Centennial Rose Garden on UTMB’s Galveston Campus. Philip Fox, a senior landscape technician, has taken care of the garden for more than 20 years and said the roses were “totally confused” by the abnormally warm winter. In fact, many rose bushes were in full bloom in lateFebruary—that’s about a month early.

Fox has been busy pruning the bushes and planting an additional 290 roses of 10 different varieties to ensure the garden is beautiful—no matter what month of the year it may be.

MARCH 2017

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