February 2013

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February 2013

Welcome to the February 2013 edition of the Round Table.

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In late October, Hurricane Sandy left a trail of devastation from the Caribbean to New England. Since then, you have no doubt seen many horrifying images of the destruction caused by this superstorm, particularly in New Jersey and New York. Because of the speed and volume of water during the flood surge, New York University (NYU) suffered terrible loses in their labs. Thousands of lab animals perished; years of work vanished as refrigerated samples spoiled. Now our colleagues at NYU are starting over, reexamining their processes for how to best safeguard their animals, their samples, and their data against future catastrophes.

And we must do the same.

We should not have to endure the pain, tragedy and lab (and education, and career) disruption that NYU experienced. We must examine our own laboratory systems and fail-safes, and take stock now. Now is the time to consider our efficiencies, to think logically about how to relocate things to the most sensible places, and to centralize mission-critical items and to the extent possible, "fail safe" our power backup.

If we are proactive in our approach to laboratory safety and the security of our data and animals, when a hurricane (or some other natural disaster) turns its eye on Charlottesville, we will be prepared. I cannot image what it must feel like for a research scientist to lose years of his or her work. I hope that none of us ever has to experience that level of loss. So please, take the time to look at your labs and their safety systems; consider possible natural disasters for our region; think about worst-case scenarios; and then let us collaborate on a plan to save our research before it might be lost.

One place to "compare notes" and plan for the future is at the School of Medicine Research Retreat coming this weekend at the Boar's Head Pavilion. Highlighted by a lecture by William N. Hait, MD, PhD, Global Head, Research and Development, Janssen Research & Development, LLC, Johnson & Johnson, we will have roundtable discussions and concurrent sessions designed to stimulate collaborations around focused scientific topics. Our thanks go to Peggy Shupnik, PhD, Senior Associate Dean for Research, for overseeing the organization of the retreat. Thanks also to our research deans and Office for Research staff for Basic Research for their tireless help in putting the retreat together.

Respectfully,

Steven T. DeKosky, MD, FAAN, FACP

CLINICAL NEWS

Reid Adams, MD, Named Interim Director of the Cancer Center of Excellence

Please join me in congratulating Reid B. Adams, MD, Professor of Surgery and Chief of Surgical Oncology, who will serve as the Director, Clinical Cancer Services, and Interim Director of the Cancer Center of Excellence that was established through our Strategic Plan.

Dr. Adams will oversee clinical care services for the Emily Couric Clinical Cancer Center, which includes all of our clinical cancer programs. Dr. Adams will manage the coordination of cancer care, promote an environment to improve processes, optimize quality and safety of cancer care, increase patient access, and enhance the patient experience across our Cancer Center.

Jody Reyes, Administrator of the Cancer Center, will collaborate with Dr. Adams by serving as co-chair of the Cancer Center of Excellence business planning effort envisioned in our Strategic Plan. They will identify and launch the business planning team, which will complete their work this summer. We have asked that the business plan identify how we will advance our clinical differentiation and integration opportunities. We envision that the business plan will serve as a roadmap for the Center Director and provide a framework for the Cancer Center’s clinical investment and operational strategies.

By meeting our goals in the coming months and years to realize our clinical strategy, we will be able to care for patients in ways that had not been possible before. We look forward to working together in this effort. Thank you for your contributions, dedication, and enthusiasm around this most important initiative.

UVA Receives Heart Failure Accreditation

Last November we welcomed The Joint Commission to the University of Virginia for a one-day survey, focusing on clinical areas that frequently treat patients for heart failure. That survey resulted in UVA receiving the Disease Specific Care Certification in Heart Failure from the Joint Commission. The certification process provided an objective evaluation of our clinical inpatient heart failure program and compliance with our quality measures. The Heart Failure Quality Support Team, which is a multidisciplinary team, collects and analyzes performance improvement data and oversees the integration of evidence-based clinical practice guidelines within the institution.

We proudly add this to the list of other certifications, including COPD, Stroke and VAD. Soon, we will apply for Total Knee and Hip Replacement. In addition to the Joint Commission certification, the institution has also achieved gold status with the American Heart Association’s “Get With The Guidelines” for heart failure. Congratulations to all for these outstanding achievements!

IRPAs are Moving into More Locations

Starting in April, the In-House Rescue Physician (IRPA) Program — designed to improve the quality of care during nights — will be expanding. There will be two MDs in-house from 7 p.m.–7 a.m. — one IRPA-Medicine and one IRPA-Surgery. The expanded coverage is listed below; the PIC numbers will be IRPA-Adult Medicine #9558, IRPA-Adult Surgery #9241.

IRPA-Medicine

Focus: Medicine ICUs and Codes on Floors

ICU Locations: MICU, NICU, NIMU, & CCU

Acute Care Wards: 3rd and 4th Floors; 8 West and SCTU

IRPA-Surgery

Focus: Surgical ICUs and Codes on Floors

ICU Locations: STBICU, TCVPO/VICU, STBIMU, TIMU

Acute Care Wards: 8E and 8C

The Sepsis BPA is Making a Difference

In the December edition of Round Table, we discussed the multidisciplinary efforts for sepsis care at UVA by building Best Practice Alerts (BPA) into Epic. The Sepsis BPA has, on average, fired four times a day. Even when the patient is already being treated, there have been Medical Emergency Team (MET) interventions that have impacted the care and antibiotic regimens that have been altered to improve patient outcomes based on the use of the order sets and the antibiotic algorithms.

We encourage you to use the order set that will pop up for the primary team, as it will help with getting appropriate antibiotics in a timely fashion. The Sepsis BPA has been in place on all adult acute care units since Nov. 13, 2012. Here are some data we have collected:

  • Between Nov. 13, 2012, and Jan. 3, 2013, the Sepsis BPA has fired for a median of four patients per day, as expected based on background firing data.
  • The units that have had the most patients triggering the BPA are 3 Central (18 pts), 8 West (18 pts), and 4 West (15 pts).
  • Generally, staff members are indeed calling MET when the BPA fires. When staff members respond with "Will Notify MET," they have called MET 89% of the time. The MET team has completed an intervention for those patients 31% of the time.
  • Lessons learned: LIPs often do not use the Sepsis Order set, which is a quick and effective way to order all of the immediate and effective interventions needed for sepsis patients; please encourage the use of this tool. Some staff members are reluctant to call MET, even when they see a Sepsis BPA for the first time. Please reinforce the effectiveness of this resource.

EDUCATION UPDATES & EVENTS

UVA Launches Breastfeeding Friendly Consortium

When it comes to food for babies, "breast is best." In an effort to promote this gold standard in infant nutrition, UVA has partnered with the Virginia Department of Health (VDH), Telligen, HIT-Global, and Scitent to launch the Breastfeeding Friendly Consortium, a one-stop service for implementing the Baby-Friendly Hospital Initiative's 10 Steps for Successful Breastfeeding. This includes a systems approach to education, individual performance improvement and institutional quality assurance; turnkey software and training solutions that include enrollment, tracking, communication, and reporting; regularly updated expert content that is consistent with current guidelines and standards of care; 20 credits of online, certified continuing education for physicians, nurses and other healthcare professionals; web-based PI program with extensive resources and tool kit; and online registry access to track quality assurance measures. The Virginia Chapter of the American Academy of Pediatrics supported and endorsed the development of these activities.

This consortium evolved out of a contract with the VDH to develop and maintain a comprehensive, web-based knowledge self-assessment activity aimed at improving performance related to the initiation, duration, and exclusivity of breastfeeding. To date, more than 30,000 users from across the United States and 69 countries have earned credit for completion of the knowledge self-assessment modules.

As funding was expected to drastically decrease or end this year, UVA Continuing Medical Education (CME) leveraged their relationships to do something new and different to keep this educational opportunity available — building a new model of education, one that would be registration-based, self-supporting, and sustainable. In the months before launching this product, CME has already received inquiries from more than 40 institutions. It is important to note, however, that this educational service is free for all Virginia healthcare workers who would like to participate.

This is a wonderful example of cross-Grounds collaboration and, indeed, a paradigm shift in thinking about how we can continue to offer quality educational services that are self-sustaining. Those from UVA who spearheaded this product should be commended for their work, including Michael Straightiff, Director, UVA Licensing & Ventures Group; Ann Kellams, MD, Director, Newborn Nursery; William Define, JD, Director of Tax Compliance and Operational Contracts; John McHugh, Assistant Director, Procurement Services; Randolph Canterbury, MD, Senior Associate Dean for Education; Karen Rheuban, MD, Senior Associate Dean for Continuing Medical Education and External Affairs, Medical Director of the Office of Telemedicine, Director of the Center for Telehealth; Jann Balmer, PhD, RN, Director of Continuing Medical Education; and Tamara Eberly, PhD, RN, Project Manager, Continuing Medical Education.

To learn more about the Breastfeeding Friendly Consortium, please visit bfconsortium.org.

Erik Hewlett, MD, Receives Outstanding Faculty Award

Please join me in congratulating Erik L. Hewlett, MD, Professor of Medicine and Microbiology, Immunology and Cancer Biology, for receiving the 2013 Outstanding Faculty Award from the State Council of Higher Education for Virginia (SCHEV). This award is the commonwealth's highest honor for faculty at Virginia's public and private colleges and universities. These awards recognize superior accomplishments in teaching, research, and public service. Once again, congratulations!

RESEARCH HONORS & DEADLINES

MSSRP Program Seeks Projects & Preceptors

The School of Medicine (SOM) Office for Research is soliciting projects for the Medical Student Summer Research Program (MSSRP). The program is restricted to rising second-year UVA medical students. Research projects will run for seven weeks. The total stipend is $2,800, though SOM can provide limited co-funding — up to $1,000 for one student per preceptor — if preceptor need is documented; SOM pays Summer Session fees for all participating students.

The large number of returning preceptors is a testimonial to the productivity of these students. A detailed program description can be found at www.medicine.virginia.edu/research/offices/research/for-students-and-postdocs/medical-student-research-programs-at-uva.html.

If you wish to participate in the program, please complete the 2013 Preceptor Form (see above link), after which students will contact you directly. To complete the approval process, student and preceptor must complete the online student form on that same site.

If you have any questions about the MSSRP, feel free to contact Dr. Steven Wasserman at ssw3an@virginia.edu.

Save the Dates: Dean's New Faculty Seminar Series

Thank you to everyone who attended January’s installment in the Dean's New Faculty Seminar series, “Renal cell carcinoma: from bedside to bench and back again,” presented by Stephen Culp, MD, PhD, Assistant Professor of Urology. In addition to education, the seminars are an opportunity for presenters to introduce themselves (and their research programs) to other faculty and to make contacts with others in their field and around the School of Medicine and the Grounds.

All faculty, students, and staff are welcome to attend these seminars held in Jordan Hall Conference Center Auditorium. Upcoming seminars include:

Wednesday, Feb. 27, 4 p.m.

  • Presenter – Jochen Zimmer, PhD, Assistant Professor of Molecular Physiology & Biological Physics
  • Topic – “Structural basis for cellulose synthesis and membrane translocation”

Wednesday, March 27, 4 p.m.

  • Presenter – Laura Jansen, MD, Associate Professor of Neurology
  • Topic – “Inhibitory neurotransmission in normal brain development & epilepsy”

For a full schedule, please visit: www.medicine.virginia.edu/research/offices/research/home/som-new-faculty-seminars.html

OTHER SCHOOL OF MEDICINE NEWS

Tina Pendleton-Fuller Named 2012 Administrator of the Year

Please join me in congratulating Tina Pendleton-Fuller as the Administrator of the Year for 2012. Tina currently serves as the Associate Administrator for the Department of Radiology and Medical Imaging. Tina has been lauded as having a consistently strong ethic as a manager, showing her team that she will not ask them to do what she won’t do herself. Tina’s remarkable work ethic, diligence, and — particularly — her positive attitude, contribute to a constructive work environment in the department and in the School of Medicine.

Tina’s contributions have spanned the entire department, from expertise in human resources, to reorganization of the educational administrative team, to being instrumental in the department receiving an unconditional five-year renewal with no citations as a result of the ACSME audit, to being the primary coordinator on the departmental renovation project, and more. Tina initiated and completed a remarkable number of projects and her commitment to excellence is her hallmark.

Alan Matsumoto, MD, Chair and Theodore E. Keats Professor of Radiology, says that Tina is an “exemplary and very valued employee and administrator, always striving to support the missions, goals, and ideals of the department and the institution.” Congratulations, Tina!

December Uteam Meeting Available Online

If you were unable to attend the December Uteam meeting, you can go online and access a video and PDF of the presentation, as well as the question-and-answer session with senior leaders. The video includes updates on:

  • Strategic focus from Ed Howell, Vice President and Chief Executive Officer of the Medical Center
  • Operational goals from Bo Cofield, Associate Vice President, Hospital and Clinics Operations
  • Magnet status from Lorna Facteau, RN, DNSc
  • Healthcare reform and environmental pressures from Brad Haws, CEO, UVA Physicians Group, Senior Associate Dean and Chief Administrative Officer, School of Medicine

If you missed the meeting, I encourage you to take time to watch the video, which can be found at: www.healthsystem.virginia.edu/pub/human-resources/employee-engagement/uteam-meetings.

MLK Day Celebration a Success

I’d like to thank all who helped make the third annual MLK Day celebration a success. Many were involved in the planning and execution of the event. A key component of that day was the faculty mentor shadowing opportunity for under-represented undergraduates here at the University.

Participant comments indicated they were inspired by and valued the opportunity to view the daily routine of healthcare providers. Michael Moxley, MD, Associate Dean for Diversity, the MLK Day Celebration Committee and I wish to express our heartfelt gratitude to the following faculty mentors who provided participants with this experience: James Ferguson II, MD, MBA; Logan Karns, MS, CGC; Dana Redick, MD; Chris Kramer, MD; Ayotunde Dokun, MD, PhD; Christine Burt Solorzano, MD; and Jennifer Humberson, MD.

We hope that your positive experience will foster further mentorship participation and I encourage all faculty interested in mentoring students of diverse backgrounds to contact Dr. Moxley directly at jjp5s@virginia.edu or the SOM Office for Diversity at 924.1867.

Take Part in February's Heart Month Happenings

While our primary job is to take care of our patients, we must remember to take care of ourselves, too. February is Heart Month and Club Red — a women's heart-health initiative brought to you by the Heart and Vascular Center — is increasing awareness of heart disease, the leading cause of death of women in the United States. This month, Club Red will be offering a range of activities to get you moving and inspired to make healthy lifestyle changes. These activities include cooking classes, exercise opportunities, panel discussions, and more. For information on this month's events, visit clubreduva.com.

Respectfully,

-STDeK