Posts from the ‘community’ category

Brigham's MLK Jr day celebration

The Brigham chapter of the Association for Multicultural Members of Partners (AMMP) invites you to attend its annual celebration of the life and legacy of the Rev. Dr. Martin Luther King Jr.

Join AMMP on Tuesday, Jan. 22, noon-1 p.m., in Bornstein Amphitheater, for a panel discussion on the “Impact of Serving Others.” The panel will discuss service in the context of empowering individuals, strengthening communities and developing solutions to many of today’s social and economic challenges.

The panel will include individuals who have dedicated decades of their lives to service: Michael Curry, immediate past president, Boston Chapter of the National Association for the Advancement of Colored People (NAACP), board member, NAACP and senior vice president and general counsel at the Massachusetts League of Community Health Centers; Kim Janey, Boston city councilor, District 7; Nia Evans, co-founder and director, Boston Ujima Project; and Shelita Bailey, director, Workforce Development and Volunteer Services, Brigham and Women’s Hospital.

All are welcome to attend. Lunch will be provided. This event will also be webcast.

Reminder: Stay Home If You Are Sick

The Brigham is seeing an increase in both influenza and respiratory syncytial virus (RSV) cases. Please remember to stay home if you are sick to avoid spreading respiratory viruses to patients or colleagues. Call Occupational Health Services at 617-732-6034 for guidance on when you can return to work. Visit to learn more about infection prevention and control strategies.

Blood Drive Donors Needed, Feb. 1

The Kraft Family Blood Donor Center will host a blood drive at 15 Francis St. on Friday, Feb. 1, 8 a.m.–3 p.m. Donate blood aboard the Dana-Farber Cancer Institute/Brigham and Women’s Hospital Blood Mobile. All donations benefit patients at the Brigham and Dana-Farber Cancer Institute. Donors will receive a Kraft Family Blood Donor Center sweatshirt. To schedule an appointment, visit For eligibility questions, email or call 617-632-3206.

Partners Clinicians Day, Feb. 1

Partners Clinicians Day is Friday, Feb. 1, 7:45 a.m.–12:30 p.m., at Partners HealthCare, 339 Revolution Drive, Assembly Row in Somerville. This is a continuing medical education program for Partners physicians, nurse practitioners and physician assistants. The program will feature a keynote address, “Health System Digital Innovation Model,” by Aaron Martin of Providence St. Joseph Health, and three teaching sessions. Register and view the agenda here.


Register for the February Vacation Club

Registration for the February Vacation Club at the Brigham Backup Childcare Center opens Tuesday, Jan. 22, at noon, by phone only. To register, call 617-732-9543. February Vacation Club runs for one week, Tuesday, Feb. 19–Friday, Feb. 22. Children ages 5–12 of Brigham and Women’s Hospital, Brigham and Women’s Faulkner Hospital and Dana-Farber Cancer Institute employees are eligible to participate. Cost is $80 per day or $300 for the four days. Limited spaces are also available for children ages 2–4. All reservations are prepaid and nonrefundable. Learn more.

From left: Christopher Fenton and James Crowley manage audio and video broadcasts in the Zinner Breakout Room and Zinner Boardroom.

From left: Christopher Fenton and James Crowley manage audio and video broadcasts in the Zinner Breakout Room and Zinner Boardroom.

High-definition video of face-transplant surgery. Aerial footage of the helipad. Livestreamed events with hundreds of webcast viewers. These are just a few examples of the highly creative work produced by the Brigham’s Audiovisual Services (A/V) team in Office Services, which comprises several talented videographers, photographers, technicians and administrators who support every major service line and department.

“Our work is really fulfilling and fun,” said Peter Linck, manager of Office Services, which is part of Materials Management. “We get to work with so many people, and we also have a lot of creative freedom; when someone dreams up an audiovisual idea, we can help make it happen.”

And they do just that. Often spotted behind a camera or soundboard, the team supports dozens of events and multimedia projects in any given week. One moment, they could be broadcasting a hospital-wide event like Town Meeting or a tribute to the Rev. Dr. Martin Luther King Jr. from the A/V booth in Bornstein Amphitheater. The next, they could be filming neurosurgery cases in the Operating Rooms.

In addition to providing audio and video services, the team also assists the Brigham community with room reservations and event bookings. To make it easier for staff to determine the right venue for their event, the A/V team has made interactive, 360-degree online “tours” of many common meeting spaces, including the Zinner Conference Center and the Hale Building for Transformative Medicine.

From left: Elton Toska, Steven Kyriakidis, James Crowley, Benjamin Lee, Angel Ayala and Christopher Fenton (not pictured: John Bourque)

From left: Elton Toska, Steven Kyriakidis, James Crowley, Benjamin Lee, Angel Ayala and Christopher Fenton (not pictured: John Bourque)

When all-hands requests arise, Linck enlists the help of their colleagues in the Mailroom, which also sits under the Office Services umbrella, to assist with coverage needs. He noted that everyone on the team works to expand their skillset and is eager to lend a hand—including being willing, at a moment’s notice, to support press conferences and large events, such as the Magnet celebration and Discover Brigham.

Many A/V staffers began their careers in the Brigham’s Mailroom and have diverse professional and freelance backgrounds spanning television, photography and graphic design. Also noteworthy is the team’s retention rate. Many have been part of A/V for over a decade, with the longest-tenured member, John Bourque, coordinator in Office Services, celebrating 39 years at the Brigham.

Angel Ayala, senior technician in Office Services, credits Linck with reinforcing the Brigham’s culture of innovation, collaboration, excellence and treating setbacks as opportunities to grow together—fostering an environment that Ayala says inspires the team to do their best every day.

“We have a really great, understanding manager who supports our growth,” he said, adding that whatever technology and skills are needed for the job—such as video adapters, GoPros, software tools and HTML programming classes—Ayala and his teammates are given what they need to produce high-quality content and provide exceptional service to the Brigham community.

“Behind the Scenes at the Brigham” is a monthly photo series in Brigham Bulletin that provides a glimpse of the people whose everyday contributions help make the Brigham a world-class institution. Is there an individual or team you’d like to see featured? Send your ideas to

Register for the 2019 B.A.A. 5K

Registration for the 2019 Boston Athletic Association (B.A.A.) 5K race opens Wednesday, Jan. 16, at 10 a.m. All runners and walkers are invited to take part in the excitement of Boston Marathon weekend while supporting trauma research and care at The Gillian Reny Stepping Strong Center. Click here to register for the race and become part of the Stepping Strong 5K team.

Brigham Health Opens Hingham Clinic

Brigham and Women’s Harbor Medical Associates opened a Brigham Health adult primary care clinic in Hingham on Jan. 2. The office, which is accepting new patients, contains 14 clinical rooms in a 9,000-square-foot space. Located at 6 Shipyard Drive in Suite 2A at the Hingham Shipyard, the clinic offers primary care services and a phlebotomy lab. To make an appointment, call 781-952-1303.

Reminder: Severe Weather Policy

With winter weather approaching, all faculty and staff are encouraged to review the Severe Weather, Emergency Policy or Significant Event policy (HR-406). All Brigham Health faculty and staff are expected to report to work as scheduled in severe weather, and decisions for individual sites, practices, departments, programs and units to remain open or to close are determined by Brigham Health leadership.

Coming Soon: Windows 10 Upgrade

Beginning in January and throughout 2019, Brigham Health will roll out the Windows 10 operating system to every eligible Partners standard desktop and laptop. Windows 10 offers a faster startup speed, improved layout, customizable user experience and improved security features. To learn more about new features and functionality with Windows 10, visit the Partners HealthCare Windows 10 Resource Center. For information specific to the Windows 10 roll out at Brigham Health, visit the Brigham Health IS Portal. Additional details and communications will be shared in the coming weeks. If you have questions or feedback, contact

Aidan Chen

Aidan Chen displays one of the books donated to the NICU.

Ever since Aidan Chen was a young child, he’s had a love for reading. Wanting to share his passion for literature and the written word with others, he recently collected and delivered a large donation of children’s books—600, to be exact—to the Brigham’s Neonatal Intensive Care Unit (NICU) for our tiniest patients and their families to enjoy.

“Even very small babies need books,” said Chen, 16, a junior at Weston High School. “I love that through my donation I am able to help one baby at a time build their first library.”

His visit last month marked the second time Chen has contributed to the unit’s Brigham Baby Academy—a program introduced in 2016 that seeks to improve neurodevelopment of NICU babies and help families bond with their babies by reading, talking and singing to them every day. During their hospital stay and upon discharge from the hospital, NICU babies and their families are gifted new books for parents to continue reading with their infants at home.

Carmina Erdei, MD, medical director of the NICU’s Growth and Development Unit and neonatologist in the Department of Pediatric Newborn Medicine, who oversees the Brigham Baby Academy, explained that babies in the womb are listening to their mother’s voice and other family members for many hours a day. For most healthy, full-term newborns, that practice continues without interruption after birth and plays a notable role in the rapid brain development that occurs in infancy and early childhood.

On the other hand, babies who require acute care in the NICU—and need to remain hospitalized for several weeks or months—have significantly less exposure to that form of auditory stimulation. Through the Brigham Baby Academy, the NICU is creating the opportunity for some of these therapeutic experiences to occur for its littlest patients.

“We do think that reading and meaningful auditory exposure is medicine,” Erdei said.

For Chen, who hopes to be a doctor when he’s older, his latest donation to the program is just one chapter of a bigger story. As a research intern at the Brigham in 2017, he learned about the NICU and its commitment to ensuring each infant is read to at least once a day by staff or a family member.

To support the program, Chen created the GoFundMe fundraiser “Books for the Babies.” He continues to collect donations to purchase books for Boston-area NICUs and military families through events sponsored by the March of Dimes.

Sarah Wood and baby Hayden

Erdei said Chen’s latest donation couldn’t have come at a better time.

“Our shelves were getting quite bare, and we are incredibly grateful for Aidan’s efforts and donations,” Erdei said. “Because of him, we are able to spread the literacy message to so many families. He’s incredible.”

During his latest visit to the NICU, Erdei introduced him to two families and their babies who received books through the Brigham Baby Academy.

Sarah Wood was reading a book to her infant daughter, Hayden, a patient in the NICU, when Chen stopped by for a visit. An educator, Wood said she’s thrilled the Brigham created the reading program because not only does it help babies and their families bond, but it also sets infants up for success later in life. She began reading to her daughter before she was born. Some of Wood’s favorite books to read to Hayden are Corduroy, Polar Express and Goodnight Moon.

“As a teacher, I am always trying to instill the importance of reading to children,” Wood said. “The more language and the more words that your child hears in these formative years, the more effective communicators they will become. Having books available in the NICU is wonderful.”

Bernard Jones headshot

Bernard Jones

“Great Friday news!!!” At first glance, it seemed that was the entirety of the email from Paula Squires, MBA, SHRM-SCP, SPHR, our senior vice president of Human Resources. But as I scrolled down to read what she had forwarded, I clearly saw why she was so excited. After a lot of hard work with a great team (Ron M. Walls, MD, executive vice president and chief operating officer; Shelita Bailey, director of Workforce Development; Carmen Santos, Workforce Development specialist; and Paula, among others), we had hired the first person through our Brigham Health SUCCESS Program.

SUCCESS is designed to increase employment opportunities at the Brigham for those members of our local communities whose life trajectories would be most transformed by them, whether due to incarceration for nonviolent offenses, past challenges with substance use disorder or simply the broad spectrum of life’s personal challenges that anyone can encounter. The program’s initial partnership is with STRIVE, a Dorchester-based organization that provides an intensive five-week training on workplace readiness, responsibility and professionalism, along with career-specific skills training. We work with STRIVE to identify graduates with career potential and an interest in health care and then help guide those graduates through our employment process.

It all sounded great in theory and it was a program we loved working on and describing to others, but it didn’t feel real until I got that Friday afternoon email. I quickly emailed back an excited response and walked over to Ron’s office. He had seen the news and we shook hands on a job well done, but we also agreed that this had to be the first of many. I’m hoping for many, many more “great news” emails and I doubt they will ever be any less exciting.

Bernard Jones
Chief of Staff to the Executive Vice President and Chief Operating Officer, Brigham Health

seasonal birch tree decorationThere were so many shining moments throughout 2018, but what brings me the most joy this holiday season are the decorative birch trees displayed across our main campus. These trees celebrate our partnerships with dozens of organizations that support our friends and neighbors in our local community, providing vital services to improve their quality of life.

Each year, we strive to celebrate the holidays in a way that honors all traditions, faiths and cultures. This year, I believe we did just that! Seeing patients, visitors and our staff stop to read about these important community services and hearing people say how beautiful the trees are truly warms my heart. As one patient so eloquently put it, these trees “remind us all, especially at this time of year, that we are all connected to each other.”

Betsy Nabel, MD
President, Brigham Health

Jason Frangos and team

From left: Zachary Holcomb, John Mohs, Jason Frangos, Margaret Cavanaugh-Hussey, Toby Crooks and Diana Woody

I made my second trip to Shiprock, N.M., in November 2018 as part of the Brigham and Women’s Outreach Program. Working alongside the dedicated doctors and staff at the Indian Health Service hospital in Shiprock has truly inspired and motivated me in my life and work. Contributing much-needed clinical care to the Navajo community has re-energized me with a sense of meaning and purpose as a physician. Volunteering at Shiprock has been my antidote to burnout and has revitalized my spirit.

Jason Frangos, MD
Director, Program for Infectious Diseases of the Skin
Department of Dermatology

Fundraising walkEvery year, Brigham and Women’s Hospital and Brigham and Women’s Faulkner Hospital participate as a team in the Boston Heart Walk and fundraise to support cardiovascular research and education, advocate for health and save lives. This walk is important to me because a few of my family members have experienced coronary artery disease, stroke and valve disease. By supporting the walk, I am doing my part to help fund current research that will make a difference for my family members and friends.

The 2018 Boston Heart Walk was very special to me. Not only was it the fifth time that I’ve organized and led the team, but it was also the year the Brigham and Faulkner team won the “Top Hospital Challenge” from the American Heart Association. I can’t begin to explain how exciting it was to stand on the Hatch Shell stage and be presented a trophy for our efforts. The team that raises the most money and has the most walkers during each year’s Heart Walk is crowned the “Top Hospital.” I also love meeting all the people who join our team each year. To be able to walk alongside patients who’ve undergone surgery and other procedures at the Brigham and elsewhere, lifts my heart with every step I make.

Merilyn Holmes
Senior Administrative Assistant, Division of Cardiovascular Medicine

Carlson with Shiprock members

Alissa Umana (far left), Sally Carlson (second from left), Loren Day Lewis (second from right) and Kyle Dale Walters (far right)

In November, I had the privilege of traveling with three of my team members to the Northern New Mexico Navajo Medical Center in Shiprock, N.M., as part of the Brigham and Women’s Outreach Program with Indian Health Service. This is the second year that we have been able to travel with the Outreach Program to provide training in customer service and communications for clinical and administrative staff throughout the hospital. It is an incredibly rewarding experience to deliver our training to such an eager and enthusiastic audience—and to know that, in some small way, we are helping them improve the quality of care delivered to the Navajo population on the reservation.

This year, our trip happened to coincide with Native American Heritage Month, and as part of the celebration, Navajo dancers of all ages performed for staff and patients. Wearing intricately detailed costumes and accompanied by traditional music, the dancers offered moving performances of ceremonial dances to a crowd gathered in the hospital atrium. After the performance, we had the honor of being photographed with one of the dancers, who is also a supervisor at the hospital. It is a wonderful memento from the trip and a reminder of our friends in Shiprock.

Sally Carlson
Senior Manager, Training and Communications, BHIS

Winter Food Drive Concludes Dec. 20
The Center for Community Health and Health Equity is hosting a winter food drive to benefit the Parker Hill/ABCD Emergency Food Pantry in Mission Hill, now–Dec. 20. Beans, rice, cereal, pasta, soups, peanut butter, jelly and canned goods are most needed. Donations can be placed in the food drive bins outside the Garden Cafe on Tower 2. For questions, or to make a cash or check donation, call 617-264-8750 or email

OHS Episodic Care Clinic for Employees
Occupational Health Services (OHS) offers conveniently located care for upper respiratory infections, sore throats, conjunctivitis, urinary tract infections and back pain. Staff who have a Brigham primary care provider and receive medical insurance through Partners HealthCare can visit the clinic Monday–Friday, 7 a.m.–3:30 p.m. Employees will not be charged a co-pay for their visit; labs, radiology exams and prescription medications are billed to insurance. The clinic is hosted at OHS’ mid-campus clinic on the Lower Pike. To schedule an appointment, call 617-732-8501.

Professional Development Series
The Professional Development Series (PDS) is available to help Brigham staff and teams gain new skills through self-led resources and classroom learning. PDS has a spring and fall semester, with spring courses beginning in February and fall courses starting in September. Class offerings include: Behavioral Interviewing; Communication Skills; Delegation; Presentation Skills; Time Management; Running Effective Meetings; Role of the Manager and more. To learn more, visit

BEI Yoga: Winter Series
The Brigham Education Institute (BEI) will host its winter series of 60-minute vinyasa yoga classes in the BEI Knowledge Center (located in the Thorn building, first floor, room 127D). The class is designed for all levels of experience, from beginners to more advanced yogis. Attendees should wear appropriate workout attire and bring their own yoga mat. Upcoming classes will be held 5:30-6:30 p.m. on Wednesday, Jan. 9, and Wednesday, Jan. 16. View a full schedule and register. 

Gift-Wrapping Fundraiser to Support the NICU

The Brigham Young Professionals group is hosting a gift-wrapping fundraiser outside of the Shop on the Pike throughout December. Bring your unwrapped holiday presents and a volunteer will wrap them for you. Donations will benefit the NICU Friends of BWH, a group that support the families of the Neonatal Intensive Care Unit (NICU). Hours of operation will be Tuesday, Dec. 11–Friday, Dec. 14 and Tuesday, Dec. 18–Thursday, Dec. 20, 11 a.m.–1 p.m.

Shop on the Pike Holiday Sale, Dec. 13-14

The Shop on the Pike will celebrate its 10th birthday by offering 20 percent off most items, including select Brigham apparel, during a holiday sale on Thursday, Dec. 13, and Friday, Dec. 14. The discount does not apply to flowers/plants, balloons, candy, food, magazines, greeting cards, website orders, phone cards, gift cards or paperback books. Call 617-732-7878 for more details.

‘Flooded: Lessons Learned from a Major Hospital Flood,’ Dec. 13

The Department of Quality and Safety hosts “Flooded: Lessons Learned from a Major Hospital Flood” as part of the Quality Rounds. Ronald Iverson Jr., MD, MPH, of Boston Medical Center will present. Attendees will learn about planning and practice for a large-scale flood, as well as the use of outside resources during a response to such an event. Thursday, Dec. 13, noon-1 p.m., in Bornstein Amphitheater. Learn more.

Holiday Reminder: Personal Package Policy

With the holidays fast approaching, the Receiving & Distribution and Office Services teams remind employees that personal package deliveries cannot be accommodated. The priority of these departments is delivering items directly related to patient care and hospital business. Due to the large volume of these deliveries alone, the added responsibility of processing personal packages delays the turnaround time on products that may directly affect patient care. Please make alternate arrangements for the delivery of personal packages. For questions, contact Jonathan Santiago at

children participating in family day at the hospital by trying out simulation items.

PACU nurse Kaitlyn Fredrickson (third from left), RN, demonstrates for “Family Day” attendees Gianni and Kelis Wilkinson (first and second from left) how to place intravenous lines, while their mother, PACU nurse Teyarnna Straughter, RN, snaps a photo.

More than 500 children, parents and siblings of staff from the Brigham’s Operating Rooms (ORs), Post-Anesthesia Care Unit (PACU) and Perioperative Services received a glimpse of what their loved ones do each day during an inaugural “Family Day” event, held in partnership with the Neil and Elise Wallace STRATUS Center for Medical Simulation, on Nov. 17.

In addition to providing tours of the ORs, PACU and Peri-op areas, staff hosted family-friendly educational activities. Interactive stations around the three areas provided hands-on opportunities for young visitors to use simulation tools to try out laparoscopy, intubation, CPR, ultrasound and more. Using models of bones, children also learned surgical skills used in orthopaedic surgery and how joint replacements are performed.

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United Way Campaign
The Brigham’s 2018 United Way Campaign is underway. Staff have received direct, personalized emails with a link to their giving pages. Online donations can be made through payroll deduction, debit/credit card or check. Information tables will be hosted throughout the month on the Tower 2 mezzanine. The campaign will run through Nov. 22. Learn more.

Sock and Underwear Donation Drive, Nov. 13-Dec. 13
The Brigham Clinical Documentation Program and the Department of Quality and Safety are hosting a sock and underwear donation event to benefit the Friends of Boston’s Homeless. The Brigham community is invited to donate new men’s or women’s socks and underwear between Tuesday, Nov. 13, and Thursday, Dec. 13. Collection boxes will be located on the Brigham’s main campus at the following locations: One Brigham Circle, second floor kitchen; outside the Garden Café at 75 Francis St.; and the second floor of Shapiro, near the Shapiro Bridge.

Town Meeting, Nov. 14
Join Brigham Health President Betsy Nabel, MD, at the next Town Meeting: An Open Forum for Brigham staff. The meeting will consist of updates on important issues, followed by an open forum for discussion and Q&A. Wednesday, Nov. 14, noon-1 p.m., in Bornstein Amphitheater.

Coffee with Martha Jurchak, Nov. 16
The Brigham Young Professionals group welcomes Martha Jurchak, PhD, RN, executive director of the Ethics Consultation Service, to its next “coffee with” session. Attend to learn more about Jurchak, her interesting work at the Brigham and career in the field of clinical ethics. Registration is required. Refreshments will be provided. Friday, Nov. 16, 8-9 a.m., in the Hale Building for Transformative Medicine, Room 10-004. Learn more and register.

While pregnancy, childbirth and motherhood are joyful times for many women, for others these experiences can be emotionally challenging, isolating or even traumatic. An estimated one in seven women experiences depression during pregnancy or in the first year after giving birth – making depression during this time nearly twice as common as gestational diabetes. 

But unless a mother or mother-to-be already has an established relationship with a behavioral health provider, she faces multiple barriers in terms of accessing specialized care to prevent, identify and manage mental health and substance use concerns.

“Psychiatrists who are trained in and comfortable with treating pregnant and postpartum patients are an extremely limited resource. There are simply not enough,” said Leena Mittal, MD, director of the Division of Women’s Mental Health in the Department of Psychiatry. “Meanwhile, in low-resource areas like Central and Western Massachusetts, the wait time to see any psychiatrist – let alone a perinatal psychiatrist – could be three or four months. In Southeastern Mass., it could take more than six months.”

That usually leaves primary care providers and obstetricians on the front line, but they don’t typically receive the specialized training necessary to feel confident treating these patients either, Mittal said. 

Helping to bridge that gap is the Massachusetts Children Psychiatry Access Program (MCPAP) for Moms, which provides free, real-time perinatal psychiatric consultations and referrals for obstetric, pediatric, primary care and psychiatric providers across Massachusetts. The Brigham serves as the Boston hub for the program, which is based out of the University of Massachusetts Medical School in Worcester. 

Supporting Patients and Providers

From fluctuating hormones to sleep deprivation to a traumatic childbirth, there are a number of circumstances that can make pregnancy and motherhood a difficult time for patients. 

Leena Mittal

Launched four years ago, MCPAP for Moms maintains a consultation, resource and referral phone line that providers can call to receive guidance on diagnosing, treating and prescribing medications for pregnant and postpartum women with mental health or substance use concerns. For complex cases, perinatal psychiatrists in the program conduct in-person consults with patients. The service can also help frontline providers identify other relevant community resources or help facilitate referrals to group and individual therapy or other services.

For example, if an obstetrician suspects that a patient who’s come in for a prenatal care visit is showing signs of depression, the provider could call MCPAP for Moms and ask for input on a possible diagnosis and treatment plan, explained Mittal, one of two Brigham psychiatrists who provide consults through the program.

“There’s this misconception that pregnancy is a time when women are always ‘glowing’ and happy, but it can be a complicated time,” said Mittal, who also serves as associate medical director of MCPAP for Moms. “In addition, women – and sometimes their providers – assume they have to stop all medications, including antidepressants, during pregnancy. But that’s not the case. We give providers evidence-based guidelines, and they can ask questions as needed.”

Nicole Smith, MD, MPH, of the Department of Obstetrics and Gynecology, has used MCPAP for Moms’ services in her practice and recommended it to colleagues as a novel, vital resource for providers. 

“A lot of programs tend to focus on trying to increase the number of and access to therapists and psychiatrists, which is wonderful and very necessary, but that may not meet our patients’ needs,” said Smith, an unpaid obstetric consultant for the program. “Patients can receive great, timely care from their primary care doctor or obstetrician, who may just need confirmation that a treatment is appropriate or a best practice.” 

MCPAP for Moms supplements the Brigham’s robust in-house psychiatric resources, she added. For example, the program makes it easy to help patients who live outside Boston find support services closer to home. “Many patients don’t want to drive to the city with a newborn, and that can be an obstacle to accessing treatment,” she said.

Looking ahead, MCPAP for Moms is expanding its services to support providers caring for perinatal patients with substance use disorders, an effort that will be based out of the Brigham and led by Mittal. 

“Massachusetts is the first state in the country with a program like MCPAP for Moms, and getting to be part of something so innovative has been very exciting,” she said. “We’re moving the needle in the way that perinatal mental health is treated, and I’m thrilled to be part of that.” 

Learn more at or contact MCPAP for Moms at 855-MOM-MCPAP (855-666-6272). Providers interested in training opportunities around perinatal mental health and substance use are also encouraged to contact the program.

Brigham Health’s Strategy in Action: Timely Access
Learn more about our strategic priorities at

Lynne A. Johnson

The Brigham community and the Department of Radiology mourn the loss of Lynne A. Johnson, RT(R)(CV), who passed away suddenly on  Sept. 17. She was 62.

Ms. Johnson worked at the Brigham for 42 years, joining the Peter Bent Brigham Hospital in 1976 as a student X-ray technologist. Holding several titles throughout her career, she most recently served as a special procedures technologist in Angiography and Neuro-Interventional Radiology in the Michael J. Davidson, MD, Hybrid Operating Room (OR) and the Advanced Multimodality Image Guided Operating (AMIGO) suite. Earlier in her career, she was assistant chief technologist for Angiography and Neuro-Interventional Radiology.

Beloved as a dedicated and caring colleague, mentor and friend, Ms. Johnson is remembered for her extraordinary work ethic, deep expertise in imaging and her gentle disposition.

Nancy Trane, RT(R)(CT)(MR), clinical manager for MRI in Radiology, who had known Ms. Johnson since they were students at Northeastern University more than four decades ago, remembered her friend and colleague’s profound commitment to helping others and steady leadership – both in and out of the OR.

“If you were her patient, you would have no idea whether it was the easiest case in the world or the hardest because Lynne always approached it with the same sense of calm and professionalism,” Trane said. “She was a prize to the Brigham. Wherever Lynne was, people wanted to be around her. She had a wonderful smile, she never slowed down and she always did what needed to be done.”

In addition to her skill as an interventional technologist, Ms. Johnson was regarded as a talented, patient teacher. Carol Upson, RT(R)(CV), CIC, clinical manager in Radiology at Brigham and Women’s Harbor Medical Associates, who worked with Ms. Johnson for 35 years, said she always could count on Ms. Johnson to take on the role of “super user” whenever a new piece of equipment or imaging technology was introduced.

“Lynne could learn anything, and she knew how to teach it, which is just as important,” Upson said. “She understood that everybody doesn’t learn the same way, and she could recognize someone’s needs and modify her teaching so they would be successful.”

Upson – who at different points in her career reported to Ms. Johnson and served as her supervisor – said she was in constant amazement at Ms. Johnson’s inexhaustible work ethic.

“In my opinion, she was the best interventional technologist there was,” Upson said. “She always pitched in and never complained – she just wanted to take care of her patients.”

Peter O’Rourke, RT(R)(VI), clinical manager in Angiography and Neuro-Interventional Radiology, who worked with Ms. Johnson for 15 years, also said Ms. Johnson was eager to support her colleagues and team at every opportunity.

“She was very flexible and understanding,” he said. “Even if all her assignments got shifted and her whole day changed, she would just say, ‘OK, let’s go.’”

Outside of work, Ms. Johnson enjoyed spending time with her family and friends, as well as several hobbies and interests, including tending to her chickens, beekeeping, traveling and baking.

Ms. Johnson is survived by her husband, Gary Tipson, and their children, Allison, Audrey, Chris, Emma and Heather, as well as many siblings, friends and other loved ones.

Members of the United Way committee, from left: Arismendy Santana, Labina Shrestha, Christian Comeau and Lisa Morrissey

How does winning New England Patriots tickets, Boston Red Sox tickets, a helmet signed by Patriots quarterback Tom Brady, a TV or many other raffle prizes sound? They’re all part of the Brigham’s 2018 campaign to benefit United Way of Massachusetts Bay and Merrimack Valley.

Funds raised through the annual hospital-wide campaign, part of Brigham Health’s commitment to supporting the local community, are distributed by United Way to area nonprofits, with a focus on increasing opportunities for children and youth and bettering the financial stability of individuals and families.

The 2018 campaign, which runs from Wednesday, Oct. 31, through Thursday, Nov. 22, has adopted a superhero theme with the tagline encouraging donors to “be a hero for change.”

Beginning Oct. 31, staff will receive personalized emails with a unique link to their own United Way donation page. The page allows staff to make online donations through payroll deduction, credit/debit card or check. Paper pledge cards will also be available.

Throughout the campaign, staff will have the opportunity to visit United Way information tables at the Brigham’s main campus to learn more about the United Way campaign. Games and prizes will be available. The four tabling events will take place on the Tower 2 mezzanine from 11:45 a.m. to 1:15 p.m. on Oct. 31; Monday, Nov. 5; Wednesday, Nov. 14; and Monday, Nov. 19.

This year’s campaign is led by Stan Ashley, MD, of the Department of Surgery, Lisa Morrissey, DNP, MBA, RN, NEA-BC, associate chief nurse of Peri-Procedural Areas, and Allen Smith, MD, MS, president of the Brigham and Women’s Physicians Organization.

Among those excited for the campaign is Ean Corduff, of Police, Security and Parking, who is serving on this year’s United Way committee. Corduff said he’s grateful to be a part of an institution whose core values include helping others in need.

“The United Way supports a network of organizations that help change people’s lives for the better,” Corduff said.

Fellow supporter Labina Shrestha, MM, T-CHEST, of Environmental Services, said she gives to United Way not only because it helps improve the lives of individuals, but it also strengthens communities.

“There might be times when life crumbles down in an unexpected way for many, but United Way is here to give people the support they need to rise up and get back to living their dreams,” she said.

Learn more about the campaign.

‘Sex Differences and the Brain’  Symposium, Sept. 26

There are many differences between female and male brains. Such differences can have important implications for brain health. Learn more about this at the first Women’s Brain Initiative symposium: “Sex Differences and the Brain: Implications for Research, Health and Disease.” Wednesday, Sept. 26, 1-5:30 p.m., in the Hale Building for Transformative Medicine, third-floor conference center. For more information, email

HealthStream Mandatory Course Deadline, Sept. 30

BWH requires all employees to comply with mandatory education requirements as related to their job role. The 2018 Annual Mandatory Education courses are due Sunday, Sept 30. Content can be accessed via the Partners Applications icon. Select the “Utilities” folder, then click on HealthStream. For assistance, contact the IS Service Desk at 617-732-5927. For course assignment questions and issues, contact your department HealthStream administrator.

Honoring Women in Medicine Month

September is Women in Medicine Month. BWH is celebrating by sharing a photo collection on its social media channels. All women in medicine are invited to participate by sending their photos to Use hashtags #WIMMonth and #WhataDoctorLooksLike when posting on your social accounts. Any photos with patients must have proper consent. Be mindful of private information that could inadvertently appear in the background.

Volunteers Needed: Discover Brigham

Brigham Health staff are needed to help volunteer at the upcoming Discover Brigham event on Wednesday, Nov. 7, to assist with registration, lunch setup, greeting attendees, attending sessions and the evening reception. To volunteer, visit

Interactive demonstrations at the ‘iHub Turns 5’ celebration showcase digital health innovation at the Brigham.

On Sept. 12, more than 200 clinicians, scientists, staff and entrepreneurs commemorated the fifth anniversary of the Brigham Digital Innovation Hub (iHub) during a celebration of innovation and digital advancement at BWH and beyond.

The half-day event, “iHub Turns 5,” featured panel discussions with BWH innovators, iHub alumni and senior leaders from the Brigham and Partners HealthCare in the Hale Building for Transformative Medicine.

Since 2013, iHub has helped innovators launch and advance projects focused on using technology to streamline hospital operations, improve care delivery and enhance the patient and employee experience. One example is the Brigham’s online wayfinding tool, which provides step-by-step directions for navigating the hospital. iHub members have also worked with Medumo, a startup co-founded by Internal Medicine and Dermatology resident Omar Badri, MD. The company’s flagship application – in use at the Brigham’s Endoscopy Center – delivers precisely timed reminders via email and text message to patients for various purposes, such as preparations for procedures.

“We are aspiring to drive the safest, most patient-centered and efficient care through the use, development, evaluation and commercialization of digital health solutions,” said Adam Landman, MD, chief information officer of Brigham Health.

Improving Lifesaving Care Through Innovation

During a panel highlighting current and former BWHers’ journeys from ideation to innovation, YiDing Yu, MD, shared her experience of working with iHub to grow a startup company from a single idea.

When she was a second-year Internal Medicine resident, Yu attended iHub’s inaugural hackathon five years ago wanting to solve a problem she had encountered firsthand, specifically the communication challenges care teams encounter when a patient is arriving via ambulance.

Due to privacy concerns, emergency medical service (EMS) responders can only transmit limited information about an incoming patient to hospital care teams over public radio channels. Yu wanted to develop a tool to bridge this gap – a technology that would provide emergency departments with timely information while protecting patient privacy.

Yu was determined to solve this problem, despite the fact that she had no experience starting a tech company. “All of us were first-time entrepreneurs. We had no idea what we were doing,” said Yu.

Yu’s application, Twiage, is now used by over 50 hospitals in 12 states. Its secure digital platform enables first responders and emergency departments to accelerate lifesaving care by sending real-time clinical data and location updates directly to hospital care teams. Yu said that while it was daunting to pivot her career path to focus on Twiage – she also practices medicine at Atrius Health a few hours a week – she believes in her startup.

Yu attributes part of her success to the support she has received from iHub and the larger Brigham community. “I came to the Brigham to train because of the culture here,” said Yu. “I think you have to be surrounded by people who support your passion – I have bosses and mentors who do that. They help ignite that fire in your belly.”

Yu was joined on the panel by Karen Fasciano, PsyD, a psychologist at BWH and Dana-Farber Cancer Institute, who discussed her work on banYAn, an app that helps young adults coping with cancer; Alexander Lin, PhD, director of the Center for Clinical Spectroscopy in the Department of Radiology, who launched a company called BrainSpec to make virtual biopsies a reality; and Scott Weiner, MD, MPH, of the Department of Emergency Medicine, who is working on several digital health projects related to the opioid crisis.

In addition to the speaking program, the celebration was a homecoming for many iHub alumni, including Lesley Solomon, MBA, who helped create iHub and was honored that evening with the inaugural Disrupting Medicine Award for her contributions and leadership.

Reflecting on iHub’s early days, Solomon said the Brigham had to chart new territory to get iHub off the ground: “You just have to go for it. You just have to start doing things.”

Ursel Hughes (center) poses with family members beside her portrait, featured in photo exhibit about the opioid crisis.

When Ursel Hughes took her first uncertain steps toward recovery nine years ago, she never imagined her story could one day inspire others. But as she recently reflected on her experiences overcoming substance use disorder, Hughes said she feels humbled and privileged to be where she is today.

One of several speakers featured at an event kicking off the Brigham’s celebration of National Recovery Month in September, Hughes underscored how important it was to be shown compassion and dignity in her greatest hour of need.

“What I give today is hope. I didn’t have any of that when I went into recovery,” she said. “I was grateful to find people who treated me like a human being.”

Held Sept. 5 on the Tower 2 mezzanine, the event brought together BWHers and Harvard Medical School (HMS) students to celebrate those in recovery and raise awareness about the services available across Brigham Health for those in need.

The event also marked the debut of “RESILIENT: Narratives of Hope from Boston’s Opioid Crisis,” a photojournalism exhibit by HMS students that features portraits of and quotes from health care professionals – including several BWHers – as well as advocates, educators, law enforcement officers, people in recovery and policymakers. The 35-foot installation will be on display in the second-floor corridor near the Amory (M) elevators until the end of October, at which point it will be moved to HMS.

Directed and curated by second-year HMS students Mimi Yen Li and Joyce Zhou, with guidance from fourth-year student Galina Gheihman, the exhibit aspires to empower, educate and engage viewers about advocacy, community and compassionate care in the context of the opioid epidemic.

“Stories of the opioid crisis are all around us,” Yen Li said. “Often these stories are bleak, but every now and then we catch a glimpse into what could be on the other side of addiction. RESILIENT is an effort to capture these narratives of hope.”

Hughes, whose photo is featured in the exhibit, is now a recovery coach with the Police-Assisted Addiction and Recovery Initiative, a Gloucester-based nonprofit partnering with police departments nationwide to provide non-arrest pathways to treatment and recovery. She urged attendees to extend the same respect and compassion she was once shown to other people with substance use disorder.

“There are many paths to recovery, but if we don’t treat a person like a human being, they’re never going to find one,” she said. “I challenge you to support others, whether they are sick and suffering coming off the street or whether they are uneducated around the disease model of thinking about addiction.”

A Supportive Environment for Recovery

Attendees were also invited to join a statewide campaign, State Without StigMA, and pledge their commitment to reducing the stigma around addiction by being compassionate and thoughtful in how they think, talk about and treat people with substance use disorder.

Scott Weiner, MD, MPH, an emergency physician and director of the Brigham Comprehensive Opioid Response and Education (B-CORE) Program, said clinicians can play a significant role in reinforcing the fact that addiction is a chronic medical condition, not a choice or moral failing, by avoiding stigmatizing language in conversation with patients, families and colleagues. Stigma often prevents patients from seeking treatment and receiving high-quality care, he noted.

“The words we use matter,” Weiner said, citing examples such as identifying a patient as a person with substance use disorder, not an addict, or describing toxicology test results as positive or negative, rather than clean or dirty.

Additionally, the event highlighted some of the recent strides the Brigham has made in its response to the opioid crisis, including the launch of the Brigham Health Bridge to Recovery – also known as the Bridge Clinic – earlier this year. The clinic provides timely access to pharmacotherapy, counseling, case management and peer support until access to a long-term recovery program can be secured.

One of the biggest goals of the Bridge Clinic was to promote a “no-wrong-door” approach to care, said Joji Suzuki, MD, director of BWH’s Division of Addiction Psychiatry. That’s because, until recently, health care organizations around the country often turned away patients with substance use disorder, simply saying they did not treat the condition there, he explained.

“We would never allow that for any other fatal or severe illness, yet that’s been done for substance use disorders for a very long time,” Suzuki said. “I am so proud to be at the Brigham and Harvard because when a patient calls, we can confidently say, ‘You’ve come to the right place.’”

Members of the “Do Right, Stay Well” Committee

If a colorful, inspirational message catches your eye while walking around the Longwood Medical Area, you may have the Department of Dermatology’s “Do Right, Stay Well” Committee to thank.

Members of the BWH volunteer group – which organizes events and activities for Dermatology staff to support wellness both in the local community and among their colleagues – recently participated in the worldwide “Kindness Rocks Project.” The initiative encourages people to spread kindness and compassion by painting positive messages on small rocks and placing them around public areas to spread positivity and joy.

It is just one of many projects the “Do Right, Stay Well” Committee has undertaken over the years that embodies what the group strives to do each day – bring people together to help others – said committee co-chair Margaret Cavanaugh-Hussey, MD, MPH, director of Public Health and Community Outreach Programs in BWH Dermatology.

“Our committee is composed of people who are passionate about and devoted to improving the community,” said Cavanaugh-Hussey. “It’s incredible to witness the goodwill of so many and how profoundly that spirit spreads out into the world.”

Founded in 2012, the “Do Right, Stay Well” Committee has a multipronged mission. Its members strive to demonstrate a commitment to service through volunteerism, philanthropy and community outreach while also supporting the department’s work to promote skin health in the local community. The group also aspires to inspire goodwill and wellness among Dermatology staff.

“Being a part of the committee has been one of the best things I’ve been able to do during my time at the Brigham,” said Marie Thistle, project manager in Dermatology and a founding member of the committee. “I’ve gained so much, both personally and professionally, from participating in the committee, and I’m grateful for the opportunities I have to give back to others.”

Since the group’s inception, it has organized dozens of events at the Brigham and beyond. Its members, totaling nearly 20 BWHers, include Dermatology administrators, clinical staff, physicians and researchers.

One of the largest ongoing projects the committee manages year-round is scheduling and hosting free skin screenings in the local community in collaboration with Dana-Farber Cancer Institute (DFCI). Brigham dermatologists, along with BWH and DFCI staff, will visit locations and events around Greater Boston – including beaches and health fairs – to educate people about skin cancer awareness and sun safety. Over the past three years, the teams have performed more than 2,800 skin cancer screenings at various events across the Boston area.

In addition to its dermatology-driven work, members of the committee volunteer at the American Cancer Society AstraZeneca Hope Lodge Center in Boston, which provides free lodging for cancer patients and their caregivers traveling from afar for outpatient care. BWH Dermatology staff come together to cook a meal for families staying at the lodge.

The committee hosts several other annual events, including a winter clothing drive and volunteer days at area nonprofits, such as Cradles to Crayons and Boston Health Care for the Homeless.

Supporting Staff Wellness

Throughout the year, the committee also brings the team together with staff lunches with an interactive component, such as creating the kindness rocks. Other luncheons have featured a healthy-choice potluck and even a lighthearted Star Wars-themed lunch on May 4, also known as Star Wars Day (which commemorates a pun on the series’ iconic catchphrase of “May the Force be with you” as “May the Fourth be with you”).

The committee’s co-chairs emphasized that the team has continued to thrive thanks to the strong support it receives from department leaders and their commitment to staff wellness. Heather Wilder, an administrator in Dermatology and committee co-chair, said that support has been incredibly meaningful.

“It’s wonderful to see how much our colleagues value the committee and everything it does to benefit the community and each other,” she said. “I’ve always had a passion for community service and philanthropy, and doing this work for the Brigham has been very rewarding.”

Anne O’Malley, an administrative supervisor in Dermatology and member of the committee, said she enjoys how the group’s work brings together staff from across the department.

“I love coming to work every day knowing that my colleagues and I are here with two common goals: to help others and to support each other,” she said. “We are all in this together – that means everything to me.”

From left: Aaron Berkowitz works with Roosevelt François, inaugural graduate of Haiti’s first neurology fellowship.

The Brigham has more than a hundred neurologists on faculty, each with their own subspecialties. Yet until recently, Haiti, a country of nearly 11 million people, had only one. Aaron Berkowitz, MD, PhD, hopes to change that.

Following the island’s devastating 2010 earthquake, Berkowitz, director of the Brigham’s Global Neurology Program, was deeply moved by what he learned from his colleagues who had traveled to Haiti to assist with medical relief efforts. The disaster magnified how the country, especially its rural areas, was in dire need of specialized care.

“Most doctors in Haiti are general practitioners because there are no specialty training programs,” said Berkowitz. “If you go to medical school in a country with few or no neurologists, you have very minimal training in neurology to help patients with neurologic conditions.”

Six years ago, Berkowitz and his colleagues, including Michelle Morse, MD, MPH, assistant program director of the Internal Medicine Residency Program and associate physician in the Division of Global Health Equity, resolved to remedy this shortage. They worked with global nonprofits Partners In Health and EqualHealth to teach neurology courses for internal and family medicine practitioners and trainees.

Following this, Berkowitz, Morse and their Haiti colleagues developed a four-week neurology rotation for five internal medicine residents at the Hôpital Universitaire de Mirebalais (HUM). Their subsequent success inspired Berkowitz and colleagues to start a new, more intensive program – thus, Haiti’s first neurology fellowship was born.

One applicant is chosen each year for the two-year fellowship, and the program is rigorous; the fellow cares for all neurology inpatients and outpatients at HUM and receives mentorship from about a dozen U.S.-based neurologists, each of whom spends one to 12 weeks teaching in Haiti annually.

Last year, the first fellow, Roosevelt François, MD, graduated from the program. He recently joined the hospital’s faculty and became director-in-training of the neurology clinical program and educational fellowship. With the second fellow set to graduate this fall and a third next year, the program is on track to reach its goal of a 500 percent increase in neurologists – from one to five – within five years.

The need for neurology care is especially critical in Haiti, Morse explained. The country has a disproportionately high rate of hypertension, which is a key risk factor for stroke, in addition to a high burden of epilepsy from neurologic infections.

Building a Pipeline

Berkowitz and Morse hope their latest milestone ignites a fast-growing, self-sustaining fellowship led by HUM faculty.

“This program is going to have an enormous impact on the next generation of health care professionals because it has this faculty pipeline built into it,” Morse said. “And, more importantly, it’s a step toward achieving what citizens of Haiti deserve: health care as a human right.”

Berkowitz expects the program will not only expand access to high-quality neurologic care in Haiti, but will also train a cohort of clinician-educators who will teach neurology to their peers and train more neurologists in Haiti. More broadly, he hopes it becomes a model that other health professionals in resource-poor settings can replicate to develop specialty training programs in partnership with visiting faculty.

“Haiti is just one country,” he said. “Around the world, patients who need specialized care often can only see their general practitioner, who has no one they can refer the patient to for specialized expertise. The need is endless, and we hope our program can inspire other clinician-educators to expand their teaching efforts beyond borders.”

Morse, who has worked on health equity initiatives in Haiti and beyond for more than a decade, said Berkowitz’s passion and dedication has positioned the project for long-term success.

“Aaron is one of my heroes for being so committed to this program,” she said. “No matter what challenge comes along, he never gives up.”

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Rich Joseph leads a class about creating a personalized health plan at Brigham and Women’s Center for Community Wellness.

When Christina Meade, MD, was invited by a fellow resident to give a talk about kidney health – one of her clinical interests – to people in the local community, she jumped at the opportunity.

“I love medicine, specifically preventive medicine, and to educate people in our local communities about their health and wellness is what makes my job so wonderful and exciting,” said Meade, a second-year resident in the Department of Medicine. “After I participated in the talk, my passion for primary care was rejuvenated.”

Last year, Rich Joseph, MD, MBA, a third-year resident in Primary Care and Population Medicine, approached Paul Ridker, MD, MPH, director of the Center for Cardiovascular Disease Prevention, about possibly launching an ongoing health and wellness series led by residents at Sportsmen’s Tennis and Enrichment Center in Dorchester. Ridker, who at the time was the board chair of Sportsmen’s, said he instantly loved the idea, knowing the series could benefit both Brigham residents and community members.

Ongoing since September 2017, the “Wednesday Wellness” series takes place twice a month at the Brigham and Women’s Center for Community Wellness, Dorchester, located within Sportsmen’s. Each course focuses on a different health- and wellness-related topic, with more than 20 sessions held to date. Courses have covered diabetes and hypertension, dementia and arthritis, among other topics.

Opened in 2015, the goal of the Brigham and Women’s Center for Community Wellness Center at Sportsmen’s is to advance health and chronic disease prevention in underserved communities of Dorchester, Mattapan and Roxbury. The facility includes both classroom space for educational activities and a full gym, free to anyone living in the area.

For Ridker, the center has been a “terrific way for the Brigham to have a positive impact on preventive health in underserved neighborhoods where so many of our patients live and work.”

Wanda McClain, MPA, vice president of Community Health and Health Equity, agreed, adding the “Wednesday Wellness” program shows the power of collaboration. “Bringing together health care providers, community residents and Sportsmen’s is a perfect trifecta for improving community health,” she said.

Toni Wiley, Sportsmen’s executive director, has seen firsthand how valuable the courses have been for attendees.

Attendees of a recent “Wednesday Wellness” course gather for a photo with Brigham resident Rich Joseph (back row, center).

“I’ve heard many success stories from our members who’ve attended the ‘Wednesday Wellness’ sessions,” Wiley said. “Some have lost a few pounds, and others have come to understand how their medications truly work. It has been truly gratifying to hear people talk about how attending these sessions has been life-changing for them.”

The series has a loyal following. William Mitchell, of Mattapan, has attended nearly every “Wednesday Wellness” session, even inviting friends to join him. A retired firefighter, Mitchell said he appreciates the residents’ thoughtful, insightful presentations.

“To me, it’s a great thing to bring health and wellness education into the local community,” he said. “I’m grateful that the Brigham and Sportsmen’s came together to bring this goodness to our community, which is helping many of us live a better life.”

The series has also benefited Brigham trainees by providing opportunities to “get outside one’s comfort zone” and talk about health and wellness in a setting other than the hospital, Joseph explained.

Since the series launched, Joseph has heard from many resident colleagues who are interested in getting involved.

“It feels good knowing our work is helping others,” said Joseph, noting the series is a collective effort and would not be possible without the support of his resident colleagues.

BWH Emergency Medicine residents and Boston Children’s Hospital pediatric residents are among those involved in the series. Since Sportsmen’s offers programs for all ages, Joseph said it has been valuable to have residents from different specialties share their expertise.

Joseph, along with a handful of other Brigham residents, including Joshua Lang, MD, MS, a third-year resident in Internal Medicine, are also teaming up with Sportsmen’s to launch related programs, including community health fairs and an educational series for children attending summer camp at Sportsmen’s. Lang said it has been wonderful to participate in this work. “I feel pretty lucky to have found out about it,” he said.

Joseph added: “Partnering with Sportsmen’s has been one of the best decisions I’ve made as a resident. For me, this is the type of work that keeps me going – it’s very motivating. I love showing people the process of discovering their own health and taking care of themselves.”

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Buprenorphine is widely considered one the most effective medications available to treat opioid use disorder. It blocks the effects of opioids and suppresses cravings and withdrawal symptoms – “tricking” the brain into believing an opioid like heroin or oxycodone has been ingested without producing a drug-induced high.

But there’s one big catch: It can be difficult for patients to access, primarily because clinicians must undergo a specialized, eight-hour training to prescribe it to patients with opioid use disorder.

The time commitment alone is a significant barrier for many providers. Additionally, access to the buprenorphine waiver training course is limited in many areas of the country.

Mia Lozada, MD, an internal medicine physician at Gallup Indian Medical Center in Gallup, N.M., and her colleagues are all too familiar with these challenges. Serving residents of the Navajo Nation, the U.S. Indian Health Services (IHS) hospital is about a two-hour drive from the nearest city, Albuquerque, where waiver training is occasionally offered.

“In addition to the time and distance, we typically don’t hear that these trainings are available until a month or two ahead of time. By then, our clinics are already scheduled, so the logistics are even more complicated,” she said.

That’s why Lozada and her colleagues jumped at the chance to remotely attend an online waiver training last month led by Joji Suzuki, MD, director of BWH’s Division of Addiction Psychiatry, organized in collaboration with the Brigham and Women’s Outreach Program. The course was scheduled several months in advance, enabling 38 Navajo-area IHS clinicians from multiple disciplines across five sites to attend without affecting patient care.

Since 2009, BWHers have collaborated with the IHS – the U.S. government agency responsible for delivering medical and public health services to members of federally recognized Native American tribes. Through the Outreach Program, BWH faculty, nurses, trainees and other providers volunteer their time and expertise to offer specialized care and training on the ground at IHS hospitals in rural New Mexico and Arizona and through remote teaching opportunities.

Providing waiver training remotely and offering it to IHS clinicians were firsts for Suzuki, who has led waiver training courses for prescribers across the Brigham, Greater Boston and New England for more than 10 years.

“The clinicians out there in Navajo Nation are doing amazing work with such limited resources, and I’m happy to do anything I can to help them,” Suzuki said. “Since we already had this relationship established through the Outreach Program and the technology to provide the training remotely, it was a great opportunity to lower some of the barriers they face in accessing waiver training.”

Joji Suzuki

Joji Suzuki provides buprenorphine waiver training to Indian Health Services clinicians based in New Mexico.

A Valuable Resource

Many patients with substance use disorder are reluctant to seek care from an addiction medicine specialist due to social stigma. They may be more open to discussing treatment options with a clinician with whom they have an existing relationship, such as a primary care provider or gynecologist, underscoring the importance of expanded waiver training.

But because those providers typically haven’t received more specialized training in treating substance use disorders, they often report not feeling confident prescribing medications such as buprenorphine. Lozada, who completed the waiver training in 2011 during her residency at the University of California, San Francisco, was thrilled to have an opportunity to retake the course with Suzuki for this exact reason.

“The training reviewed a lot of areas in which we sometimes feel a little uncertain and would otherwise push some of us away from prescribing buprenorphine,” she said. “Hearing from an expert such as Dr. Suzuki was really valuable and reassuring. It gave me a lot more confidence in how to care for patients with opioid use disorder.”

Lozada noted that not only did the recent training help IHS clinicians increase their roster of buprenorphine prescribers, but it also expanded the range of specialties where patients can now access the medication. In addition to internal medicine practitioners, Navajo-area IHS clinicians representing inpatient care, obstetrics/gynecology, pediatrics and pharmacy services attended, as well.

“Having that diversity in expertise is important because it gives us the opportunity to provide this treatment to more patients, regardless of age or condition,” Lozada said. “It’s also a chance to cross-collaborate between our departments in a way we haven’t been able to do before.”

Another benefit is that having so many colleagues take the same training together will result in more consistent practice across multiple sites and disciplines, Lozada added.

“It puts us all on the same page,” she said. “Rather than attending different waiver trainings across the country, we all have a common foundation as we prescribe medications to treat opioid use disorder.”

While the number of clinicians receiving waiver training across the country is increasing, Suzuki noted it is one piece of a far bigger, more complex puzzle in responding to the opioid crisis.

“There’s a huge educational gap that’s going to take an entire generation to close,” he said. “You have several generations of physicians and health care providers who never received any substantial training around addiction treatment. One eight-hour course is not going to solve that problem. But it’s part of the solution.”

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Training class for staff at Gillette Stadium

This tourniquet training class for staff at Gillette Stadium was one of many conducted by BWH researchers last year.

In the immediate aftermath of an accident or attack, can bystanders help save the life of someone who has experienced a traumatic injury? Brigham researchers recently sought to answer this question by studying how well different training methods prepared laypeople to apply tourniquets to stop uncontrolled bleeding, finding that those who underwent in-person training were most likely to successfully perform and retain this skill.

Traumatic injuries are the leading cause of death for Americans under 46, and uncontrolled bleeding is the most common cause of preventable death following a traumatic injury. Since the Boston Marathon bombings in 2013, several national initiatives, including the White House’s “Stop the Bleed” program, have emerged to empower laypeople to act as immediate responders until emergency personnel arrive on scene. These efforts have led to the development of different training methods, but it was previously unknown which type, frequency and format of training would competently prepare nonmedical personnel to conduct hemorrhage control.

To determine the best training method for tourniquet education, BWH researchers completed the PATTS Trial (Public Access and Tourniquet Training Study). The study was funded by The Gillian Reny Stepping Strong Center for Trauma Innovation and conducted in partnership with Gillette Stadium and the New England Patriots.

In total, 465 Gillette employees, who had no prior training in this area, participated in the study. The trial was designed to not only train staff in responding to uncontrolled bleeding, but also to test whether, and under what conditions, such training was effective. The results were published in JAMA Surgery this month.

Participants were randomly assigned to one of four groups. The first was provided instructional flashcards to learn about proper tourniquet application. The second group used flashcards and audio kits. The third received in-person training through the Bleeding Control Basic (B-Con) course, led by BWH instructors. The final cohort was asked to apply tourniquets with no training or instructions. Participants in the first, second and fourth groups later received in-person training.

Researchers found that in-person training, via the B-Con course, was the most effective instructional method and resulted in 88 percent of participants correctly applying a tourniquet. By comparison, participants who received no training applied a tourniquet correctly only 16 percent of the time, and participants who had access to instructional flashcards or an audio kit with flashcards experienced only small gains in effectiveness.

Looking at skill retention, researchers discovered that only about half of the participants could correctly apply a tourniquet three to nine months later, emphasizing the need for refresher training.

“Before the PATTS Trial, we didn’t know what was the best way to train the public in bleeding control,” said Adil Haider, MD, MPH, a trauma surgeon and Kessler director of the Center for Surgery and Public Health. “Now that we know, we can be more effective in creating training programs, public awareness campaigns and tools to empower people.”

Researchers stress that most external hemorrhages, or bleeds, can and should be controlled by direct pressure. While bystanders were critical first responders following the Boston Marathon bombings, subsequent research indicated that all 27 improvised tourniquets administered at the scene were applied incorrectly.

Looking ahead, Eric Goralnick, MD, MS, medical director of Emergency Preparedness and lead author of this study, said clinicians and public health investigators will convene to define a common research agenda for laypeople and bleeding control.

Meghan McDonald, MSN, RN, nurse director of the Trauma Program in the Division of Trauma, Burn and Surgical Critical Care and co-author of the study, said intervention from bystanders in any situation, not just mass-casualty events, can help save lives.

“Some people hesitate, especially when it comes to tourniquets, because they are afraid of causing more harm,” McDonald said. “Educating laypeople on hemorrhage control, be it direct pressure or tourniquet application, is not only the responsible thing to do as a trauma center – it is also the right thing to do.”

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