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What Are Our Strategic Priorities and Areas of Focus?

Strategic Priorities

We have prioritized these seven objectives to ensure that we are a high-performance health care organization that meets patient needs and remains competitive in the marketplace. The examples listed below are meant to illustrate one instance—not a comprehensive review—of how we meet these goals. For more examples of how we achieve these priorities, visit BWHPikeNotes.org. As our strategic priorities evolve in fiscal year 2017, read BWH Bulletin for the latest updates.

Scalable Innovation

The remarkable discoveries and innovations at BWHC improve our understanding, prevention and treatment of diseases.

BWH researchers were the first to study the long-term effects of multivitamins, discovering in 2012 that men over 50 who take a daily multivitamin reduce their risk of cancer, but not cardiovascular disease—a finding that affects millions.

Advanced, Expert Care

Patients from around the world seek out the expertise of our highly specialized clinical and research staff, who pioneer medical breakthroughs and provide individualized care.

Launched as an initiative of the Dana-Farber/Brigham and Women’s Cancer Center, PrecisionCancerMedicine.org serves as a hub for physicians and patients looking for resources, including clinical trials, to help pinpoint therapeutic agents designed to precisely target and treat an individual’s cancer.

Improve Health

Healing and caring for patients locally and globally means not only treating disease, but also preventing it and improving a patient’s quality of life.

The Center for Community Health and Health Equity works with community partners to reduce health care inequities and increase access to care for vulnerable populations. Our primary care and specialty services enable us to help patients sustain good health and prevent disease.

Timely Access

Our ongoing efforts to optimize operations, productivity and efficiency mean we can help more patients in need of BWHC’s expert care and in their preferred timeline.

Our Epic system helps make scheduling for appointments and procedures easier for patients and families. We also aim to assign patients to a room as quickly as possible and ensure we can rapidly accept direct transfers of patients who need our care.

Exceptional Experience

BWHC is committed to providing patients and families with the best possible care experience—from their first interaction with BWHC to follow-up care they receive after leaving the hospital.

This includes valet services when patients or family members arrive, a seamless registration process, clean inpatient rooms, high-quality meals, compassionate and highly skilled care, among many other elements.

Highest-Quality, Safe Care

Our patients and families deserve the best possible care, which means the right diagnosis and treatment, coordinated communication with care teams, transparency and prevention of harm.

We are improving patient safety by fostering a Just Culture, where staff feel comfortable reporting errors so that we can prevent them from reoccurring. Our Safety Matters initiative encourages transparency and sharing stories about mistakes we made, what we learned from them and the improvements we are making as a result.

Affordability

The effective use of clinical, research and administrative resources and processes helps reduce the cost of care.

As part of a hospital-wide effort to reduce costs and improve efficiency, the BWH Audiovisual Service team began providing furniture moving assistance last year for internal events. The hospital had previously relied on an outside vendor. Using our in-house staff is expected to save the Brigham $60,000 this year.

Areas of Focus: Fiscal Year 2016

These areas of strategic focus position BWHC to achieve the seven objectives outlined above. Included with each description are examples of how we’re bringing these to life. For a full list of objectives, visit BWHPikeNotes.org.

Discovery & Innovation

BWHC will continue to build on our rich legacy as pioneers in patient care and research.

FY ’16 goals: Brigham Building for the Future will be completed this fall on time and on budget. Increase our number of invention disclosures from 200 in 2015 to 210 this year to advance academic, clinical and financial progress.

Leading-Edge Care Redesign

We never stop looking for ways to improve patient care.

FY ’16 goal: Implementing an initiative called “Active Asset Management,” focused on improving the effective utilization of surgical, procedural and inpatient resources; improved transfer of patients; more efficient and supportive discharge processes; and improved referral management and ambulatory access.

Business Development

Sustaining our mission requires an ongoing commitment to revenue growth and financial stability.

FY ’16 goals: Partnering with Bermuda Cancer and Health Centre to construct the island’s first radiation oncology facility. The business development team has also identified opportunities in China to lend Brigham expertise to new health systems there, greatly benefiting both organizations. Locally, we will meet our target of providing primary care for more than 200,000 patients in Greater Boston and Southeastern Massachusetts.

Our Foundation

People, Education, Skills and Capabilities

We seek to attract and retain the best staff, whose talents make our work possible.

FY ’16 goal: Strengthen the newly launched Brigham Education Institute—a central, cross-department organization launched earlier this year to coordinate medical education opportunities for our health care providers and trainees.

Financial Strength

Without a solid financial foundation, our work in carrying out our mission and achieving our vision simply isn’t possible.

FY ’16 goal: Use our existing assets wisely to generate margin and operate within our budget so that we can continue to provide exceptional, leading-edge care, regardless of external challenges.

Improving Surgical Care in Resource-Limited Countries

Filming an NOTSS training video in Rwanda

All physicians want to provide the best possible care to their patients, but clinicians in parts of the world where resources are limited can face many challenges in doing so.

Recognizing this challenge, John Scott, MD, MPH, a general surgery resident and research fellow at the Center for Surgery and Public Health, teamed up with surgeons in Rwanda to improve surgical care for patients through the Non-Technical Skills for Surgeons (NOTSS) training program. This program—originally designed in Scotland by a team of psychologists, surgeons and anesthesiologists—was created to assess and improve surgeons’ non-technical skills, such as situation awareness, decision-making, communication, teamwork and leadership.

With the help of his mentors Robert Riviello, MD, MPH, of Trauma, Burns and Critical Care, and Steven Yule, PhD, of the STRATUS Center for Medical Simulation, Scott redesigned the NOTSS program to be used in a resource-limited setting for the first time. Additionally, they collaborated with students at the KWETU Film Institute in Kigali, Rwanda, to produce an on-location video series to complement the curriculum.

“Surgery is very technical, but expert performance takes more than just cutting and stitching,” said Scott. “Before the NOTSS program, we didn’t have a reliable way to teach these critically important non-technical skills.”

Having training in skills like situation awareness, leadership and decision-making makes it easier for doctors in resource-limited settings to resolve problems that may be specific to their operating rooms, Scott says. For instance, surgeons in Rwanda see variability in the equipment they use, the personnel and assistance they receive, and the support systems they work within. This makes it difficult for surgeons to plan ahead, and they must think creatively and deal with changes very rapidly, as their access to these medical resources can change quickly.

“The long-term goal is to improve the surgical service in Rwanda so that resource variability is no longer an issue,” said Scott. “But NOTSS enables us to improve patient safety and surgical performance here and now, without waiting around for more money and technology.”

For more information about BWH’s global health initiatives, visit BWHGlobalHealthHub.org.

Indian Health Service: At the Heart of Patient Care, Teaching and Community Outreach

From left: Michael Givertz, Arnold Ketchum, Nicolette McDermott-Ketchum and Lynne Stevenson

At Northern Navajo Medical Center in Shiprock, New Mexico, physician assistant Nicolette McDermott-Ketchum, PA-C, cares for patients who are part of Navajo Nation, the largest Native American tribe in the U.S. at about 175,000 people.

About 37 percent of Navajos live in poverty. Access to specialty and preventive medical care is limited, with patients often having to travel a long distance to obtain medical services. Adding to these challenges is a lack of primary care physicians and specialists in New Mexico, Arizona and Utah, where Navajo Nation is based.

Clinicians like McDermott-Ketchum, who are part of the Indian Health Service (IHS)—a federal agency within the Department of Health and Human Services—provide care to nearly 2 million Native Americans at 35 hospitals and more than 300 health centers across the country. In 2008, the BWPO formed the Brigham and Women’s Outreach Program with the Indian Health Service. The outreach effort enables BWH clinicians to provide ongoing training and up-to-date clinical knowledge to IHS clinicians, with the goal of expanding IHS clinicians’ expertise in managing a spectrum of conditions.

McDermott-Ketchum and her husband, Arnold Ketchum, PA-C, a fellow IHS physician assistant, visited BWH last month to sharpen their cardiac care skills and heart disease knowledge in service to their patients in New Mexico. Many of their patients suffer from diabetes, high blood pressure and high cholesterol.

“I married into the tribe, and I love serving the Navajo people, who are kind, patient, resilient and family-oriented,” said McDermott-Ketchum.

During their visit, the couple shadowed Lynne Stevenson, MD, director of the Cardiomyopathy and Heart Failure Program, and Michael Givertz, MD, medical director of the Heart Transplant and Mechanical Circulatory Support Program.

“It was an amazing opportunity to observe Drs. Givertz and Stevenson in the Watkins Clinic and see the compassion and skill they demonstrated in every patient encounter,” said McDermott-Ketchum. “It is one thing to hear didactics about how clinical cardiology practice is supposed to operate, but viewing the interactions between BWH staff and their patients reinforced the knowledge with a human element. This is something I will keep in mind during my patient sessions.”

As part of the three-pronged Outreach Program, more than 100 Brigham clinicians have traveled to the Navajo Reservation in Shiprock and Gallup, New Mexico, and Chinle, Arizona, to care for patients and teach members of the local medical staff. Dozens more lead remote teaching and patient consultation sessions by video conference or volunteer to host IHS visitors here in Boston for more focused learning, says Ellen Bell, MBA, MPH, senior project manager for the Brigham and Women’s Outreach Program.

During the past seven years, 14 IHS clinicians have visited BWH to shadow clinicians across a wide range of specialties, including Emergency Medicine, Dermatology, Gynecology, Radiology and Cardiology.

“The Brigham and Women’s Outreach Program is the perfect reflection of the core values of the hospital in that we have been able to apply the expertise of our senior clinicians to improve the health of the community through teaching and clinical care,” said Tom Sequist, MD, MPH, medical director of the Brigham and Women’s Outreach Program. “Most importantly, this is not a one-way street, as our clinicians have been very vocal in expressing that they gain as much, if not more, from their experience volunteering in the program. In many ways, our program offers a life-changing experience.”

To learn more about the Outreach Program and how you can participate, visit http://www.brighamandwomens.org/ihs.

MFCDA Grand Rounds, Awards Presented

Audra Meadows

Part of BWH’s mission of providing excellent patient care involves not only identifying health care inequities that some patient populations face, but also working to eliminate those disadvantages.

Closing that gap comes with challenges, but at the 2016 Minority Faculty Career Development Award Grand Rounds, held on May 4, Audra Meadows, MD, MPH, of Obstetrics and Gynecology, shed light on potential solutions.

The event—hosted by the Center for Faculty Development & Diversity’s Office for Multicultural Careers—also included recognition of this year’s MFCDA recipients, Joseph Mancias, MD, PhD, of Radiation Oncology, and Viviany Taqueti, MD, MPH, of the Division of Nuclear Medicine and Molecular Imaging, and an honorees’ breakfast reception.

The MFCDA program, founded in 1996, provides financial support to early-career underrepresented in medicine (URM) physicians and scientists at BWH, with the goal of increasing their presence across the institution. The five-year $100,000 award is given to two URM faculty members annually, with more than 30 awards having been distributed since the program began.

During her presentation, Meadows, a 2009 MFCDA recipient, explored whether group prenatal care is the future of care in Obstetrics. Group prenatal care particularly benefits women at high risk of preterm birth and infant mortality, which includes African-Americans and women under the age of 21.

“The goals of obstetric care are a healthy mom, a healthy baby and a term delivery,” said Meadows. “But for black patients, infant mortality is higher in Boston, in Massachusetts and across the U.S. We want to know why this disparity exists and how to reduce the gap and bring infant mortality to zero.”

Meadows detailed BWH’s CenteringPregnancy® program, a partnership between BWH’s Ambulatory Obstetrics Practice and the Center for Community Health and Health Equity, which has garnered success since its launch last June. The program provides prenatal care and peer support in a group setting, as well as individual clinical evaluations and time with BWH clinicians. The women learn how to conduct self-health assessments, take their own blood pressure and record their weight. They also meet each week in groups of eight to 12, with dedicated physicians and nurses present, for 90 minutes to discuss prenatal and parenting topics.

The program is helping young women through such issues as teen pregnancy, family support and pregnancy education. Several studies have demonstrated the benefits of group prenatal care compared to traditional, individual care when it comes to pregnancy outcomes and health behaviors. Of 83 BWH participants surveyed, 100 percent reported satisfaction with their care. Additionally, the average weight of participants’ babies was a healthy 7 pounds, and the average gestation period was 39 weeks.

“CenteringPregnancy® is one of very few ongoing training programs available to expand the reach of this care model to more women, and we’re proud to be championing it here,” said Meadows.

Learn more about the MFCDA.

Operation Walk Boston Volunteers Go the Extra Mile

Kara Burge (center), a staff nurse in Orthopaedic Surgery, with two Operation Walk Boston patients

A year had passed since a young man came to the clinic with severe joint disease in his hips that left him unable to stand up straight, his torso pitched forward about 45 degrees as he steadied himself on a crutch.

But thanks in part to a group of volunteer clinicians from the Brigham, he was now running laps up and down a hallway at a hospital in the Dominican Republic, where he had received bilateral hip-joint replacement surgery through Operation Walk Boston—an orthopedic medical mission founded by Thomas S. Thornhill, MD, former chair of the BWH Department of Orthopaedic Surgery.

The program partners with Hospital General de la Plaza de la Salud in Santo Domingo to perform hip- and knee-joint replacements for patients who can’t afford the procedures. It completed its ninth mission last month.

Seeing that young man run down the hall when he came back for a follow-up visit was an unforgettable moment—one that illustrates why BWH volunteers give their time to give back, said Judith Nagle, MSN, RN, CNOR, nurse-in-charge in the Orthopaedics Operating Room who has gone on every Operation Walk Boston mission since its launch in 2008.

“When people come back and show you what they can now do that they couldn’t do last year, it just overwhelms you,” said Nagle, who took on the role of scrub nurse in the Operating Room during the trip. “I only did my job; these patients did the hard work.”

The latest mission served 37 patients and resulted in 56 replaced joints over five days. To date, Operation Walk Boston has provided 380 people with joint replacements. Clinicians perform the procedures pro bono, and all supplies are donated.

Each year, the mission takes about 50 volunteers, including surgeons, anesthesiologists, nurses, physical therapists, pharmacists and Operating Room staff. That group also includes residents from Orthopaedic Surgery, the Department of Anesthesiology, Perioperative and Pain Medicine, and Pharmacy. Additionally, the team trains about 70 medical students in the Dominican Republic to help support local care providers.

Daniel Tobert, MD, a third-year resident in Orthopaedic Surgery, went on his first Operation Walk Boston mission this year. Although the days were long, often starting at 4:30 a.m., he says the experience was fulfilling both personally and professionally.

“Everyone on the trip is giving up their free time to do hard work—and, in some respects, harder work than we’d do in a normal week—but it’s an incredibly rewarding experience,” said Tobert, who will be the mission’s chief medical officer next year.

Sarah Kelly, PT, DPT, a senior physical therapist in the Department of Rehabilitation Services, also joined Operation Walk Boston for the first time and says she was humbled by not only how grateful the patients were, but also how hard they worked during recovery. Because the volunteers are there for such a short time, they have to get patients walking as soon as possible, sometimes within a few hours of surgery.

“It’s one of those trips that reminds you why you wanted to be a physical therapist in the first place,” Kelly said. “Patients who haven’t walked in years can finally get up and sit at the edge of the bed, stand on two feet or bend their knee a little more. To help somebody do that for the first time is unbelievable.”

Julia Rodriguez, RN, a staff nurse in the Post-Anesthesia Care Unit who has gone on several Operation Walk Boston missions, says she enjoys connecting with the patients and the Dominican clinicians and medical students. She also appreciates having the opportunity to speak her second language, Spanish.

“It appealed to me: going to a country that had fewer medical services than we have and being able to do mission work for patients who can’t afford this surgery on their own,” Rodriguez said.

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Taking the Lessons Home

Volunteers say the mission also provided learning experiences they wouldn’t normally be exposed to and fostered a deep sense of teamwork. Nagle appreciated the opportunity to attend a grand rounds-style meeting where doctors discussed their plans for surgery that week.

“You get to hear their thought process, which adds a whole other dimension to my practice here at home,” Nagle said.

Learning is also a two-way street, she said. Over the years, BWH volunteers have trained hundreds of medical students in Santo Domingo and helped local practitioners improve their quality of care.

The limited resources during the mission can be challenging, but volunteers say they enjoyed having the chance to think critically and creatively to find solutions.

“It presents a situation we don’t normally have here, where you have an isolated opportunity to intervene surgically,” Tobert said. “This gives me experience in how to deal with more complex care decisions, which is something they don’t teach you in medical school.”

B.A.A. 10K: Racing Toward Life-Giving Breakthroughs

Elizabeth Matzkin

There’s a reason many people prefer to enjoy the Boston Marathon from the sidelines: Running 26.2 miles is a demanding endeavor that requires months of training through the winter and, for charity runners, a significant fundraising commitment.

While marathon running is not for everyone, other races can give runners that same euphoric feeling of crossing the finish while helping a cause—albeit with a more manageable commitment. BWH employees participating in the 2016 Boston Athletic Association (B.A.A.) 10K race, sponsored by BWH this year, say the event is far more accessible to runners—and even non-runners—who may feel intimidated by the training routines or fundraising minimums of larger races.

“You can run a 10K in one hour, or you could run it in two; there’s no rush and no pressure,” said Giorgio Giatsidis, MD, a researcher in the Department of Surgery and a plastic surgeon, who is running on the Gillian Reny Stepping Strong team. “My goal is to get to the end—it doesn’t matter to me how long it takes.”

The 6.2-mile race is on Sunday, June 26. Its route loops through Back Bay, starting and ending in the Boston Common.

Giatsidis had never tried running until last year and almost quit when he couldn’t finish one mile on his first run. But he stuck with it, and last month he completed the Boston Marathon.

To help novice and even first-time runners get ready for race day, the B.A.A. offers several training programs that can help new runners get ready for a 10K in just a few weeks, says Jonathan Hawkes, a member of the BWH Development Office who formed a team to support the Ann Romney Center for Neurologic Diseases at BWH. Because of these resources, the 10K felt like a far more realistic goal than the Boston Marathon.

“I’ve had a number of colleagues run the Boston Marathon, and I see how it brings people together,” Hawkes said. “There’s a real sense of community at events like these, and I want to be part of that experience.”

Elizabeth Matzkin, MD, an orthopedic surgeon and chief of Women’s Sports Medicine, says that with the right training plan, a 10K is doable for a healthy person who has never run a race before. She notes that runners should increase mileage and distance slowly each week, and ensure they’re meeting their nutritional needs to avoid injury during training.

“Train to finish, not for a personal record, if it is your first 10K,” advised Matzkin, who is running with “Bone” to Run, a team she organized to raise money for research and education in women’s sports medicine. “Training for a half-marathon or a marathon is a big commitment, but a 10K is a great distance for everybody.”

Putting ‘Fun’ in Fundraising

Giorgio Giatsidis

This year, BWH is the exclusive fundraising partner for the race, meaning that individuals and teams who join the BWH team will run to raise funds for the hospital. The fundraising minimum is $500, and runners can allocate funds raised to a BWH fund of their choosing, allowing them to support the life-giving breakthroughs most meaningful to them.

Giatsidis says he was initially nervous about meeting the goal but has found that fundraising is actually his favorite part of the process.

“Fundraising gives me the opportunity to reach out to a lot of people, explain why I am doing this and get their feedback,” he said. “I love the fact that I can share my motivations and passions with a lot of people I haven’t been in touch with for a long time.”

Hawkes chose to run to support the Ann Romney Center for Neurologic Diseases in honor of his grandmother, who has lived with Alzheimer’s disease for the past eight years. While his fundraising efforts are still ongoing, Hawkes says that potential runners shouldn’t be intimidated by the goal.

“Your network is larger than you think it is,” he said. “Five-hundred dollars may seem like a lot, but if you think of it in smaller increments—say, 20 donations of $25—it becomes a lot more manageable.”

To learn more or register for the B.A.A. 10K, visit www.crowdrise.com/baa10k.

BWH, JazzBoston and RTH Unite to Improve Lung Health

JazzBoston musicians perform for fair attendees.

On April 30, the BWH Lung Center, BWH Center for Pulmonary Heart Disease and JazzBoston—a nonprofit advocacy organization for Greater Boston’s jazz community—teamed up with the Roxbury Tenants of Harvard (RTH) for the first “Good Music = Good Health Jazz Fair,” a community-based health and wellness event held in RTH’s outdoor Levinson Plaza in Mission Hill. In addition to spirited musical performances, the event provided education about lung health, physical fitness and nutrition to community members.

The event is the result of the Lung Center and JazzBoston’s joint initiative in music and medicine, announced last month, to create a new model for managing and improving lung health based on the breathing and blowing techniques of jazz singers and wind instrumentalists. The April 30 event, which coincided with International Jazz Day, was a great way to kick off an important partnership, said Bruce Levy, MD, medical director of the Lung Center and chief of the Pulmonary and Critical Care Medicine Division.

“Music therapy is increasingly recognized for its holistic roles in health and healthy living,” Levy said. “We are delighted to join these outstanding community leaders in a unique collaboration that promotes music as a healing medium and expands both our organizations’ outreach to the city of Boston.”

BWHers Aaron Waxman, MD, PhD, director of the Pulmonary Vascular Disease Program; Brad Wertheim, MD, of the Center for Chest Diseases; Abbey Karin and Julie Tracy, senior exercise physiologists in the Dyspnea and Performance Evaluation Program; Eliza Shirazi, BWH health and fitness specialist; staff from Brigham and Women’s Primary Care Associates, Longwood; and others were on hand to talk with community members about their lung health. Jackie Rodriguez-Louis, MPH, MEd, program coordinator for the Partners Asthma Center, provided smoking cessation education.

More than 300 people attended and were able to participate in asthma and blood pressure screenings and exercise assessments, while performers from JazzBoston encouraged attendees to join in on the music-making. The event included an instrument petting zoo, which gave visitors a chance to hold and try out instruments, and contests and prizes for attendees of all ages. The afternoon concluded with a community concert.

“The idea is to play good music, and to do that, you need healthy lungs,” Waxman said.

The BWH Lung Center, Center for Pulmonary Heart Disease and JazzBoston have begun organizing additional community-based health and wellness fairs in Boston that integrate education and music to help raise awareness of the importance of taking care of one’s lungs and teach participants techniques for strengthening their lungs, whether they have a respiratory disorder or not.

Master teachers and performers identified by JazzBoston will also work with Lung Center physicians to develop new therapies that accelerate the rehabilitation process for patients who have chronic lung disease or are recovering from chest surgery. The musician/physician team will design and hold clinics that incorporate wind instruments, including the voice, to create a lively, motivational therapy experience.

BWHers Share Insights into Allergies and the Immune System at Cambridge Science Festival

Lesley Solomon introduces speakers at the Cambridge Science Festival.

The immune system can be a force for good—protecting the body from outside invaders—but it can also have a so-called dark side. Expert speakers explored that dark side, discussing the science behind allergies to food, medication and the environment during a session at the Cambridge Science Festival in Bornstein Amphitheater on April 20. The event, titled “The Immune System Awakens: The Force Behind Allergies,” was organized by the Brigham Research Institute (BRI) and open to the general public. The BRI has participated in the Cambridge Science Festival for the last four years with the goal of raising the visibility of BWH research and researchers within the local community.

Lesley Solomon, MBA, executive director of Brigham Innovation Hub and director of strategy and innovation in the BRI, introduced the evening’s speakers and theme for the event by sharing her personal connection to the subject: Her son has a severe food allergy to dairy, peanuts and tree nuts. Solomon noted that food allergies affect 15 million Americans and approximately one in every 13 children. From 1997 to 2011, food allergies among children rose by 50 percent.

“One of my personal goals is to make sure that over the next 15-year period, that number doesn’t increase by another 50 percent,” said Solomon.

The evening’s first speaker, Andrew MacGinnitie, MD, PhD, the clinical director of the Division of Immunology at Boston Children’s Hospital, described new thinking and therapies to prevent and treat food allergies. Previously, allergists advised that children likely at risk for food allergies should not be given highly allergenic foods until age 3, but new studies now suggest that the opposite may be true: Exposure early in life to foods like peanuts may actually prevent food allergies. A study published last year from the U.K. found that children at risk of developing allergies who were regularly given peanut snacks beginning in the first 11 months of life had lower peanut allergy rates than those who were not given peanut products until age 5.

“Our understanding and advice about allergies has changed,” said MacGinnitie. “New studies on peanut allergies offer a new way of thinking about prevention.”

Paige Wickner, MD, of BWH’s Division of Rheumatology, Immunology and Allergy, then discussed the challenges of drug allergies and potential solutions. The most commonly reported drug allergy is to penicillin; at BWH, more than 220,000 patients report having a penicillin allergy. However, studies have found that 90 to 99 percent of patients are not actually allergic when tested. Through funding from BCRISP (Brigham and Women’s Care Redesign Incubator and Startup Program), Wickner and her colleagues are working on a project to safely and efficiently administer antibiotics to patients who have a history of a penicillin allergy.

The evening’s final speaker, Juan Carlos Cardet, MD, also of BWH’s Division of Rheumatology, Immunology and Allergy, studies and treats patients with asthma. One of his research projects focuses on the connection between asthma and a diet-derived chemical known as enterolactone. Enterolactone is commonly detected in people who consume a Western diet, and new research suggests that higher rates of enterolactone are tied to lower probability of asthma. Cardet and his colleagues are exploring this connection and the role that the microbes living in the gut may be playing in asthma.

“Treatment for food allergies remains an unmet need,” said Solomon. “Diagnosis is limited and so is prognosis. We’re unable to predict if and when someone will outgrow an allergy. Our hope is that by bringing more attention to food allergies, we will create more funding opportunities and bring more scientists into the field.”

Not Just a Name on the Door: Building Meaningful National, International Relationships

Radiation Oncology’s Rose Damaskos, sr. director of Clinical Planning and Development, and Tatiana Lingos, MD, network director; Mark Davis; and Ann Egan, director of business development at DFCI.

Radiation Oncology’s Rose Damaskos, senior director of Clinical Planning and Development, and Tatiana Lingos, MD, network director; Mark Davis; and Ann Egan, director of business development at DFCI

In the last 18 months, the newly formed BWHC Business Development team has been busy assessing potential collaborations with organizations around the world that will enable the hospital’s unique expertise to benefit countless patients in new ways. These relationships are also an important means of generating new sources of revenue, a vital part of BWHC’s institutional strategy to help ensure financial stability at a time when health care organizations are faced with constant pressures to cut costs.

Mark A. Davis, MD, MS, executive director for Strategic Initiatives and Business Development, gave BWH Bulletin an inside look at the work that he and Chief Business Development Officer Steven Thompson, MBA, are doing to help BWH promote both “mission and margin” objectives.

How do you determine which relationships are right for BWH?

We are a charitable, mission-based organization that puts patients first. We apply the same principles when we decide how to work nationally and internationally. The opportunities we participate in must improve the way our collaborators deliver care to their patients, share best practices and research protocols and, if needed, transfer highly complex patients to BWHC. These guiding principles exemplify our joint mission and margin approach to growth.

Can you provide an example?

As a result of our relationship with Bermuda Cancer and Health Centre, construction is underway for the island’s first radiation oncology facility. This means that residents of Bermuda will no longer need to fly elsewhere to receive treatment. Our world-class Dana-Farber/Brigham and Women’s Cancer Center Radiation Oncology group, as well as their expert colleagues in Oncology and Urology, are working closely with clinicians on the island to ensure the best possible care is delivered at this new facility. Patients with the most complex needs who cannot receive local treatment can be seamlessly transferred to DF/BWCC for the highly specialized care we provide here.

Do you ever decline opportunities for collaboration?

Absolutely. Each opportunity must be aligned strategically with BWHC’s priorities for the future. Deals that are a no-go may seem fantastic on paper in every way except one—they’re not consistent with our mission.

You mentioned Bermuda. Where else are we forging relationships?

Our Pediatric Newborn Medicine team is exploring the development of a program focused on high-risk fetal and newborn medicine in Florida. We are also now entering the first phase of work with the Evergrande Health Industry Group in China, which will be building a hospital that will be the flagship of a new health care system. Additionally, we are considering a number of other opportunities in various places, including Asia, the Middle East and South America. In many cases, these potential partners wish to build or augment their local capabilities.

Tell us more about the relationship with Evergrande.

Evergrande is the second-largest real estate group in China, and it recently expanded into health care. Evergrande leaders approached us about joining as strategic advisors to help guide them as they seek to ultimately build a network of hospitals and web-based patient support systems. This includes new technologies that will enable BWHC staff to remotely provide second opinions on complex medical conditions to patients through their local physicians.

Why is collaborating with a real estate group the right fit for BWH?

We are actually working with the health care company that is part of that group. The relationship utilizes their experience with development in China and our expertise in health care delivery and research to improve health in China. There’s a real need to advance the health care system in China. It’s not uncommon to see hundreds of patients lined up to literally spend just a minute or two seeing a doctor. They get a quick opinion, and the doctor has to move on because of that tremendous volume of patients. We want to be part of a relationship that will help evolve that system with committed local collaborators. We’ve had very open conversations with Evergrande leadership about the purpose of our agreement before we began. We both agreed that BWHC’s role is to help them create a system of hospitals grounded in evidence-based practices.

Who from BWH will be involved?

Our administrators, physicians, nurses, scientists and many other staff will have the opportunity to teach and learn as this relationship evolves in many elements—academic, clinical development and appropriate transfer of patients to BWHC. We will have a true exchange of ideas and visits with health care professionals from China as the next phases of work get underway. I have no doubt that each side will learn from the other.

What opportunities are there for research?

When Evergrande builds its first hospital, the plan is to construct a co-located research facility. You can imagine the tremendous innovation that will result. The diagnostics and therapeutics will be cutting-edge. We will be working closely with the hospital and leading academic institutions in China on research and clinical care.

How can people get involved with the work you’re doing?

Given the talents of our staff here at the Brigham, we want to involve as many people as possible. The idea of business development is to harness the creative ideas of all of our talented staff members, along with our collective national and international contacts, and build relationships that advance our mission while supporting our margin. I encourage staff to reach out to me directly with ideas and questions.

What are you most excited about?

I’ve been at BWH for almost 20 years, and this is truly an extraordinary time. We are limited only by our ability to think differently. The traditional ways of operating give us a foundation upon which to build, but now is the time to evolve our approach so we can ensure the Brigham will thrive and continue to advance health for generations to come.

Exploring Telemedicine to Benefit Patients

Endocrinologist and Brigham Diabetes Program Director Marie McDonnell conducts a video visit with one of her patients.

If you asked Adam Licurse, MD, MHS, five years ago about telemedicine—the remote diagnosis and treatment of patients by means of mobile and telecommunications technology—he may have likened it to a science project.

“It has long been a cool idea, but the technology was not that good and the workflow was clunky,” said Licurse, a primary care physician at Brigham and Women’s Advanced Primary Care Associates, South Huntington, assistant medical director of the BWPO and associate medical director of Partners Population Health Management. “Providers were not reimbursed for their time, and the demand just wasn’t there.”

Contrast this notion with today, with advanced video technology that works as well as Skype and FaceTime and a clear demand from patients and providers to have new ways to connect with each other outside of the traditional health care setting.

“Telemedicine has taken off,” said Licurse. “A lot of doctors and practices are becoming really excited about it, and we’ve hit a point where patients are hearing about video visits and other technologies through media and their health plans and asking their physicians about them.”

BWH has been exploring telemedicine through several BWPO-led pilots for the past two years. These pilots consist of video visits and e-visits between providers and patients, as well as video consults and e-consults between providers.

“There is a large and growing group of departments and divisions at BWH that are offering video visits to replace or supplement outpatient visits for certain groups of patients,” said Jasdeep Sahota, MSc, EMBA, senior project manager for the BWPO. “The Department of Medicine, including Endocrinology, Gastroenterology and Primary Care, is the largest group, and the departments of Surgery and Psychiatry are also exploring these tools.” Fifteen to 20 additional groups are expected to begin using video visits in the next six months.

E-visits are underway through Partners Patient Gateway. Instead of patients asking their providers questions through the portal’s email functionality, patients use Patient Gateway to fill out a questionnaire that simulates the questions that clinicians would ask during an in-person visit. When providers later answer their patients’ questions via the portal, they have much more information at their disposal thanks to the robust questionnaire, which on the provider side is integrated into Partners eCare.

Provider-to-provider video consults are used when clinicians at different institutions need to connect with each other about a shared patient, sometimes directly involving that patient in the video encounter, such as through BWH’s current pilot with Spaulding Rehabilitation Hospital. The effort is focused on improving patient care and avoiding unnecessary hospital readmissions.

Lastly, through provider e-consults, primary care providers can get feedback from specialists on specific patient cases to see if a referral to a specialist is necessary. This type of communication has been happening informally for years but is now formalized through Partners eCare, with many primary care physicians and specialists participating.

“These tools are helping providers create more access for patients in their clinics,” said Sahota. “Video visits and e-visits are more convenient for patients who struggle to get into the city, and follow-up visits are quicker and easier for patients.”

Licurse says these tools also allow providers to better meet patients where they are, helping to make health care more patient-centric and lower-cost.

“At the highest level, these tools translate into better care for appropriate patients,” said Licurse. “With more tools for self-care, patients feel more engaged and empowered to participate in their care. Our goal is to continue to use these tools to tailor our care based on the unique populations we serve.”

BCRISP Lung Cancer Pilot Sees Success and Will Expand

From left: Piper Orton, Katie Armstrong, Yolonda Colson, Cheryl Arena and Sophie-Charlotte Hofferberth, of BWH’s Lung Cancer Strategist Program

When it comes to lung cancer diagnosis, time is of the essence. But due to the complexity of the disease and individual barriers to care, a portion of BWH’s lung cancer patients are at higher risk of falling through the cracks and losing contact with the hospital leading up to and after diagnosis, says thoracic surgeon Yolonda Colson, MD, PhD.

In 2014, thanks to the Brigham Care Redesign Incubator and Startup Program (BCRISP), Colson and her team launched a pilot study called the Lung Cancer Strategist Program (LCSP) to help these vulnerable patients. Established in 2013, BCRISP is an initiative in which teams of frontline clinicians submit proposals for projects that improve quality of care and reduce health care costs.

The LCSP is a patient-centered approach to lung cancer care for vulnerable patients—racial and ethnic minorities, patients with a physical disability or mental illness, individuals with language barriers or difficulties with transportation, and others. These patients are referred to the LCSP by a primary care physician or other care provider, and a dedicated thoracic surgery physician assistant serves as a clinical strategist. The clinical strategist works with a group of physicians and surgeons to create a care plan and then coordinates care for each patient.

“The program is our way of changing the system,” said Colson, who directs the Women’s Lung Cancer Program. “Many of these patients don’t need multiple tests or hospital visits, but rather, more coordinated care. We are streamlining the system and being strategic about the fastest way to get patients the care they need and make it easier for them to access it.”

Once patients are referred to the program, relevant testing is arranged, and patients are often seen on the same day by a multidisciplinary care team tailored to meet their unique needs. The team may consist of a pulmonologist, radiation oncologist, medical oncologist, social worker and other specialists.

“The clinical strategist, Cheryl Arena, PA-C, has extensive expertise in working with lung cancer patients and is able to identify barriers to care and the treatment goals for each patient,” said BWH Surgery resident Sophie-Charlotte Hofferberth, MD, who helped launch the LCSP program with Colson. “The clinical strategist provides a streamlined work-up and organizes the right team around each individual patient, so that at the first clinic visit, each patient is seen by those specialists who are going to be involved in his or her care throughout treatment.”

During the six-month pilot, the LCSP cared for 11 high-risk lung cancer patients. Many of these vulnerable patients previously did not receive treatment for several months due to the logistics of multiple tests and missed appointments, but within the LCSP, the average time to diagnosis was only 15 days. Additionally, LCSP patients received treatment for their lung cancer in an average of one month, as opposed to five months before the pilot. Hofferberth says the pilot study results are highly encouraging and that the team is eager to move on to the next phase—one of the goals of which is to care for at least 50 new patients through LCSP in the coming year.

Since the LCSP pilot ended last year, there have been ongoing referrals to the program. The team will be appointing a new thoracic surgery physician assistant to serve as the dedicated clinical strategist going forward in order to increase referrals and services, and it also hopes to establish key performance metrics for each stage of the program so that it can be reproduced as a model for other programs and institutions.

“We’ve been extremely fortunate to receive funding through BCRISP to enable us to launch the program, and we are excited to be moving to the next phase,” said Hofferberth. “The goal of the program is meeting the needs of high-risk groups of patients using a clinical strategist-led care model beyond the Brigham and ultimately improving care for all patients with lung cancer. BCRISP has been a fantastic support.”

Learn more about BCRISP.

BWH Nurse Comes to Aid of Local Student on MBTA Bus

Michael McKenery

When Michael McKenery, BSN, RN, a clinical research nurse in BWH’s Center for Alzheimer’s Research and Treatment, stepped on the bus to go to work one morning last month, he didn’t realize he would end up coming to the aid of a local high school student onboard.

The crowded bus was on its way to the Longwood Medical Area when McKenery noticed a young passenger who was standing near him begin to fall and convulse. He and another nurse on the bus were able to reach the student before she fell completely and slowly lowered her down to the ground, protecting her head from injury.

“The whole incident lasted about 10 to 15 seconds; she came to very quickly but was disoriented and scared,” said McKenery, who also works in BWH’s Infusion Center. McKenery then asked the student questions to reorient her, such as if she knew the name of the president and the day of the week.

When she was ready, the student sat up with McKenery’s help. He called her mother, learning that she had no history of seizures. The bus driver, who had pulled the bus over to the side of the road, called the student’s school to ensure that a police officer could meet her at her bus stop and take her to the school nurse. McKenery, who was an EMT before becoming a nurse and is currently pursuing a master’s degree in adult geriatric primary care, said he was relieved the student was ultimately fine.

“What Michael demonstrated is that being a Brigham nurse is not a job, but rather a way of living and being in world,” said Jackie Somerville, PhD, RN, FAAN, chief nursing officer and senior vice president of Patient Care Services. “Michael is a great ambassador for our practice beyond our walls.”

BWH Employees, Local Students Participate in Job Shadow Day

From left: BWH employee Shauntéa Turner with Community Academy of Science and Health senior Lisea Scales

On March 11, local high school students had the opportunity to shadow BWH employees and learn about various jobs in the medical field during the 21st annual Job Shadow Day.

Hosted at BWH by Workforce Development, Job Shadow Day is a city-wide initiative of the Boston Private Industry Council that connects local youth and adults with education and employment opportunities.

BWHers from across the institution, including the Office for Sponsored Staff and Volunteer Services, Department of Medicine, Primary Care and Radiology, were paired with students from local schools in Boston for a half-day of shadowing and learning.

During a tour of the hospital with Shauntéa Turner, program and training coordinator for Sponsored Staff and Volunteer Services, Lisea Scales, a senior at Community Academy of Science and Health in Dorchester, talked about her desire to pursue pulmonary nursing someday. Scales said she learned a lot about the field after taking care of her father, who suffered from chronic obstructive pulmonary disease before passing away.

“My dad motivated me to help others,” Scales said. “I was in charge of changing his oxygen tanks and tubes. To have the opportunity to participate in Job Shadow Day and learn more about the hospital is very important to me.”

In Radiology, Victoria Glassman, director of Education, reviewed X-ray images with Sergio Molina, a junior at Josiah Quincy Upper School in Boston, and spoke with him about the field. Molina hopes to one day become an MRI technologist.

At Brigham and Women’s Primary Care, Longwood, which opened its doors last June, Ferlisa Comas, a senior at Margarita Muñiz Academy in Jamaica Plain, and Mahogany Northcross, a junior at Josiah Quincy Upper School, received a tour of the practice from Medical Director Larissa Nekhlyudov, MD, MPH. The students spent the rest of the morning learning about the practice’s team-based approach by shadowing providers, nurses and medical assistants. Comas hopes to pursue nursing, and Northcross hopes to become a pediatrician.

View a photo gallery from this year’s Job Shadow Day.

AMMP Honors Scholarship Award Recipients

BWH President Betsy Nabel (fourth from left) with AMMP awardees (from left) Eunice Charles, Kimberly Olmilla, Lucy Kirakous, Maxine Rose, Loren Valdez, Rhonda Glenn and Deborah Sitter. Not pictured: Award recipient Jahkia Yancey.

The Association of Multicultural Members of Partners (AMMP) recently celebrated its 2015 Scholarship Award recipients during its annual Scholarship Award Breakfast in the Zinner Breakout Room on March 7. BWHC President Betsy Nabel, MD, presented the awards to scholarship recipients during the ceremony.

AMMP is committed to the advancement, retention, recruitment and development of multicultural professionals into leadership roles across Partners. Founded in 1998, the group provides scholarships to help expand access to a variety of career opportunities within Partners. The award provides financial assistance to multicultural staff members pursuing professional certificates, associate or bachelor’s degrees.

“I admire you for taking on the challenge of pursuing a degree while working and, in some cases, supporting a family at the same time,” said Nabel. “It is very important to me to create a work environment where all individuals have every opportunity to develop themselves into the people that they want to be. I am so proud of all that you have accomplished and wish you the best of luck.”

The award recipients are Eunice Charles, of the Emergency Department; Rhonda Glenn, of Rehabilitation Services; Lucy Kirakous, of the Fish Center for Women’s Health; Kimberly Olmilla, of Patient Care Services; Maxine Rose, of the ICU Float Pool; Deborah Sitter, LPN, of Dermatology; Loren Valdez, of Obstetrics and Gynecology; and Jahkia Yancey, of the Connors Center for Women and Newborns. At the ceremony, Nabel also thanked AMMP volunteers for their integral work benefitting the BWH community.

To learn more, email BWHAMMP@partners.org.

Donations Stack Up for Brigham Baby Academy

Nearly 2,000 books have been donated to the Brigham Baby Academy, a program introduced earlier this year that seeks to prevent language delays among NICU babies by ensuring they are read to at least once a day. NICU families are also discharged with several new books for parents to read to their babies at home. Members of the design firm Tsoi/Kobus & Associates recently delivered a generous donation of books to the NICU and Department of Pediatric Newborn Medicine. To make a donation of your own, bring a new or gently used book to the Connors Center for Women’s Health security desk on the Lower Pike, or visit giving.brighamandwomens.org/nicu-reading-program.

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Studying Asthma Intervention in African-Americans, Hispanics and Latinos

Elliot Israel

More than 25 million people in the U.S. suffer from asthma. Asthma attacks, also known as exacerbations, lead to days lost from work or school, impact people’s quality of life and account for 50 percent of asthma health care costs.

“African-Americans and Hispanic/Latinos bear a disproportionate share of morbidity and mortality with two to three times the death rate from asthma as Caucasians,” said Elliot Israel, MD, director of Clinical Research in BWH’s Pulmonary Division. “Despite the introduction of national guidelines for asthma treatment, the gap between these groups and white people has been stagnant at best or widening.”

For his work to address this problem, Israel recently received a $13.9-million, five-year funding award from the Patient-Centered Outcomes Research Institute (PCORI)—an independent nonprofit authorized by Congress in 2010. PCORI’s mission is to improve the quality and relevance of research available to help patients, clinicians and policy makers make informed health decisions. The organization funds comparative effectiveness research (CER)—research that compares existing health care interventions to determine which work best for which patients and which pose the greatest benefits and harms.

Israel says that patients with asthma typically use a reliever inhaler, often called a puffer, to ease symptoms such as wheezing or being out of breath. One way to prevent exacerbations is by using another puffer called an inhaled corticosteroid, or ICS, each day. However, many asthma patients don’t do this; they often feel well enough without it or worry about overusing a medication they don’t believe is necessary.

Israel is investigating a new strategy that presents an alternative to using an ICS inhaler every day. With this approach—called the Patient Activated Reliever-Triggered Inhaled CorticoSteroid (PARTICS) strategy—patients use the ICS inhaler at the same time they use their reliever puffer. Israel’s study is the first attempt to test the effectiveness of the strategy in real-world situations.

“In small studies in controlled situations, the PARTICS strategy has been shown effective at controlling asthma and preventing exacerbations,” said Israel. “We don’t yet know if PARTICS will work in real-world situations.”

The study, called the Patient Empowered Strategy to Reduce Asthma Morbidity in Highly Impacted Populations, seeks to find out if the PARTICS strategy, in addition to provider education, reduces exacerbations among African-American and Hispanic/Latino adults better than provider education alone.

The study will recruit 1,200 African-American and Hispanic/Latino participants 18 years or older with asthma who are using an ICS or who have had an exacerbation in the past year. Their physicians will receive supplemental training about how best to treat asthma. Patients will be randomly chosen to follow the PARTICS strategy in addition to receiving education-enhanced care for asthma, or to receive provider-educated care only. Both groups will complete monthly questionnaires for 15 months. The research team will compare the number of exacerbations in both groups to determine which treatment strategy works better and will also look at days lost from work, symptoms and asthma control.

Notably, two groups of patients from impacted populations have been contributing to the study design, implementation and recruitment by taking part in regularly scheduled conference calls and in-person meetings.

“We are excited to be able to test an approach that is patient-centered and that we believe will help reduce the burden of asthma,” said Israel.

BWH’s V-Day Event on Human Trafficking Enlightens, Inspires

From left: Ellen Golden, Hanni Stoklosa and Jasmine Grace Marino

Though it may seem like a faraway issue, human trafficking—defined as the recruitment, acquisition, harboring or transporting of adults or children by improper means such as force, fraud or deception, with the aim of exploiting them for profit—happens here in the U.S., including in Boston.

On Feb. 12, BWH hosted an event in honor of V-Day, a global movement dedicated to ending violence against women and girls. The BWH event featured a compelling presentation by a survivor of human trafficking, followed by a panel discussion of how trauma-informed care can better identify and heal survivors of violence and human trafficking. Of the 21 million victims of human trafficking around the world, up to 88 percent report having interacted with a health care provider during the time they were being trafficked.

Survivor and advocate Jasmine Grace Marino was once one of these victims. During the five years when she was being trafficked, Marino had many appointments with her primary care physician at another hospital, but the physician never noticed the signs or the danger she was in, which included brainwashing, violence and the threat of violence by her trafficker.

“Human trafficking is hidden in plain sight,” said Marino, who, at 19 years old, first met the man who would become her trafficker. He paid her attention and treated her like a girlfriend at first, said Marino, who had experienced sexual violence in the past. “We were both coming out of a broken system.”

Marino has since founded a nonprofit called Bags of Hope, which provides basic needs and resources to women who are victims of trafficking.

“Human trafficking victims present in many clinical settings, including emergency medicine, OB/GYN, psychiatry, and primary and urgent care,” said panelist Hanni Stoklosa, MD, MPH, an attending physician in the Department of Emergency Medicine and a member of the Division of Women’s Health. “Health systems need to develop frameworks to better care for this highly vulnerable population.”

Annie Lewis-O’Connor, PhD, NP, founder and director of the BWH Coordinated Approach to Recovery and Empowerment (C.A.R.E.) Clinic, highlighted the importance of trauma-informed care—an approach to patient care that recognizes the presence of trauma symptoms in patients and acknowledges the role that trauma has played in their lives. She also shared some of the new approaches she and her C.A.R.E. Clinic staff are using to engage patients in their care, such as texting patients to check in on them between appointments.

“Each visit with a patient is an opportunity to act in a trauma-informed way,” said panelist Eve Rittenberg, MD, medical director for Primary Care at the Fish Center for Women’s Health. “That patient-clinician relationship is at the core of what patient care should be.”

Ellen Golden, MSW, LICSW, Emergency Department lead social worker, also lent her expertise to the panel, which was moderated by Paula Johnson, MD, MPH, executive director of the Connors Center for Women’s Health and Gender Biology and chief of the Division of Women’s Health.

Using Past Successes as a Guide: Walls’s First Year as COO

Ron M. Walls

Since becoming executive vice president and chief operating officer of Brigham and Women’s Health Care in January 2015, Ron M. Walls, MD, has set his sights on working with BWHC President Betsy Nabel, MD, to steer the institution through the nation’s troubled health care landscape. As founding chair of the Department of Emergency Medicine at BWH, Walls is more than prepared for the task.

“Running a hospital, as is the case in Emergency Medicine, requires everyone to have shared goals,” said Walls, who was Emergency Medicine chair for 21 years. “You need to create a plan based on those shared goals and be willing to execute it, even when you have incomplete information. You need to know when to hold the course, even when others are uncertain, but also when to reassess and to have the courage to change the plan if it’s not right.”

In his current role, Walls’s renowned leadership, composure and strategic expertise gained a broader focus: two hospitals, two ambulatory care centers, more than 160 outpatient practices, more than 18,000 employees and a growing number of national and international affiliations. He is inspired by the institution’s storied legacy of turning obstacles into opportunities.

“The Brigham has accomplished so many firsts in health care, like the first human organ transplant and the discovery that aspirin can prevent heart attacks,” he said. “We need that kind of vision and determination to develop the new competencies and courage to launch the next era of academic medicine.”

Walls faced a number of challenges in his first year. Last February’s snowfalls established new records and crippled access to ambulatory services, eventually costing millions of dollars in lost revenue. The BWHC-wide deployment of Partners eCare from May through the end of the year was one of the biggest health IT implementations in Epic history and required outstanding effort from thousands of personnel across the system. On top of this, changes in the external payer environment presented new barriers to achieving financial success and required extensive planning to confront.

As fiscal year 2016 began in October, it was clear that new management systems were essential if BWHC was to continue to generate the margin required to meet its research, education, community service and clinical care missions. With the support of senior leaders and chairs, Walls initiated a new program of “active asset management” to allow BWHC’s many providers to make more effective and efficient use of facilities, providing better care for more patients. The program will fine-tune or redesign, as needed, oversight and management of all key areas, including operating rooms, procedural areas, inpatient beds, ambulatory specialty and primary care access, among others. Teams have begun work in these areas, and a weekly meeting of several department chairs with senior administrative and clinical leaders provides timely analysis and tactical planning to improve performance.

As his team pursues new business models and efficiencies, Walls draws on his Emergency Medicine successes to drive progress. During his tenure as chair, the department grew from four board-certified emergency physicians to more than 50, and annual patient volume more than doubled, from 38,000 to more than 80,000. The department was completely redesigned and rebuilt, implementing new and innovative care programs.

But the growth came at a cost. While quality and safety metrics were excellent, the clinical space for such high patient volume was undersized by nearly 50 percent, resulting in patient wait times of more than an hour and satisfaction ratings as low as the sixth percentile nationally.

To address this, Walls led an 18-month redesign to improve value and efficiencies at every step of the patient journey. By 2011, more than half of the department’s patients were in a bed within nine minutes of arrival, and patient satisfaction soared to the 99th percentile nationally.

These victories inspire Walls to lead BWHC toward future breakthroughs.

“In the beginning and in the end, it is all about people,” he said. “We are extraordinarily fortunate to have the absolute best talent here: in the administrative leadership team, in our chairs, among our care providers and researchers, and throughout our entire system. That, really, is the secret to success.”

Additional Partners Urgent Care Centers Open in Newton, Watertown

Partners Urgent Care opened its first urgent care center last year in Brookline’s Coolidge Corner. Two additional centers opened this past December at 11 Mt. Auburn St. in Watertown and 71 Needham St. in Newton.

Partners Urgent Care is a collaboration between Partners and MedSpring Urgent Care—a national urgent care provider that focuses on delivering excellent medical care, convenient service and value to patients. In addition to the Boston-area sites, MedSpring operates more than two dozen urgent care centers in Austin, Chicago, Dallas-Fort Worth and Houston.

The centers offer patients affordable, high-quality health care alternatives to emergency rooms. They also support primary care physicians whose patients need non-emergency care after normal office hours.

“We had 15 patients on our first day,” said Julia Sinclair, MBA, senior vice president of Clinical Services at BWH and executive administrator of Partners Urgent Care, referring to the Coolidge Corner location. “The average daily volume in September was 29 patients per day; by December, it was 47 patients per day. We are hearing that patients appreciate the comfort of the facility, as well as the convenience, both in terms of location—it’s right in front of an MBTA Green Line stop—and efficiency—they appreciate being able to be seen quickly.”

Partners Urgent Care centers provide medical care to adults and children over 1 year old. Physicians are on-site from 9 a.m. to 9 p.m. every day, including weekends and holidays. Providers treat a wide range of illnesses and injuries, from coughs and colds to cuts and broken bones. All centers are equipped with digital X-ray and on-site lab capabilities in addition to occupational health services. Also offered are amenities such as free Wi-Fi, snacks and beverages and children’s activities.

Walk-ins are welcome and same-day appointments are available. Patients covered by most commercial and public insurance plans can be seen at any Partners Urgent Care location. The center is open to everyone, however, not just existing Partners patients.

All locations are operated under the clinical and quality oversight of Partners HealthCare, BWH, MGH and MedSpring. Patients who require follow-up can receive care elsewhere within the Partners system or be referred back to their primary care physician or another health practice or community health center.

Partners Urgent Care expects to open additional centers in Eastern Massachusetts in the coming year. For more information, visit partnersurgentcare.org.

Ways to Wellness at BWH

Center for Community Health and Health Equity staff

All last month, BWH Bulletin asked BWHers to submit photos of their ideas of wellness for a photo campaign called “Your Health: What’s Your Wellness Choice?” From snapshots of quiet moments spent practicing yoga or flats fishing and plates filled with healthy offerings to people hiking, biking and competing in Spartan races, Bulletin received a variety of responses showcasing what wellness means to members of the BWH community.

The Center for Community Health and Health Equity (CCHHE) shared a staff photo with the quote: “Wellness for us is when people of all ages are valued and engaged, and our neighborhoods and families are at peace. We work together with all BWH staff to ensure racial and ethnic health inequities are eliminated.”

Beth Klos, RD, LDN, CDE, of Nutrition, shared a photo of a homemade Mexican-inspired dish, consisting of white fish with cilantro and lime, jicama and chili powder, and pineapple. “When I make a healthy meal, I sometimes try to mimic the culinary traditions I’ve enjoyed while traveling. The meal is not only a healthy and balanced plate but also a delicious souvenir.”

Spanish interpreter Rebecca Leiter, CMI, shared that she enjoys riding her bike from Newton to work each day. “It gives me time outside, some exercise and relaxes me. I also don’t pay for parking or deal with rush-hour traffic.”

For Psychiatry resident Claire Twark, training for triathlons is a major component of wellness.

BWH Food Services staff shared that they seek to cultivate a sense of wellness among employees, patients, families and visitors.

“The goal is for dining services at BWH to be integrated with the hospital’s mission of overall health and well-being,” said chef Peter Lamb, director of Food Services. “We have already introduced a variety of mindful recipes that use lots of fresh ingredients, and we are excited to offer meals that celebrate cultural diversity in the upcoming new Cafeteria space.”

Lamb and the Food Services team are looking into farm shares as a means of bringing in a variety of locally grown fruits, vegetables and dairy products. In addition to an upgraded menu, the new Cafeteria’s physical space will be transformed with more windows and light, creating a respite for guests, after renovations occur in the coming months.

“People use the Cafeteria as a place to take a break and relax,” said Ken Coder, operations manager for Food Services. “We want it to be a calming environment for our staff, patients and visitors.”

BWH offers a variety of wellness resources, including walking maps, online health assessments and workshops, desk yoga instruction, a smoking cessation study, running club, ergonomics training, spiritual care and employee assistance programs, and more. Learn more about employee wellness resources at BWH. View the photo gallery.

From left: Thoracic Surgery’s Corinne Gustafson and Yifan Zheng find wellness atop Mt. Monadnock in New Hampshire.

Zika Virus 101: Learning More From BWH’s Paul Sax

Paul Sax

BWH Bulletin recently sat down with Paul Sax, MD, clinical director of the Division of Infectious Diseases, to learn more about the Zika virus.

Can you tell us about the Zika virus, including its symptoms and how it is spread?

Zika virus is a tropical infection spread by mosquitoes. It’s been known since the 1940s, but it only recently entered the Western Hemisphere. The largest outbreak so far has been in Brazil, but it has now been observed throughout much of South and Central America and the Caribbean. When symptomatic, the illness tends to be mild, with some people noting fever, headache, rash, joint aches and red eyes; 80 percent of people have no symptoms at all.

The reason Zika is getting much attention is that the infection in pregnant women may lead to a potentially serious complication in their babies called microcephaly. Babies with microcephaly have abnormally small heads and may have multiple neurologic problems as well. As a result, it is potentially a very severe condition, though some children with microcephaly have mild or no impairment. The reported rates of microcephaly in Brazil have recently increased 20- to 30-fold; it’s not clear if this is related only to Zika or whether a greater awareness of the problem has led to increased reporting of microcephaly. Probably both are contributing.

Does Zika virus cause microcephaly?

This has not been proven, but the association is strong enough that the Centers for Disease Control and Prevention (CDC) has made a recommendation that women who are pregnant or trying to become pregnant should not travel to countries where Zika virus transmission is occurring. These countries include Mexico and many in South and Central America, such as Costa Rica, as well as some of the Caribbean islands, including Puerto Rico and the Dominican Republic. The list is being updated frequently, so women who are pregnant or planning to become pregnant should consult the CDC website before traveling. The World Health Organization (WHO) has given the Zika virus the same designation as it did for Ebola: a public health emergency.

Should people who are not pregnant or trying to become pregnant also avoid these countries?

There is no reason for U.S. travelers to avoid going to places where Zika virus transmission is occurring if they are not pregnant and not trying to become pregnant. As mentioned above, four out of five people who are infected develop no symptoms at all; many who do experience a mild viral-like illness.

Do you expect Zika virus to spread in the U.S.?

Yes. The mosquito that most efficiently transmits Zika virus is the Aedes aegypti mosquito and can be found in the southern U.S., specifically in Florida and the Gulf states. This type of mosquito doesn’t find its way much north of that. A reason that Zika transmission in the U.S. will likely be of smaller magnitude is that we have greater resources to control mosquitoes than many tropical countries and far more widespread air conditioning. Still, I have little doubt that there will be cases of Zika virus in this country affecting those who have not travelled to countries with Zika virus transmission, but it seems unlikely there will be an epidemic anywhere near the scale we’re seeing in tropical countries. The cases so far in the U.S. have been related to travel or, in very rare instances, sexual transmission.

Who is being tested for the virus?

The patients for whom testing is recommended are pregnant women who have had an illness consistent with Zika virus and who have traveled to a region where Zika transmission is occurring. Testing must first be cleared by the Massachusetts Department of Public Health; it is then being done at CDC. There is no local testing yet, but I expect there will be more widespread testing in the future. It is recommended that all pregnant women who have traveled to these regions notify their providers and have fetal ultrasound monitoring; this is commonly done here anyway.

Can people become re-infected by the virus?

Much is still not known about Zika, but if it is like many other viruses, the first time the infection occurs is most likely the period of greatest vulnerability. Indeed, many viral infections induce lifelong immunity, and second infections are rare. Once an infection becomes widespread in a community, many of the first infections happen during childhood, and hence women of childbearing age would already be immune. This is one theory why the association between Zika and microcephaly had not been noted in Africa.

If people travel to one of the countries where Zika virus transmission is occurring, is there anything they can do to protect themselves?

The best prevention is to try to minimize mosquito bites. Recommended measures include residing in air-conditioned settings as much as possible, use of insecticides at all times and wearing long pants, long sleeves and hats. There is excellent specific information on how to avoid mosquito bites on the CDC website.

Learn more on the CDC website.

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BWH Celebrates Dr. King’s Legacy with Music, Special Tribute

Orchard Garden Elementary School first-graders

Listen to Orchard Garden Elementary School students recite a portion of Dr. King’s “I Have A Dream” speech:

On the morning of Jan. 19, BWHers gathered in Bornstein Amphitheater for the hospital’s annual celebration of the Rev. Dr. Martin Luther King, Jr. During the celebration, BWHC President Betsy Nabel, MD, announced that she, along with BWFH President Michael Gustafson, MD, MBA, have signed the #123forEquity Pledge to Eliminate Health Care Disparities, sponsored by the American Hospital Association (AHA).

“Dr. King’s spirit is very much alive today in our hearts and minds as we at Brigham and Women’s Health Care work to reduce disparities in health care and improve the health of our communities locally and globally,” Nabel said. “As a country and as a community, we have made significant progress in achieving Dr. King’s vision of a more just society, but I think we can all agree that there is still work to be done.”

The AHA and four national partners in the Equity of Care initiative encourage hospitals to take the pledge to work to accelerate achievement of the three areas of the initiative’s call to action: increasing the collection and use of race, ethnicity and language preference data; increasing cultural competency training and increasing diversity in governance and leadership.

Nabel said BWHC is committed to identifying health care disparities and strengthening efforts to address inequality: “Our goal is to ensure the health and well-being of the communities we serve.”

The moving tribute to Dr. King, presented by the Association of Multicultural Members of Partners, also included several attendees from around the room reciting inspirational Dr. King quotes and a gospel concert performed by Gary Lyon and Living Water.

2016 BWH YMCA Achievers Award recipient Neldine Alexandre, MS, BSN, RN, of Tower 11, was also honored at the event. Alexandre, a nurse-in-charge, received the award for her various volunteer activities, including serving as a mentor for Roxbury Community College (RCC) students as part of BWH and RCC’s mentoring partnership, which focuses on increasing diversity of the nursing workforce at BWH.

Another highlight of the tribute was a passionate and powerful recitation of a portion of Dr. King’s well-known “I Have A Dream” speech by Orchard Garden Elementary School’s first-grade class. Dressed in their school uniforms, students lined up in two rows at the front of Bornstein and enthusiastically recited the speech, which received a standing ovation. Guided by their teacher, Mrs. White-Dottin, the students have also presented the address to Gov. Charlie Baker and President Barack Obama.

Gary Lyon and Living Water

Listen to the students’ full recitation:

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BWHers’ Generosity Makes United Way Campaign a Success

United Way committee member Earl Strong presents campaign donor Judy Walls, of BWH’s Medical Library, with a raffle prize.

This past fall, BWH held its annual campaign for United Way of Massachusetts Bay and Merrimack Valley, raising a grand total of $206,215.

United Way improves the condition of the communities that BWH serves by focusing on three building blocks of strong, vibrant communities: ensuring that all families have the resources and opportunities to lift themselves out of poverty, preparing children to enter school ready to learn and succeed, and supporting youth to stay in school and realize positive options for their future.

Lisa Morrissey, MBA, BSN, RN, associate chief nurse of Perioperative Nursing and Procedure Areas, Stan Ashley, MD, chief medical officer, and Allen Smith, MD, MS, president of the Brigham and Women’s Physicians Organization, co-chaired the campaign, the theme of which was “BWH and United Way: United We Can.” Throughout the six-week campaign, donors won a host of raffle prizes, including a football signed by New England Patriots quarterback Tom Brady.

The co-chairs thanked the United Way committee and ambassadors who donated their time, describing them as a critical part to making the campaign a success.

Listen to what United Way means to BWHers in their own words below:

Bill Churchill, MS, RPh, chief pharmacy officer for Brigham and Women’s Health Care, said through his work in leading multiple United Way campaigns he’s learned how the organization helps people.

Judy Walls, of the BWH Medical Library, feels good knowing that her donations are helping children and families in need.

Stephen Moore, PhD, of Radiology, talks about the importance of donating to organizations that support the local community.

Annemarie Austin, RN, business director of Clinical Operations in the OR, volunteered at the United Way rolling rally raffle cart and ice cream social.

Luis Soto, director of Environmental and Central Transport Services, said it is a great feeling being able to help others.

Sarah Abbett, MD, MPH, clinical consultant with the Brigham and Women’s Physicians Organization, supports United Way because the organization supports local families.

Tao Harris, senior OR administrative assistant, and his colleagues donated funds from a Fitbit contest to the United Way.

Ellen Bergeron, MSN, RN, program director at the Center for Nursing Excellence, supports United Way because many of the programs support the physical, academic and emotional development of individuals of all ages.

Training the First Generation of Neurologists in Haiti

Michelle Morse leads an interactive educational session for Haitian clinicians.

Haiti has just one neurologist for 10 million citizens, but the burden of neurological disease there is enormous, say BWH’s Aaron Berkowitz, MD, PhD, and Louine Martineau, MD, of the University Hospital in Mirebalais in Haiti.

Since BWH helped the University Hospital open in 2013, Martineau has regularly consulted on his neurologic patients with Berkowitz, who leads BWH’s Global Neurology Program. “By opening an outpatient clinic in communication with Dr. Berkowitz, we have created a way to manage patients with neurologic problems,” said Martineau.

To address the larger problem, Berkowitz and colleagues are launching Haiti’s first neurology training program. Initial seed funding will allow them to train two neurologists over the next two years.

“With further investment in the fellowship, we hope to train a few neurologists every year,” said Berkowitz. “These neurologists will serve different regions of the country so patients can get the care they need from local providers.”

Along with colleagues at Partners In Health and Equal Health—nonprofits connected with the University Hospital and BWH—Berkowitz will train the first two neurology fellows, and mentor them to train the next class and become the program’s core faculty.

“Watching the first class of residents support and guide the next, evolve as phenomenal clinicians and begin to dream of the impact they can have on health in Haiti is fantastic,” said Michelle Morse, MD, MPH, assistant program director for BWH’s Internal Medicine Residency and an advisor to University Hospital’s medical director.

The team hopes the fellowship will become a self-sustaining neurology residency program so that patients can get the care they need closer to home.

“The neurology fellowship at University Hospital in Mirebalais will plant the seeds for neurology in Haiti going forward,” said Berkowitz.

Added Morse: “Mirebalais will give us incredible evidence to share with the world on how to go from one neurologist serving a large population to many neurologists. Then we can begin to address the global burden of neurologic disease in earnest.”

Aaron Berkowitz teaches clinicians in Haiti.

Aaron Berkowitz speaks with clinicians in Haiti.

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BWH Celebrates 20th Annual Partners in Excellence Awards

From left: PIE Award recipients Jim McKinnon, Paula Barry, Therese Breen, Jonathan Santiago and Patrick Lally

More than 70 individuals from BWH, the Brigham and Women’s Physicians Organization and Dana-Farber/Brigham and Women’s Cancer Center were honored last month during the 20th annual Partners in Excellence (PIE) Awards. Additionally, 613 members of 38 project teams were recognized, all nominated by their peers. Awardees spanned departments and locations throughout the main and distributed campus.

BWHC President Betsy Nabel, MD, shared words of pride and gratitude with recipients, highlighting their work and dedication to the institution. “You fulfill our mission by providing the best care to our patients and their families, advancing our innovation and discovery through research, training the next generation of health care providers and leaders and serving our local and global communities.”

David McCready, senior vice president of Surgical, Procedural and Imaging Services, served as the ceremony’s emcee and shared his heartfelt thanks to recipients: “Quite simply, you are the reason that we are and will remain one of the finest hospitals in the world.”

Recipients and guests also heard from Paul Nuccio, MS, RRT, FAARC, director of BWH Pulmonary Services, a 2014 PIE award recipient. Nuccio asked attendees to take time to reflect on the positive impact they have on colleagues, as well as patients and families who look to BWH every day for support and healing.

During a special part of the program, the family of Christina Ruth, RN, a NICU nurse who passed away in October, accepted an individual PIE award on her behalf.

NICU nurse and friend Kerri Duggan, RN, spoke briefly about Ruth and her path to BWH, describing her as a “one-of-a-kind Brigham nurse.”

“Christina could instantly make a new mom comfortable leaving her most treasured gift in her hands,” Duggan said. “She could put a nervous father at ease through her genuine interactions and confidence. The way she connected with everyone who came across her path was truly one of her greatest gifts.”

The ceremony, which was held in Bornstein Amphitheater, concluded with a reception in Carrie Hall.

Team-Based Care for the Betterment of Patients

BWHers Share Their One Shining Moments
BWH Bulletin’s year-end issue is a time to highlight BWHers’ proudest moments from the past year. We asked you to share one BWH-related memory from 2015 that was meaningful to you, and you offered touching stories about colleagues, patients, families, events and milestones that inspired you. We hope you enjoy these remarkable moments.

A woman appeared in my office in distress. She was terrified and didn’t know what to do. I didn’t know what to do, either. But I knew who would: a social worker. I brought her to the Social Work team, which helped her come up with a plan to address her concerns.

Another patient started taking her medicine and was at target for her treatment plan. Why? Regular meetings with our pharmacist convinced her that she wanted to live healthily.

I could keep sharing stories. The family meeting supported by the geriatrician, organized by the CMP nurse, including three different specialties; the connections made by a medical assistant or a nurse; the communication between home health care and us for a demented woman; medical treatment of alcohol use disorder. These are my stories, but they could have happened to any patient in the Jen Center. This is team-based care.

Teams share their strengths and knowledge to bring patients to a new level of care. Warmly handed from one caregiver to the next, the patient learns that he or she has not just a medical provider, but a group of people who can gather together, brainstorm, use their skills and provide so much more than a consultation or a checkup.

This doesn’t happen by accident. This happens because of hard work, dedication and efforts to understand each other’s roles and responsibilities. It is also a product of deep respect for each other and for our patients. In this season of giving, I am so thankful for what each member of our team does for our patients, and for each other.

Lori Tishler, MD
Medical Director, Jen Center

View all One Shining Moments

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The Magic of the Season

It’s like holiday magic takes over the Tower lobby. A sleigh suddenly appears, and then reindeer, then some elves. There is holiday music playing while one Marine in his dress blue uniform appears and stands next to the sleigh. He looks joyfully happy to be there, and as if on cue, people begin to hand him and the elves toys and donations to buy more toys. The magic continues for three days and by then the sleigh is almost invisible under a huge pile of toys. It is an annual magical event that reflects the true spirit of giving, and it is the favorite Shining Moment for this Marine and many others. Christmas will be brighter for many children because it happened, and because people care. The Marine smiles . . .

Bob Donaghue
Operations Manager, Security and Parking

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Strengthening Health Care in Haiti

Over the past year, we have continued to promote our goal of strengthening Haitian health care by providing continuing education to health professionals in Haiti. One of the main focuses of our nursing team has been working on a research-based needs assessment regarding the attitudes and knowledge of Haitian nurses toward continuing education. One year ago, our team traveled to Haiti to conduct focus groups and administer surveys across Haiti at four different health care locations, including public and private hospitals. We have just finished analyzing our data and plan to submit to a peer-reviewed journal. This past November, we shared our results at the annual EqualHealth Conference in Haiti and presented a poster on our research. More than 85 Haitian nurses attended the workshop.

The over-arching goal of the Haitian health community is to learn, engage and work together and strengthen team-based care. The BWH community has been very supportive of our EqualHealth team, as well as our Haitian nurse partners—a true Shining Moment for us all.

Nadia Raymond, MSN, MHA, RN
Nurse, Intensive Care Unit Float Pool

Annie Lewis-O’Connor, PhD, MPH, NP, FAAN
Senior Nursing Scientist, Founder and Director of the C.A.R.E Clinic

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Extending Kindness and Generosity

Our office remains open during lunch hours so that patients can get an appointment during their own lunch breaks. Women, Infants and Children (WIC) and Nutrition staff stagger their lunch breaks in order to provide office coverage during this time.

One day earlier this year, one of our WIC staff, Myrta Montijo, went out to pick up lunch at a local restaurant while other staff covered the front desk. As Myrta returned to Brookside to eat her lunch, she passed through the waiting area. There was one woman waiting for her WIC appointment. The patient commented to Myrta that her lunch smelled so good and that she was so hungry, having spent many hours on the road and at appointments that day. She asked Myrta where she got her lunch, as she was hoping to stop there on her way home. The patient still had an hour or so longer before she would finish her appointments at Brookside and Myrta could see how exhausted she was, so she asked the patient if she could share half of her lunch with her.

The patient quickly agreed and was so grateful for Myrta’s kind gesture and generosity!

Maria Dievler, MA, RD, LDN
Director of WIC and Nutrition, Brookside Community Health Center

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The Brigham’s Year in Photos

2015 was a year marked by world-class patient care, innovative research, community events and education milestones. It also included moments of joy and celebration, as well as times of great difficulty and sorrow that drew the BWH community together.

Relive the moments in our “Year in Photos” gallery.

Winter Drives Benefit Local Community and Warm Hearts

Tobin Elementary School students enjoy their new knit caps.

Each holiday season, the BWH community comes together to brighten the lives of those in need. By collecting toys, food, clothing and other items, BWHers do what they can to spread joy and bring smiles to people’s faces.

Wanda McClain, MPA, vice president of Community Health and Health Equity, said she’s astounded by the generosity of BWHers, not only during the holidays, but every day of the year. “Giving back is part of our mission and commitment to our local community,” she said. “These acts of kindness are just as important as the care we deliver to patients.”

Here are some of the ways BWH is giving back this season:

Toys for Tots Drive
More than 1,000 toys were collected this year and packed into 13 giant boxes to be delivered to the U.S. Marine Corps Reserve Toys for Tots Program. The generosity of BWHers and visitors has made the Toys for Tots collection at BWH a huge success for the last three years. A team of volunteers led by Bob Donaghue, operations manager for Security and Parking, organizes the drive each year.

Welcome Winter Food Drive
From now until Dec. 29, BWH is hosting a food drive to benefit the Parker Hill/Fenway ABCD Emergency Food Pantry in Mission Hill. Collection bins for canned, boxed and other non-perishable foods have been placed at various locations across BWH.

Caps for Kids
For more than 25 years, senior physical therapist Joan Casby and volunteers from BWH, the Dana-Farber Cancer Institute and elsewhere collect handmade hats, mittens, scarves and other warm winter items that are donated to local schoolchildren in Boston. On Dec. 16, 500 knitted items were distributed to students at the Tobin Elementary School in Mission Hill. Volunteers spent time with students as they chose their new warm winter items, and students later came back with thank-you notes in hand for the volunteers. This year, more than 13,000 hats, scarves and other items were made, all going to various schools and hospitals in the Boston area.

Caps for Kids organizer Joan Casby reads a thank-you letter from one student.

Bringing the Magic of the Holidays to BWH
For the 34th consecutive year, Jim Nentwig’s family and volunteers will present patients with flowers, gifts, knitted hats and blankets around Christmas. Nentwig first dressed up as Santa (and his children as elves) when his wife, Elizabeth, was a cancer patient at BWH in 1982 and brought gifts for all of the patients on her unit. Elizabeth asked Nentwig to continue the tradition after her death, which he has, facilitating the donation of hundreds of gifts to patients and staff, which now get delivered by many of his family members and volunteers dressed as Santa and elves here at BWH and elsewhere in the area.

Neurology Blood Drive
Earlier this month, BWH’s Department of Neurology hosted a team-wide blood drive challenge. Neurology physicians, researchers, staff, patients and families were invited to donate blood at the Kraft Family Blood Donor Center and Blood Mobile to help BWH patients in need. In total, 80 units of blood were donated.

View a gallery of photos.

Partnership for Community Health Awards $6 Million in Grants to CHCs

This fall, Partnership for Community Health, co-founded by Partners HealthCare, awarded $6 million through a dozen grants that will support 22 community health centers (CHCs) across Massachusetts. The two-year Excellence and Innovation grants are allied with elements of the overall Partners strategy—improving the patient experience, increasing capacity to serve more patients and improving quality while reducing costs.

The partnership was launched three years ago as a joint initiative of Partners and Neighborhood Health Plan, in collaboration with the Massachusetts League of Community Health Centers. The goal is to support the continued efforts of CHCs to reduce barriers to access, promote health equity and provide patient care locally. To date, the partnership has committed $16 million to CHCs across the state.

Overall, the grants support the efforts of the centers to transform their operations and patient communications and find new ways to deliver shared services across different health centers.

Sixteen CHCs will benefit from three multi-institutional grants ranging from $450,000 to $1 million. All three projects involve the use of technology—from telemedicine to imaging to patient portals—to improve access and quality of care and reduce costs.

Individual grants ranging from $200,000 to $600,000 were awarded to 12 community health centers, half in Boston and half in other parts of the state, including Springfield, Worcester and Cape Cod.

Some grants will bolster staffing. For example, Southern Jamaica Plain Health Center will add a medical social worker and a health coach to help patients change health behaviors, and Caring Health Center in Springfield will add community health workers to support improved access and use of wellness services.

Others seek to enhance patient engagement. For example, both East Boston Neighborhood Health Center and South Cove Community Health Center will work on call center enhancements that will improve care coordination.

Additionally, other grants will target chronic conditions and process improvement.

Delivering Personalized Care to Chronic Heart Failure Patients at BWH

Mary Chalifoux-Conley

With its team of nurse care coordinators across Primary Care, BWH’s integrated Care Management Program (iCMP) has been providing personalized care and attention to some of the hospital’s most high-risk patients for more than five years. A large subset of these patients suffers from chronic heart failure—the most common cause of iCMP patients’ hospital admission.

Helping these patients to stay well is a privilege, says Mary Chalifoux-Conley, RN. She co-manages 71 iCMP heart failure patients alongside practice-based nurse care coordinators, with the goal of improving their care and reducing inpatient admissions through coaching and intensive disease management. The team also collaborates with BWH primary care physicians (PCP), cardiologists, heart failure nurse practitioners and palliative care specialists.

“I assess patients’ understanding of their diet and their medications,” said Chalifoux-Conley. “I help them navigate the health care system, engage their families in their care and support behavioral changes aimed at improving their health.”

She also frequently communicates with her patients’ PCPs and cardiologists, providing them with status updates or changes in vital signs, to determine if adjustments to medications or dietary restrictions are needed.

If patients are admitted to BWH, Chalifoux-Conley makes a point to visit them. She says it is important that these patients understand the role she plays in their care—especially if they are new to the Brigham—and how to find her. When they are ready for discharge, she strives to make their transition home as seamless as possible.

“Mary has been able to engage many high-risk patients in their own care, help them improve their health and prevent them from needing to be admitted to the hospital,” said Lisa Wichmann, RN, iCMP nursing director. “Everyone’s experience with Mary has been very positive.”

One of many beneficiaries of Chalifoux-Conley’s care is James Ackerman, a semi-retired professor who recently celebrated his 96th birthday. In the past year, Chalifoux-Conley has coordinated Ackerman’s home care, followed up with him on important test results and remained in touch with his PCP and cardiologist every step of the way.

Ackerman’s wife, Jill Slosburg-Ackerman, said, “I am so grateful to the staff at the Brigham for the amazing care that our family receives. I had no idea there would be this kind of support for my husband. Mary has an ability to balance the science and medical issues with humanity. It’s more than just the medicine; Mary has made it easier for all of us.”

When needed, Chalifoux-Conley refers patients to BWH’s Ambulatory Cardiac Triage Intervention and Education (ACTIVE) Unit, a multi-disciplinary outpatient cardiology infusion center led by advanced heart disease nurse practitioners. In the ACTIVE Unit, patients can receive intravenous diuretics as needed, as well as pharmacist-led medication reconciliation, and education and assessment by a nurse practitioner. As an ambulatory treatment alternative to a hospital admission, the unit has become a successful option for patients with worsening heart failure symptoms. To date, Chalifoux-Conley has referred 18 patients to the ACTIVE Unit for the most specialized care.

Chalifoux-Conley and her colleagues believe that the future of iCMP and heart failure outreach lies in preventive care. Rebecca Cunningham, MD, iCMP medical director, says there is a cohort of patients Chalifoux-Conley is not yet seeing who could benefit from earlier intervention and additional self-management tools.

“I think there’s a lot more we can do to educate patients,” said Chalifoux-Conley. “It’s the 40- to 50-year-olds who may all of a sudden start to see a rise in their blood pressure or lipids. We need to educate them more quickly about nutrition, and if they’re pre-diabetic, get them on the right medications and help them learn how to manage their health.”

Providing Care, Support to HIV Patients for 25 Years and Counting

BWH’s HIV Program team

Paul Sax, MD, clinical director of the Division of Infectious Diseases and BWH’s HIV Program, says that a person diagnosed with HIV today can live a life measured in decades.

This is a marked improvement from when the HIV Program was first established in 1990, when the average life expectancy after being diagnosed with AIDS was one to two years.

HIV, which stands for human immunodeficiency virus, weakens the body’s immune system and can lead to acquired immunodeficiency syndrome (AIDS)—a chronic, potentially life-threatening condition that leaves the body vulnerable to other infections and cancers if not medically managed. Each year, World AIDS Day is held on Dec. 1 to unite people in the fight against HIV/AIDS, in support of those living with the condition and those who have died from it.

“There has been enormous progress in the prevention, diagnosis and treatment of HIV infection throughout the world,” said Sax, who joined BWH and the HIV Program in 1992. “Among the greatest advances in the history of infectious diseases is the transformation of a rapidly fatal disease into a treatable, chronic condition. Many Brigham clinicians and researchers have played a major role in moving the field forward through their work in both basic and clinical research, and the hospital has become a well-known center for excellence in HIV care.”

BWH’s HIV Program has been providing compassionate, multidisciplinary high-quality care since its earliest days 25 years ago. As part of the Division of Infectious Diseases, the program uses the medical home model to achieve its mission of optimizing health outcomes for people living with HIV and conducting innovative research to benefit these patients. The team recently celebrated at an anniversary gala, at which several patients shared their stories.

The program’s 800 patients—ranging from 18 years old to patients in their late 80s—mostly hail from the greater Boston area and reflect the diversity of the community BWH serves. This includes a higher proportion of women (35-40 percent) than Boston’s other hospital-based HIV programs.

Where the program was once charged with managing a very sick population of inpatients with HIV/AIDS, including providing end-of-life counseling, everything changed when HIV became treatable in 1996, says Sax. Hospital admissions declined substantially, patients started to live longer and the program’s outpatient clinic became much busier.

“I’m now following people much longer term,” said social worker Susan Larrabee, LICSW, who has been part of the team since it was founded. “If people take their medication consistently, having children and healthy families is a reality now, as is working full-time and having productive careers. It’s very exciting to have been there at the beginning and to see how the prognosis has changed. I now see our patients living fully with this diagnosis.”

In addition to counseling, testing and clinical care, the program provides patients with access to resources to manage HIV, social work services, assistance with home care, medication coverage, housing and insurance, information about community-based services and support groups and additional resources.

Along with Sax and Larrabee, the team consists of the Infectious Disease Clinic’s Sigal Yawetz, MD, Jennifer Johnson, MD, Lisa Cosimi, MD, Cameron Ashbaugh, MD, Dan Kuritzkes, MD, chief of the Division of Infectious Diseases, fellow Mary Montgomery, MD, Charles Dewan, RN, ARCN, Brandi Couto, LPN, Brian Kavanah, LPN, and David Kubiak, PharmD; social worker Carrie Braverman, LICSW; psychiatrist John Grimaldi, MD; dermatologist Adam Lipworth, MD; neurologist Jennifer Lyons, MD; gynecologist Khady Diouf, MD; and hematologist Aric Parnes, MD.

“We have an incredible collaborative team model here that patients immediately recognize and feel comfortable in,” said Larrabee. “Some patients feel shame when they come in for the first time, but they leave feeling cared for and hopeful. It’s apparent to other professionals who come here, too, that something special happens here. Working with our patients is such a privilege.”

The program is also committed to research, as well as educating and training the next generation of clinicians. In addition to his laboratory-based work, Kuritzkes is the director of the AIDS Clinical Trials Group, the largest network of HIV researchers and clinical trial units in the world. Lindsey Baden, MD, runs an HIV vaccine research program, and numerous faculty conduct HIV-related research in international settings. Additionally, each year, an Infectious Disease Clinic fellow rotates through the program, gaining a deep expertise in HIV and becoming an integral part of the team. Larrabee also shares her work and knowledge with the nearly 85 social workers in her department to help them stay informed about issues related to HIV.

To learn more about the program, email slarrabee@partners.org.

Former BWH Physician, Trainee Returns to Present Winshall Lecture

Guest speaker Heidi Behforouz (second from right), with the family of the late James Winshall—wife, Gail Levine, and children Dan and Lisa

The eighth annual James S. Winshall Lectureship in General Internal Medicine was a homecoming of sorts for guest speaker Heidi Behforouz, MD, who attended Harvard Medical School (HMS), completed her residency and fellowship at BWH and later practiced in the Phyllis Jen Center and Division of Global Health Equity (DGHE).

Now an internist in Compton, Calif.; medical director of the LA County Department of Health Services’s Care Connections Program; and director of Innovations at Martin Luther King Outpatient Center in Los Angeles, Behforouz received a warm welcome back from a packed crowd of colleagues, former fellow trainees and others. (Behforouz remains affiliated with HMS and BWH’s DGHE.)

The lectureship is named in honor of James “Jamie” Winshall, MD, a beloved BWH primary care physician who died 10 years ago. Winshall’s wife, Gail Levine, MD, of the Department of Medicine, helps to organize the lecture each year.

“The reason we’re here today is Jamie’s impact as a primary care physician,” said Joel Katz, MD, director of the Internal Medicine Residency Program, during the Nov. 6 lecture. “He was an inventive community member, founder of the precursor to BWH’s hospitalist service and a gifted teacher and role-model. He had an eclectic taste in music, and I think we can all remember his cackle of a laugh.”

Behforouz, who worked with Winshall as an intern, has focused her career on the health issues of the urban poor. Committed to transforming primary care to better serve the needs of the most vulnerable patients, she founded Partners In Health’s Prevention and Access to Care and Treatment (PACT) project in Boston, which employs community health workers to advocate for the health and well-being of inner city residents infected with or at risk for HIV and other chronic diseases.

During the lecture, Behforouz discussed the unique role of community health workers in augmenting the patient-centered medical home model and reducing disparities and improving outcomes among the most high-risk patients. She drew upon recent patient cases and examples from the Mississippi Delta to Navajo Nation, where primary care resources tend to be more limited. She shared the story of one man who presented to her hospital in Compton with a simple sore throat, but was facing brain injury and alcohol use issues and had recently experienced a traumatic event with the police.

“The question is always: ‘What is a good primary care physician to do?’” said Behforouz. “There are so many forces that factor into health. If we don’t address the whole person, it is difficult for our patients to achieve health. We are spending increasing dollars and time on health care delivery, but are we addressing the root cause of this gentleman’s sore throat?”

This is where Behforouz believes community health workers come in, especially in resource-poor settings. Acting as guides, advocates and care facilitators, community health workers can increase patient engagement, provide social support and care planning, advocate for illness management support and much more.

Behforouz asked attendees to think about how the Brigham could be a pioneer in redefining health not only for patients here in Boston, but across the country and globe.

“How do all people reap the benefits of our advances?” she asked.

Making a Difference in the Lives of Women

Nawal Nour

As director of the BWH Ambulatory Obstetrics Practice and founder of the African Women’s Health Center at BWH, Nawal Nour, MD, MPH, knows the importance of providing culturally competent care to each of her patients.

“Many of the women I see have received inadequate care in the past,” she said. “It’s our duty as physicians to listen to our patients and provide compassionate care. By doing so, we gain their trust, maintain their access to health care, serve their needs and improve their quality of life.”

Nour and her clinical team in the African Women’s Health Center, which was founded in 1999, provide culturally and linguistically appropriate obstetric, gynecologic and reproductive health care to African immigrants and refugees. The center, which Nour says is “filled with beautiful colors” from the traditional African gowns and veils that many of its patients wear, is the first and only health practice in the U.S. that focuses on issues related to female genital mutilation/cutting, a practice Nour has devoted her career to researching.

Born in Sudan and raised in Egypt and England, Nour has spoken at many academic and national conferences regarding the medical management of women who have undergone this practice, which includes procedures that intentionally alter or injure the female genital organs for non-medical reasons. The practice has no health benefits and can cause severe bleeding, problems urinating, cysts, infections, infertility and complications in childbirth. According to the World Health Organization (WHO), more than 125 million girls and women alive today have undergone this practice in Africa and the Middle East, where female genital mutilation/cutting most often occurs. The practice is perpetuated because of cultural, not religious, beliefs.

Nour has also traveled throughout the U.S. to conduct workshops to educate African refugees and immigrants about the medical complications and legal issues of female genital mutilation/cutting.

Most recently, she has been working with WHO to publish recommendations that will help identify gaps in female genital mutilation/cutting research and the types of guidelines that are set for health providers in Africa and the Middle East who are performing the practice. She anticipates that the recommendations will be published soon.

“From a clinical perspective, we are trying to educate as many people as possible, especially physicians,” Nour said. “The practice is a violation of the human rights of girls and women, and those affected suffer long-term complications and require sensitive care. We need to create a safe haven for those who have undergone the practice and ensure that this practice is eradicated.”

Nour has also worked with the American College of Obstetricians and Gynecologists (ACOG) to create recommendations on how to provide culturally competent clinical care to women who have undergone female genital mutilation/cutting. These recommendations have been used nationwide and in Canada.

She says there has been more national attention focused on younger children who are at risk of female genital mutilation/cutting. Some women and girls living in the U.S. are being taken to their native countries in order to undergo the practice. These trips abroad are sometimes referred to as “vacation cutting.”

Nour joined Senate Minority Leader Harry Reid, Sen. Elizabeth Warren, Sandra Carson, MD, ACOG vice president for education, and key advocates in Washington, D.C., this past summer to discuss what is being done to fight vacation cutting and female genital mutilation/cutting in general across the globe.

“We do not know the scope of the problem with vacation cutting, but it’s time we investigate how widespread this issue is,” Nour said. “We need to advocate for families and protect the women and girls who are at risk.”

BWH’s United Way Campaign Kicks Off

From left: United Way campaign co-chairs Allen Smith, Stan Ashley and Lisa Morrissey

BWH’s United Way campaign co-chair Lisa Morrissey, MBA, BSN, RN, supports United Way because it assists organizations that enhance the lives of community members.

“Every dollar we donate goes a long way in helping to provide services and programs to improve the quality of life for children and families in need,” said Morrissey, associate chief nurse of Perioperative Nursing and Procedure Areas.

Once again this year, BWH is partnering with United Way of Massachusetts Bay and Merrimack Valley through a hospital-wide fundraising campaign. United Way works to improve the conditions of the communities that BWH serves, by focusing on increasing opportunities for children and youth and bettering the financial stability of individuals and families.

The 2015 campaign, which officially launched on Nov. 2, will run for three weeks. Morrissey, along with Stan Ashley, MD, chief medical officer, and Allen Smith, MD, MS, BWPO president, are this year’s co-chairs. Their goals are to raise a record-breaking $215,000 and increase participation among BWH employees.

BWHers have already begun to receive direct, personalized emails with a link to their own giving pages. Online donations can be made through payroll deduction, credit card or check. Printed pledge cards will also be available. The co-chairs emphasized that no donation is too small.

“This is about lifting children and families up so they can achieve their dreams,” said Smith. “BWHers know firsthand the importance of giving and strive to instill a spirit of generosity in all we do.”

This year, donors will have the opportunity to win a host of exciting prizes, including a football signed by New England Patriots quarterback Tom Brady, a month of free parking, Bruins, Celtics and Red Sox tickets, restaurant gift cards, a TV, a mountain bike and much more.

Earlier this week, the campaign committee hosted a kick-off ice cream social at BWH, and upcoming socials are scheduled for 850 Boylston and Brigham and Women’s/Mass General Health Care Center in Foxborough. In addition, United Way ambassadors will be visiting units and departments throughout the month to educate employees about the campaign and how to get involved.

“Supporting United Way is an opportunity to give back to an organization that does so much for others,” said Ashley.

To learn more about the campaign and how you can donate, visit BWHPikeNotes.org. View more photos from the ice cream social.

BWHers Participate in Health Fair Kickoff at RTH

BWH volunteers at the RTH Health Fair

Late last month, BWH’s Lung Center, Heart & Vascular Center and Phyllis Jen Center joined the Roxbury Tenants of Harvard (RTH) for its annual health fair, providing health resources and information to community members and other attendees.

BWH physicians and staff, including Aaron Waxman, MD, PhD, director of the Pulmonary Vascular Disease Program; Chris Fanta, MD, of the Pulmonary Division and director of the Partners Asthma Center; Lori Tishler, MD, medical director of the Jen Center; and Jorge Plutzky, MD, director of Preventive Cardiology, were on hand to talk with community members about their heart and lung health. The BWHers offered lung fitness tests using spirometers, an instrument for measuring the air capacity of the lungs, as well as screening for asthma and chronic obstructive pulmonary disease (COPD), an inflammatory lung disease. Information about smoking cessation and hands-only CPR was also available.

“We had more than 180 members of the community drop in, and we signed up more than 40 people for a healthy nutrition program and 30 for a healthy exercise program,” said Waxman. “It was a very successful health fair.”

Other organizations at the fair included Dana-Farber Cancer Institute, the National Kidney Foundation, Harvard School of Dental Medicine, Mass Eye and Ear and the American Heart Association.

BWH is a longstanding partner of RTH—a nonprofit organization devoted to developing and maintaining safe and affordable housing for low- and moderate-income people of diverse backgrounds in Mission Hill.

October is Interpersonal Violence Awareness Month at BWH

Every October, with the help of the Center for Community Health and Health Equity (CCHHE), BWH takes part in national Domestic Violence Awareness Month. This year, the hospital is broadening its efforts and recognizing the month as Interpersonal Violence Awareness Month in order to educate and raise awareness of not only domestic violence, but all forms of violence that take place in our community, homes and institutions.

“Patients present with many forms of trauma and injury caused by violence,” said Mardi Chadwick, JD, director of Violence Intervention and Prevention Programs for the CCHHE. “By silo-ing care, we may be missing the larger context of our patients’ lives. Changing Domestic Violence Awareness Month to Interpersonal Violence Awareness Month is the first in many steps to re-envision how we understand and provide trauma-informed care to all patients.”

By focusing on the intersections of trauma and violence, the Brigham community is considering the ways in which trauma is differentially experienced across the lines of race, gender, culture, class, sexual identity and socioeconomic status, and how these many factors impact health.

“The more we learn about, recognize and support patients who have complicated experiences, the more we will advance in our efforts to achieve greater health and social equity for patients surviving trauma,” said Chadwick.

Several events will be held this month to generate awareness of interpersonal violence and promote safety and well-being for everyone in the BWH community. BWHers can stop by an information table in the 75 Francis St. lobby all month long to learn more and obtain resources about interpersonal violence.

Additionally, Schwartz Rounds on Oct. 13 will highlight a specific case related to community violence, and a service on Oct. 14 will honor all survivors, victims and community members impacted by violence and trauma, among other events. BWHers will also see the hospital’s “Do No Harm” campaign on the television screens across BWH and the distributed campus, featuring personal messages of hope, support and inspiration to those experiencing interpersonal violence.

BWHers can join the cause virtually on Facebook or Twitter (@passagewayBWH). For more information, email passageway@partners.org. View the full calendar of events and the “Do No Harm” campaign.

BWHers Celebrated at Annual Employee Service Awards Ceremony

For Maria Mejias, a program assistant for the Women, Infants and Children Nutrition Department at Brookside Community Health Center, BWH has been more than a workplace for the past 20 years—it has been a second home.

“I love my job because I’ve developed excellent relationships with my co-workers, patients and their families in the last two decades,” she said. “It’s wonderful being able to come to work and see the different stages children experience in life as they grow and develop.”

Mejias and many other BWHers and guests gathered in the Joseph B. Martin Conference Center at Harvard Medical School on Sept. 21 to celebrate the dedication and achievements of employees during the 35th annual Employee Service Awards ceremony. The event honors employees who have worked at the hospital in increments of five years. Employees with five years of service through 40 years were honored this year.

Julie Celano, vice president of Human Resources, thanked employees for their service to the Brigham.

“You are the reason we are one of the very best hospitals in the world,” Celano said. “Your passion and commitment make an extraordinary difference in the lives of our patients, their families and our community.”

Added BWHC President Betsy Nabel, MD: “I want to thank each and every one of you for your outstanding contributions this year and every year. You are committed to making this hospital a true community—a place where you stay for years, strengthening your skills, building relationships and welcoming new members to our family.”

Nabel noted that this year’s ceremony held extra meaning for her as she is celebrating five years of service at BWH.

With noise makers in hand, hospital leaders recognized employees and recounted milestones and major events—both at BWH and around the world—that took place at each five-year interval. Leadership and attendees also danced along to snippets of chart-topping songs from those years.

View more photos from the event.

BWH Co-Hosts First Camp for Stroke Survivors, Families in New England

Participants of this year’s Retreat & Refresh Stroke Camp, the first such event in New England

At first glance, there was nothing out of the ordinary about the group gathered at the St. Methodios Faith & Heritage Center in New Hampshire last month, as they enjoyed activities such as fishing, dancing and games. But the more than 50 people there shared a unique bond—all were stroke survivors or caregivers.

The gathering was the result of a collaboration between BWH, Massachusetts General Hospital and Spaulding Rehabilitation Hospital to host a “Retreat & Refresh Stroke Camp.” The weekend for stroke survivors and their families was the first such event in New England.

Ali Aziz-Sultan, MD, chief of the Division of Vascular and Endovascular Neurosurgery at BWH, first heard about the camp when he was asked to get involved. He knew right away that he wanted BWH to be part of the effort.

Clinicians from each of the three participating hospitals volunteered their time to make the camp a success. Attendees from BWH included Aziz-Sultan; Mary Amatangelo, NP, a nurse practitioner in the Neuroscience ICU; Galen Henderson, MD, neurologist and director of the Neuroscience ICU; Kristin Lewis, MS, NP, nurse practitioner in Interventional Neuroradiology; Tim Lynch, executive director of Neurology; and Simone Renault, clinical research coordinator in Neurology.

“As clinicians, we often only see our patients when they are in acute distress,” said Amatangelo. “It was incredibly heart-warming to see these stroke survivors one year later and witness how much better they are doing.”

Amatangelo recounted the story of one patient who survived a stroke the prior year. When he first walked into the camp, he seemed uncomfortable, but the next day, after becoming immersed in the camp’s uplifting environment, he was laughing and dancing with his wife.

Participants followed a carefully planned agenda with both recreational and educational activities—including a clinical update on the latest advancements in neurology trials and stroke care and a lecture about stroke warning signs.

“Our goal is for survivors and family members to meet one another, share experiences and enjoy a relaxing weekend together in a comfortable and understanding environment,” said Lauren Kramer, director of operations for the Retreat & Refresh Stroke Camp. “It gives them an opportunity to focus on what they can do after stroke, instead of what they can’t do, and form long-lasting friendships.”

Innovation and Discovery Await at “Discover Brigham”

Coinciding with Boston’s first-ever HUBweek—a week celebrating art, science and technology in Boston—the Brigham Research Institute (BRI) and Brigham Innovation Hub (Brigham iHub) will host Discover Brigham on Wednesday, Oct. 7. This all-day event will bring together the BWH community and greater Boston health care ecosystem to educate, inspire and foster collaborations around innovative science, technology and medicine.

Discover Brigham will celebrate the contributions of BWH’s 1,300 physician-investigators and renowned biomedical scientists and 1,700 physicians. Sessions will highlight cutting-edge work spanning research and clinical disciplines with the potential to change health care, including sleep medicine, trauma, mental health, newborn medicine, allergy and wearables. The day will feature a poster session, panel discussions and awards ceremony.

Discover Brigham combines Clinical Innovation Day, held for the past two years in the summer, and Research Day, held for the past three years in November, into one energizing and exciting day.

“Discover Brigham gives our community the opportunity to showcase the progress and discoveries being made across BWH,” said Jacqueline Slavik, PhD, BRI executive director. “We are deeply proud of BWH’s role as an international leader in basic, clinical and translational research, and this event gives us the ability to share that research with our community, our collaborators and the general public.”

The event will also feature notable guest speakers and moderators, including Maria Konnikova, author and contributing writer at The New Yorker; Mallika Marshall, MD, medical reporter for WBZ TV; Brian Gormley, writer for The Wall Street Journal; and many more.

“We’re thrilled that Discover Brigham will bring everyone together around big ideas that have the potential to transform medicine,” said Lesley Solomon, executive director of Brigham iHub.

The day will conclude with a ceremony where more than $1.2 million will be awarded through the BRI Director’s Transformative Awards, the fourth annual BRIght Futures Prize, the Stepping Strong Innovator Awards and the Research Excellence Awards, followed by a reception celebrating the BRI’s 10th anniversary.

Register for Discover Brigham at discoverbrigham.org. You can also vote for this year’s BRIght Futures Prize and Stepping Strong Innovator Awards winners at discoverbrigham.org.

Another Successful Summer for Workforce Development Youth Program

WFD Youth Summer Program participants gather for a closing ceremony in Bornstein.

More than 100 local high school students filled Bornstein Amphitheater last month for a celebration honoring their hard work at BWH this summer.

For six-and-a-half weeks, 117 students gained new skills and experience while interning across the hospital and distributed campus as part of Workforce Development’s (WFD) Youth Summer Program. More than 40 departments, divisions and teams volunteered to host a student this summer, including Ambulatory OB/GYN, Anesthesiology, Perioperative and Pain Medicine, Care Coordination, the Endoscopy Center and Radiology, to name a few.

“You significantly contributed to the departments in which you worked,” said WFD Director M.J. Ryan during her keynote address. “The people you learned from are now your champions. Working side-by-side with you brought much joy to our staff.”

At the event, Director of Organizational Effectiveness Ellen Gilmore congratulated the students on a productive, successful summer and thanked BWH managers for their help in teaching the next-generation health care workforce. Partners Biobank project manager Nicole Allen shared a few words of advice, encouraging the students to recognize and celebrate the different gifts and contributions that they bring to their surroundings.

Student speaker Julian Smith-Sparks, who interned with the Division of Sleep Medicine, spoke about the confidence he gained from the program. Smith-Sparks graduated from English High School earlier this year and is headed to Stonehill College with a full scholarship this fall.

“The division treated me like I belonged there,” he said. “I got to experience teamwork and get a glimpse of the future after college.”

Patient Care Services Plants Herb Garden for Patients, Families, Staff

The herb garden on Shattuck Street

Earlier this summer, members of Patient Care Services (PCS) had the idea to create something new on BWH’s campus: a small herb garden on Shattuck Street.

The effort to plant and maintain the garden was led by Kathy McManus, MS, RD, director of Nutrition, and Maureen Fagan, DNP, MHA, WHNP-BC, FNP-BC, associate chief nurse for Obstetrics and Gynecology and executive director of the Center for Patients and Families. They have developed a schedule in which members of the Nursing and PCS departments take turns watering the herbs.

“We are always trying to find creative ways to promote health and wellness,” said McManus, who routinely sends her PCS colleagues unique recipes from Food Services that incorporate the herbs. “We hope that this garden will inspire us all to get back to the fundamentals of cooking at home and taking care of ourselves. We know there is a strong connection between food and medicine and that many cultures rely on food as medicine. Nutrition is very powerful.”

The garden contains mint, basil, Thai basil, cilantro, parsley, sage and rosemary. Patients, families, staff and visitors are welcome to take a cutting from the herbs to use when preparing meals. Cutting the herbs helps them grow and, in turn, yield more herbs.

The garden is symbolic of several core values of the PCS department, such as including the family as a key part of the care team; promoting cooking and living a healthy lifestyle; and incorporating healing and caring modalities.

“The beauty found in nature can enhance healing,” said Fagan. “Seeing a beautiful garden helps our patients, their families and our staff relieve stress, which benefits their well-being.”

McManus and Fagan encourage all BWH staff with or without a green thumb to join them in their gardening and healthy eating efforts. For more information, call 617-732-6636.

The Nutrition and Food Services departments host a Heart-Healthy Cooking Demo on the first Wednesday of every month from 2 to 2:30 p.m. on the second floor of 75 Francis St., near the entrance to the Shapiro bridge.

BWH Trauma and Burn Centers Donate Bike Helmets

Boston Police Sgt. Gino Provenzano reads a thank-you letter from BPD Commissioner Bill Evans to BWH’s Trauma and Burn Centers.

When Elizabeth Bryant, MPH, joined BWH in May as injury prevention and outreach coordinator for the Trauma and Burn Centers, she was greeted by dozens of new children’s bike helmets in a nearby colleague’s office closet. The helmets were left over from past donation events the centers had organized.

In her role at BWH, Bryant is responsible for developing and implementing trauma and burn prevention programs in the community and raising awareness within the hospital about these programs and their benefits to patients, families and staff. Determined to make sure the helmets were put to good use, Bryant contacted the Boston Police Department (BPD) to see if they could assist in distributing the helmets to local children.

“The first thing that came to mind was that there are kids in our city in need of these helmets,” Bryant said. “We know the dangers of riding without a helmet, and it’s important to educate kids about bicycle safety.”

Sgt. Gino Provenzano, BPD community service coordinator, visited BWH on Aug. 5 to recognize the Trauma and Burn Centers for their efforts to keep the local community safe. Several times a year, BPD staff hand out donated helmets to children and families around Boston during bike safety workshops, which is how the donated helmets will be used. Provenzano presented members of the centers with a certificate from BPD Commissioner William Evans, thanking them for their generosity and commitment.

“The Boston Police Department is thrilled with this donation,” Provenzano said. “These helmets could potentially prevent traumatic brain injuries and save lives. On behalf of the Boston Police Department, I thank you for your donation.”

Ali Salim, MD, division chief of Trauma, Burns and Surgical Critical Care, who attended the visit along with Jonathan Gates, MD, MBA, Trauma medical director, added: “We are happy to be a part of any opportunity to promote bike safety in order to help prevent injuries to children. It was our pleasure to donate the helmets to the Boston Police Department so they could be distributed before the end of the summer.”

Bryant and her colleagues at the centers look forward to collaborating with the BPD and local organizations in the future.

The Burn and Trauma Centers invite volunteers to walk with them in the 10th annual New England Walk for Burn Survivors on Saturday, Sept. 12, 10:15 a.m.–2 p.m., at the American Legion Marsh Post 442 in Cambridge. The walk supports regional and national programs for burn survivors. You can learn more and register at bsofne.ning.com, or email eabryant@partners.org.

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BWHers Honored As 2015 BBJ Health Care Heroes

The Boston Business Journal recently announced its 2015 Healthcare Heroes, recognizing those who have been steadfast in their commitment to improving the health and wellness of Massachusetts residents. Four members of the BWH community were named to the list of 14 recipients from across the city: Joel Katz, MD, Stephanie Shine, BSN, RN, Adam Landman, MD, MS, MIS, MHS, and Audrey Epstein Reny.

“Our BWH honorees are truly accomplished in their fields and have made a difference here at BWH, in the greater Boston community and beyond,” said BWHC President Betsy Nabel, MD. “We are proud that they have been recognized for their tireless efforts to advance the highest-quality patient care, innovative research, stellar education and community outreach.”

The award winners, listed by name and category below, were featured in a special section in the Boston Business Journal on Aug. 14.

Educator: Joel Katz, MD

Joel Katz

As director of the Internal Medicine Residency Program, a general internist and an infectious disease specialist, Joel Katz, MD, has been responsible for training 170 residents each year for the last 15 years. Since becoming director in 2000, he has dedicated himself to creating a vision and infrastructure in order for residents to simultaneously achieve clinical excellence and establish themselves as productive innovators, researchers and leaders in internal medicine. He also co-created innovative courses that unite his greatest interests—fine arts and teaching. For example, the first-year Harvard Medical School preclinical course “Training the Eye: Improving the Art of Physical Diagnosis” features observation exercises at Boston’s Museum of Fine Arts to train students to look carefully for subtle clues in patients. The course has become a model for this type of cross-disciplinary medical humanities teaching throughout the U.S.

Non-Physician Provider: Stephanie Shine, BSN, RN

Stephanie Shine

An expert clinician, innovative researcher, driven leader and compassionate caregiver, Stephanie Shine, BSN, RN, provides excellent care to infants, mothers and families in the NICU during what is often the most difficult time of their lives. She is the principal investigator of an innovative study called “Love at First Sight” that incorporates video conferencing into the NICU via Google Glass, allowing new mothers to see and hear their babies in real time through the eyes of their birth partner as they are recovering. The study addresses maternal-infant separation after birth, and to date, 250 mothers have been enrolled as participants.

Innovator: Adam Landman, MD, MS, MIS, MHS

Adam Landman

Adam Landman, MD, MS, MIS, MHS, BWHC chief medical information officer (CMIO) for Health Information Innovation & Integration, oversees BWHC’s clinical information technology innovation initiatives, including many projects related to Partners eCare. He has also developed mobile apps to securely capture and store clinical images and to improve electronic medication administration and reconciliation. Landman is also exploring how secure video can be used in the Emergency Department and elsewhere to capture details, including patient histories and assessments, faster.

Volunteer: Audrey Epstein Reny

Audrey Reny

On April 15, 2013, Audrey Epstein Reny stood at the finish line of the Boston Marathon with her family, including her daughter Gillian, who was critically injured during the bombings. Gillian was rushed to BWH, where a multidisciplinary trauma team saved her life and her legs. Out of gratitude, the Reny family established the Gillian Reny Stepping Strong Fund at BWH to fuel innovative trauma research and clinical care. Since establishing the fund in 2014, Audrey Epstein Reny has made it her life’s work to turn tragedy into hope for future trauma patients by raising funds and awareness about the field. In just 17 months, the Stepping Strong Fund has raised nearly $4.4 million, funded six researchers and engaged more than 7,100 people around the globe in the mission.

Responding to a Public Health Epidemic, Opioid Addiction in Mass.

Christopher Chiodo

Earlier this year, the state’s Department of Public Health released data showing that opioid overdoses and deaths are increasing at an alarming rate.

Opioids are medications that are commonly prescribed after surgery for short-term pain relief, especially for musculoskeletal pain. In addition to significant side effects, long-term opioid use can result in physical dependence.

The number of opioid-related deaths in 2014 (approximately 1,000) was 33 percent higher than two years ago, as well as the most ever recorded in Massachusetts. Every county in the state experienced at least one opioid-related death, and a few Boston-area counties, such as Middlesex and Essex, saw significant spikes.

Thousands of opioid overdoses result in emergency room visits and hospital stays and cause immeasurable suffering for families. Hospitals throughout the Partners system, including BWFH, have developed a variety of responses to this escalating crisis.

BWFH’s Addiction Recovery Program has a long-standing tradition of comprehensive care for people seeking recovery from alcohol and other drug addictions. Services include inpatient detox, group treatment programs and self-help meetings, as well as individual counseling. One of the program offerings is an outpatient suboxone program. Suboxone is a medication used to treat opioid addiction and help with pain control. The program involves suboxone induction followed by weekly maintenance group sessions for at least 12 weeks.

Additionally, a team at BWH and BWFH is exploring the cause of addiction and how it can be prevented. After a recently conducted study found that opioid addiction may begin in the doctor’s office, the team set out to learn why opioid consumption and dependence have become so common in the first place.

“I see patients every week who are battling or have battled addiction,” said Christopher Chiodo, MD, chief of Brigham and Women’s Foot and Ankle Surgery Service. “Even outside of the health care industry, just about everyone knows someone who has been affected by opioid addiction. My colleagues and I began to wonder where these patients get their initial exposure to opioids and to what extent we as physicians play a role?”

Together with Orthopedics colleagues Eric Bluman, MD, and Jeremy Smith, MD, psychiatrist Joji Suzuki, MD, and Orthopedics research assistant Mike Penna, Chiodo conducted a study titled “Opioid Addiction Resulting from Legitimate Medical Prescriptions” to explore the topic.

The study surveyed 50 patients ages 19 to 59 who were being treated for opioid addiction at BWFH’s Outpatient Addiction Treatment Center. Patients were asked about their initial exposure to opioids, when they first considered themselves “addicted” and about their later dependency. They were also asked about heroin use, comorbid psychiatric disorders, such as depression and anxiety, and the nature of the disorder for which opioids were initially prescribed.

The survey found that 58 percent of patients first began taking opioids when they were prescribed by a doctor. The most common drugs patients began with were Percocet (oxycodone), OxyContin (oxycodone) and Vicodin (hydrocodone). After they considered themselves “addicted,” 45 percent of patients reported getting the majority of their opioids through a prescription. Seventy-two percent of patients surveyed reported a history of heroin use.

Chiodo presented these findings at the 2015 American Psychiatric Association annual meeting held in Toronto.

“Too often surgeons prescribe an opioid pain medication for a longer time period than necessary,” said Chiodo. “I make sure to explain the side effects and risks of dependence to my patients. Opioids can mask symptoms that we need to know about and can cause gastrointestinal problems. But most importantly, we know they are highly addictive.”

State legislators including Governor Charlie Baker and former Senator Steven Tolman have also expressed concern about prescription opioids, urging physicians to take action.

“We need improved prescription monitoring programs, and our patients need better access to pain management specialists,” Chiodo added. “But even before that, as physicians who prescribe these types of medications, we need to be aware that we are oftentimes the starting point. We need to take our time with our patients and watch for warning signs. When we see signs of dependence, we have to be willing to have that difficult conversation with our patients.”

Parking, Security Recognize Staff at Awards Night

20150624, Wednesday, June 24, 2015, Boston, MA, USA; Brigham and Women's Hospital Department of Parking and Security held their annual appreciation banquet and awards event inside the Longwood Hall function room at the Longwood Galleria on Wednesday June 24, 2015. Presenting at the event in order: Robert Donaghue, operations manager, BWH Security and Parking; Robert Chicarello, director, BWH Security and Parking; Kevin Croake, account manager, Securitas; Kevin Leary Jr., president, VPNE Parking Solutions; ( 2015 © lightchaser photography )

From left: Bob Donaghue, Earl Strong, Ean Corduff and Gabriel Legesse, aka “Maroon 4”

Late last month, the Department of Security and Parking held its annual appreciation and awards event. The festive evening featured lip-synched performances by the department’s own Bob Donaghue, Earl Strong, Gabriel Legesse and Ean Corduff, who nicknamed themselves “Maroon 4” for the event, as well as dinner, music and the presentation of several awards.

“Our staff’s work directly influences the experience of so many people who come to the Brigham,” said Robert Chicarello, director of Security and Parking.

Added Donaghue, operations manager for the department: “The awards night is a small way to thank staff for what they do every day, which is incredible.”

This year’s Security Award winners were Arthur Hoffman (Officer of the Year), John Gomes (Dispatcher of the Year) and Sgt. Troy Askew (Supervisor of the Year). Parking Award winners were Chafik Essaouabi (Valet of Year), Khadda El Bouazzaoui (Supervisor of the Year), Ines Perez (Transporter of the Year), Joan Welch (Customer Service Person of the Year), Shewengzaw Chala (Cashier of the Year), Esteban Bonilla-Perez (80 Francis St. Garage Employee of the Year) and Geylor Espinal and Khadda El Bouazzaoui (Excellence in Patient Care Award Winners).

The event also recognized Boston Police and the city’s first-responders, several of whom attended with their families, for their response to the events of Jan. 20 at BWH.

New Primary Care Practice Opens for Community Members, Employees

The Brigham and Women’s Primary Care Associates, Longwood, team. (Not all are pictured.)

On June 22, BWH’s newest primary care practice, Brigham and Women’s Primary Care Associates, Longwood, opened its doors at 800 Huntington Ave. Just a few blocks from BWH’s main campus, the practice is a patient-centered medical home, meaning that patients will experience an innovative approach to team-based care when they step inside.

The multidisciplinary team currently consists of internists Mustafa Khaled, MD—who speaks Spanish, Arabic and Portuguese—Erika Pabo, MD, MBA, Sonja Solomon, MD, and nurse practitioner Elizabeth Donahue, NP, (see related story on page 3) all of whom care for their own panel of patients. Longwood Medical Director Larissa Nekhlyudov, MD, MPH, who comes to BWH from Harvard Vanguard Medical Associates, will begin seeing patients in September.

“Our hope is to welcome a diverse patient population to our practice from the local community and from BWH and encourage them to be active participants in their care,” Nekhlyudov said.

The team also includes Wendy Alcantara, LPN, Irma Valsamakis, LICSW, Elizabeth Decossa, MA, Adriana Paranhos, MA, Jennifer Allen, PharmD, practice manager Sheyla Aponte and practice assistants Ruth Rodriguez and Jennifer Fields. The practice is hiring additional clinicians, including a nutritionist, with the goal of having a fully staffed practice in about a year.

“BWHC and the entire Partners system understand and support the reality that we need to invest in creating new practices that reflect our best thinking about team-based care,” said Joseph P. Frolkis, MD, PhD, vice chair of Primary Care. “In addition to continuing to offer care to our local community, we are excited that we are also able to provide care to another important part of this community: our employees.”

The practice seeks to build a strong network of specialty providers from BWH and develop effective ways for the team and these specialists to communicate about patient care. This will include inviting specialists to visit the site, in person or virtually, to meet the team and learn more about the practice. The team will also work closely with BWH inpatient clinicians to ensure a smooth transition following hospital discharge.

The practice seeks to fill a gap as the need for primary care providers increases.

“It’s on the team’s shoulders to do the best job it can at preventing unnecessary utilization, so we can improve care and drive down costs,” said Frolkis.

Partners’ goal is to have all BWH and BWFH primary care sites certified as patient-centered medical homes by the National Committee for Quality Assurance (NCQA) by 2018. Currently, three BWH practices are recognized by the NCQA as patient-centered medical homes: Brigham and Women’s Advanced Primary Care Associates, South Huntington, Brigham and Women’s Primary Care Associates, Newton Corner, and Southern Jamaica Plain Health Center.

Similar to other primary care practices, the Longwood practice is incorporating medical students and residents, and two residents have already followed Solomon, their preceptor, from the Phyllis Jen Center.

“Whether or not trainees eventually go into primary care, it’s important to expose them to this evolving model of care delivery that is becoming increasingly common at a national level,” Frolkis said.

To learn more or make an appointment, call 857-307-2200. View photos of the new practice.

Student Success Jobs Program Graduates to Begin New Journey

When Arnold Castaneda first joined BWH’s Student Success Jobs Program (SSJP) as a sophomore at Boston Latin Academy, he says he was reserved and unsure of himself. Three years later, as Castaneda prepares to begin college at Tufts University this fall, he’s proud of how much he has grown both personally and professionally, thanks in part to SSJP and his mentors.

“Being a part of SSJP was life-changing for me,” said Castaneda, who dreams of becoming a doctor focused on improving health care access for LGBT patients. During his time at BWH, he worked in the OB/GYN laboratory. “I was extremely shy and afraid to advocate for myself when I first joined SSJP, but the program helped me to come out of my shell.”

A program of BWH’s Center for Community Health and Health Equity (CCHHE), SSJP is in its 15th year of matching Boston-area high school students with mentors across BWH for year-long internships. The program is committed to building a talented, diverse health care workforce for the future of BWH, Partners and the broader health care community.

On June 22, SSJP recognized students for their hard work and accomplishments during a graduation ceremony in the Joseph B. Martin Conference Center at Harvard Medical School. This year’s class of 87 participants includes 33 graduating high school seniors, all of whom have enrolled in a two- or four-year college program.

Many students participate in the program for more than one year, gaining experience in different departments and teams. SSJP also supports students with the college application process, provides SAT preparation and offers scholarships to graduating seniors with the financial support of Partners.

At the ceremony, Sasha DuBois, MSN, RN, nurse-in-charge of Tower 10BA and former SSJP participant, told students that if they set their minds to their dreams, they will achieve success.

“SSJP helped me carry out my dream of becoming a nurse by giving me opportunities to not only get my foot in the door of the health care industry, but to thrive in it as well,” she said. “The program gives students a chance to start their careers early.”

Fenway High School graduate Giselle Colon hopes to pursue a similar career path as DuBois. Colon, who has been involved in CCHHE’s programs since middle school, said that because of SSJP, she’s ready to begin a new journey at the University of Massachusetts Boston studying nursing.

At the ceremony, students also heard from Turahn “Rahn” Dorsey, the City of Boston’s first chief of education and a member of Mayor Marty Walsh’s cabinet.

Michelle Keenan, director of Community Programs for the CCHHE, and Lisa Taylor-Montminy, CCHHE Youth Development manager, said they are proud of the graduates and excited to see what the future holds for them. They thanked BWH volunteers who serve as SSJP mentors for all that they have done to teach and motivate students.

“The culmination of watching the students grow into adults and knowing the commitment it took for them to get to where they are today is so exciting,” Keenan said. “The students are so thankful for their experiences with SSJP, and we appreciate their dedication to the program. These diverse and talented students are the future of BWH, and undoubtedly, the future looks bright.”

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Bill Churchill, MS, RPh, chief pharmacy officer for Brigham and Women’s Health Care, said through his work in leading multiple United Way campaigns he’s learned how the organization helps people.

Judy Walls, of the BWH Medical Library, feels good knowing that her donations are helping children and families in need.

Stephen Moore, PhD, of Radiology, talks about the importance of donating to organizations that support the local community.

Annemarie Austin, RN, business director of Clinical Operations in the OR, volunteered at the United Way rolling rally raffle cart and ice cream social.

Luis Soto, director of Environmental and Central Transport Services, said it is a great feeling being able to help others.

Sarah Abbett, MD, MPH, clinical consultant with the Brigham and Women’s Physicians Organization, supports United Way because the organization supports local families.

Tao Harris, senior OR administrative assistant, and his colleagues donated funds from a Fitbit contest to the United Way.

Ellen Bergeron, MSN, RN, program director at the Center for Nursing Excellence, supports United Way because many of the programs support the physical, academic and emotional development of individuals of all ages.