Tower 14AB staff

BWH is pursuing Magnet designation to be formally recognized for the everyday excellence, teamwork and innovation demonstrated at the Brigham. Magnet is the highest recognition given by the American Nurses Credentialing Center for health care institutions providing exceptional patient care.

BWH submitted a body of evidence in April that demonstrates how the hospital meets the Magnet model. The Brigham will be notified in the coming months whether it has met the requirements for a site visit. During a site visit, which would take place in early 2018, appraisers speak with employees, patients and families about the quality of care provided.

As part of this journey, BWH Bulletin will regularly share examples of projects and initiatives that reflect our commitment to quality, safety, collaboration and innovation in care to ensure that all staff are aware of how we meet the criteria for Magnet.

Goal for the Day, Goal for the Stay

• Tower 14AB staff wanted to increase patient engagement in developing plans of care to ensure patient-centeredness.
• An interprofessional team was formed to evaluate bedside rounding practices.
• The unit-based nursing practice council developed a “Goal for the Day/Goal for the Stay” card and implemented a process to engage patients and their families in completing the card each day.
• Using “Goal for the Day/Goal for the Stay” cards to guide beside rounds has increased patient and family engagement in the development of plans of care and enhanced care team communication and collaboration.

Magnet Exemplary Professional Practice (EP) Standard 4

There are two main areas of personal satisfaction that have been afforded to me while at the Brigham.

MRI exams may be unpleasant or even frightening experiences for patients – either due to the unknown, claustrophobia or a prior negative experience. A special experience occurs when a patient or family member smiles and comments that they are happy that you are once again performing their exam. This is accomplished by simply, as the Patriots would say, “doing your job,” which is maintaining a professional atmosphere where the patient feels comfortable and protected, and providing images that are of diagnostic quality for the clinicians.

I have also enjoyed being able to observe the transformation of a student technologist assigned to our area into a professional technologist, fully competent and prepared to safely attend to the needs of the patient.

Kenneth Kinser, BS, RT (R) (CT) (MR), MRI Technologist, Department of Radiology

Bill Churchill watches the IntelliFill robot sort syringes – one of the many innovations implemented in the Pharmacy under his leadership.

I’ve been at the Brigham for nearly 43 years, starting as an intern at the Boston Hospital for Women. My three proudest accomplishments with the incredible Pharmacy team reflect our deep commitment to improving patient safety through innovation and interdisciplinary collaboration. Our pioneering work has made care safer for patients at BWH and around the world. 

1. The introduction of clinical pharmacists to patient care areas. Previously, pharmacists worked primarily in the pharmacy. I made it my goal for pharmacists to be available to physicians, nurses, patients and families on the units, and many people have told me how much this change advanced the care of our patients.
2. The advent of electronic medication administration record (eMAR) and barcode verification systems. We were the first hospital in the world to implement two-dimensional barcode scanning, which changed the way we dispensed and administered medications. Because of our pioneering work, we made care safer for patients worldwide.
3. The transition to computerized physician order-entry (CPOE). Previously, we used paper records, charts, orders and medication profiles. CPOE, which allows us to electronically enter medication orders and physician instructions, was a major change in how patients were cared for, starting in the early 1990s. Many hospitals around the country implemented CPOE at that time, but it was a complex transition. We were one of the few hospitals that did it successfully.

Bill Churchill, MS, RPh, FMSHP, Chief Pharmacy Officer

Opioid-related deaths: Massachusetts / Source: Massachusetts Department of Public Health

Opioid use disorder and opioid-related overdoses continue to devastate communities and families across the U.S. In Massachusetts last year, the severity of the crisis prompted policymakers to enact legislation to set limits on clinical opioid prescription and to establish screening systems to identify high-risk individuals.

To support this legislation and develop additional best practices, Partners created the Opioid Steering Committee, which includes representatives from the Brigham Comprehensive Opioid Response and Education (B-CORE) program at BWH.

A major component of this initiative has been the development of new functionality in Partners eCare to help providers document a patient’s history with opioids, educate patients about potential risks associated with opioid use and evaluate a patient’s risk factors for developing a substance use disorder.

BWH providers can use these tools to easily view opioid-related patient information and compliance requirements as well as document patient conversations regarding the appropriate use of prescription opioids.

Safe opioid-prescribing practices are fundamental to mitigating opioid abuse in our community, said Scott Weiner, MD, MPH, of the Department of Emergency Medicine and director of B-CORE.

“This crisis is affecting the entire country, and Massachusetts is definitely no exception,” said Weiner, who presented on the topic at the BWH Town Meeting on May 25. “As a group, we spent a lot of time thinking about how we can make opioid prescribing more uniform and evidence-based across the institution. We found that there are a lot of ways that Epic can help us achieve this.”

Partners’ Opioid Steering Committee, along with hospital leadership, continues to identify ways to support providers in managing medications, educating patients and safely treating acute pain. Partners and Brigham Health are also working closely with local communities and the state government to treat and prevent addiction.

Learn more at partnersecare.partners.org/opioid.

Rachel and Jason Miller cradle their newborn son, Greyson.

Rachel and Jason Miller had an extra special reason to celebrate the birth of their first child, Greyson, when he arrived two days early on May 14 – just in time for Mother’s Day.

Rocking Greyson in her arms in the Connors Center for Women and Newborns on Monday, Rachel described the process of giving birth as tiring but magical.

“Life has changed in ways we never could have imagined,” Rachel said with a wide smile. “We can’t stop staring at Greyson.”

Sitting with Rachel on her hospital bed, Jason said he felt as if he was in a “dreamland” with his family of three.

“It’s fitting that a first-time mom got such a special gift on Mother’s Day,” Jason said. “I’m incredibly proud of her. Every day will be Mother’s Day in our house.”

When Rachel went into labor, she called her mother, Nancy Presseau, to give her an update. Presseau, who lives in California, took a red-eye flight and arrived at the Brigham an hour before Greyson, her first grandchild, was born.

The day was especially heartwarming for Nancy because she was also born on Mother’s Day.

“Before I booked my ticket, I was running in circles around my house because I was so excited,” Nancy said. “I couldn’t wait to hold Greyson in my arms for the first time. It’s a feeling you can’t describe.”

Both Rachel and Jason praised the teams who cared for Rachel and Greyson. Every time a new care provider walked into the room, Jason would make a note of their name in his phone so he could remember to thank each of them personally.

“Everyone has been awesome,” Jason said. “Rachel, Greyson and I appreciate everything they are doing for us.”

BWH Employee Welcomes Third Child

After coming to the hospital twice on Saturday believing she was in labor – only to learn that both events were false alarms – Danielle Garlinger knew the next morning was the real deal when her contractions began. She was ready to deliver her baby.

Upon arriving at the Brigham’s main entrance around 6:40 a.m. on Mother’s Day, she was wheeled into the hospital and, within five minutes, was introduced to her new baby girl, Charlotte.

“I still can’t believe she’s here,” said Garlinger, a senior revenue analyst in the Brigham and Women’s Physicians Organization. “Charlotte arrived with quite a little kick.”

This is Garlinger’s third child. Due on May 30, she said it was clear Charlotte didn’t want to wait another second to make her entrance to the world.

Garlinger said delivering her daughter on Mother’s Day was a wonderful surprise, and she looks forward to sharing the story with Charlotte when she’s older.

Staff, patients and advocates celebrate the unveiling of a new memorial honoring organ and tissue donors.

A new memorial on the second-floor mezzanine was recently unveiled to honor organ and tissue donors whose gift of life has resulted in critically needed transplants for BWH patients.

The memorial, depicting a tree of life on the wall, was revealed during a brief ceremony on April 11 as part of the Brigham’s activities commemorating Donate Life month. Kathleen Gallivan, SNDden, PhD, director of Spiritual Care Services, led a prayer to express appreciation for and remembrance of all donors.

“The tree represents rebirth, as an organ or tissue donation gives someone a new chance at life,” said Galen Henderson, MD, medical director of Neurocritical Care and the Neuroscience ICU. “I hope people passing by look at it and recognize the Brigham’s history of saving lives with transplantation and the importance of signing up to be a donor.”

More than 119,000 people in the U.S. are on the national transplant waiting list; the number of registered donors is only a fraction of that, according to the U.S. Department of Health and Human Services.

Brad Biscornet, 44, a firefighter and emergency medical technical from Tyngsborough who received a heart transplant at BWH in 2007, attended the unveiling.

“There is no possible way anyone can pay due tribute to the sacrifices that these donors made, but the Donate Life memorial is one small way we can show our gratitude as transplant recipients,” Biscornet said.

Alma Tambone on a recent training run with the Stepping Strong team

This is the final installment in a weekly series profiling runners participating in this year’s Boston Marathon on behalf of BWH.

Although Alma Tambone doesn’t remember being in BWH’s NICU as an infant, she’ll never forget that the expert care she and her twin sister received as premature newborns saved their lives.

Born at 29 weeks, Tambone and her sister, Linsey, arrived three days after their mother was admitted to BWH. The sisters required constant medical attention, as their organs were still undeveloped. They had been given a 50 percent chance of survival. But thanks to the advanced care they received at the Brigham, today Tambone and her sister are healthy, thriving 24 year olds who live, respectively, in Boston and New York.

“Our mother was first brought to the local hospital in Winchester, but after she had arrived there and was assessed, they rushed her to BWH due to the severity of her premature labor,” Tambone said. “BWH was the only option, having the highest level of care for premature babies. It was a scary time for her, but she was relieved and comforted by the reputation and the staff of BWH.”

To show her appreciation for the hospital that cared for her and her family, Tambone will run the Boston Marathon as a member of BWH’s Stepping Strong Marathon Team on Monday, April 17.

Tambone has long enjoyed running, but this will be her first marathon. She acknowledged that the training and dieting regimens have been new challenges. Though she’s gradually increased her mileage since November, her body is still adjusting to the physical toll of long-distance running.

“I’ll run at least four times a week – usually three, six, nine, or 12 miles – and I’ve been increasing that distance” she said. “Once I hit 20 miles, I step back a little bit. You run 20 miles one day and don’t feel it until a week later at the gym.”

To keep up with the physical demands of training, Tambone and other runners on the Stepping Strong Marathon Team have also been following dietary plans, which include a spike in caloric consumption during meals to keep up with the training.

“Training for the marathon is the hardest thing I’ve ever done, but I’ll never forget the camaraderie of the team and the people I’ve met throughout the process,” she said. “It’s been an amazing experience, and I wouldn’t change it for the world.”

To learn more about the BWH marathon program, visit crowdrise.com/steppingstrongboston2017.

Jim and Jennifer Davis

This is the final installment in a weekly series profiling runners participating in this year’s Boston Marathon on behalf of BWH.

Jim Davis was a mile into last year’s Boston Athletic Association 5K when suddenly he couldn’t breathe. The last thing he remembered was hearing his wife, Jennifer, who was also running in the race, call out for help.

“I knew something was wrong,” said Jim, a professor from Utah. “I thought I had been fighting a cold a week or so before the race, but it ended up being much worse.”

Jim was rushed by ambulance to Massachusetts General Hospital, where doctors discovered that four major arteries in his heart were 75 percent blocked. Two days later, on Marathon Monday, he underwent heart surgery.

The events of that weekend were supposed to play out much differently for the pair who met on a blind date almost four years ago. They had planned to run the 5K together that Saturday, and then Jennifer was set to run her 16th consecutive Boston Marathon on Monday.

“We were so excited, but then everything changed in the blink of an eye,” said Jennifer, a commercial interior designer and long-time runner. “We went from hearing the cheers from the crowds along the route to hearing sirens.”

Jennifer ended up not running the 2016 Boston Marathon. Instead, she watched the race on TV from her husband’s hospital room – an image Jim says he’ll never be able to forget.

“I saw the pain in Jennifer’s eyes as she sat there watching the elite runners take off,” he said. “I wanted nothing more than for her to run. She should have been there. It breaks my heart she ended her string of consecutive Boston Marathons because of what happened to me.”

Before surgery, Jim, who wore Jennifer’s Boston Marathon bib as he was wheeled into the operating room, made a promise to his wife that they would run together in the 2017 Boston Marathon. And that’s exactly what they will do on Monday, April 17.

While researching different teams they could join for the 2017 race, Jennifer and Jim said they were inspired to run with BWH’s Stepping Strong Marathon Team after learning more about the mission and work of The Gillian Reny Stepping Strong Center for Trauma Innovation.

Jim said he wants to run to help raise awareness of the center and everything it does to inspire hope and transform outcomes for civilians and soldiers who have suffered traumatic injuries and events. He also felt a personal connection to BWH, as one of his care providers, Sanjay Divakaran, MD, was a BWH Cardiovascular Medicine fellow doing a rotation at MGH at the time of Jim’s surgery.

“Being in Boston for the Marathon literally saved my life,” said Jim, who will run his first Boston Marathon this year. “I received care in the greatest city for health care in the world. I want to run to save the lives of others. Running with the Stepping Strong team is an absolute honor.”

The couple has run several races together, including a marathon at Mount Kilimanjaro in Tanzania, Africa, but participating in the Boston Marathon together will be something they’ll forever cherish.

Describing the Boston Marathon as the “Super Bowl of races,” Jim is looking forward to crossing the finish line holding Jennifer’s hand.

“Running together is the best part of our lives,” Jim said. “Running Boston with Jennifer is a dream come true. I’m so much happier when I’m running alongside her. It means the world to me that in just a few short days, we’ll be back in the city that saved my life.”

To learn more about the BWH marathon program, visit crowdrise.com/steppingstrongboston2017.

From left: Juan Jaime de Zengotita, Meghan Doherty, Erica Tobias and Ole-Petter Hamnvik

After Erica Tobias finished filling in an intake form for her first endocrinology appointment at a clinic in Western Massachusetts, she delivered the paperwork to the practice assistant with a small, but important, request: “My name is Richard, but if there is some way you could refer to me as Erica, I would appreciate it,” she said.

Tobias had recently begun to live as a transgender woman. Sitting with her sister in the clinic’s waiting room, Tobias felt relieved and grateful. She had finally found the strength to accept and address the lifelong uncertainty she had felt about her gender identity.

Then, a nurse came into the clinic’s waiting room: “Richard?” she called out.

Although possibly unintentional, the mix-up felt insensitive, Tobias recalled. It’s also a scenario many transgender patients encounter – and one that may discourage them from accessing health care – said Tobias and other speakers during a panel at BWH about transgender health issues on March 29.

“The thing that’s most important to me as a patient is to be treated with respect and dignity,” said Tobias, 62, a transgender advocate and retail beauty manager.

The event, “Tackling Disparities in Health Care for Transgender Patients,” was co-sponsored by Brigham Health’s LGBTQ Patient Family Advisory Council (PFAC) and LGBT & Allies Employee Resource Group as part of National LGBT Health Awareness Week 2017. In addition that day, the Human Rights Campaign named BWH and BWFH as 2017 Leaders in LGBT Healthcare Equality, marking the ninth year the institutions have received the honor as part of a national survey.

“Because LGBTQ people are regularly discriminated against in employment, relationship recognition and insurance coverage, they are more likely to get sick and less likely to be able to afford vital health care,” said panel moderator and PFAC member Gary Bailey, MSW, ACSW, a professor at Simmons College.

Education, Support and Advocacy

Health care providers play a vital role during the transition process – the time period during which someone starts to live according to their gender identity, rather than the one assigned to them at birth – panelists said. This creates many opportunities for discussion and education about sensitivity and health concerns.

“In my journey to become Erica, the health care that I’ve received along the way has been so important, starting with my primary care physician, who practices at Brigham and Women’s in Foxborough,” Tobias said. “Educating people, including health care providers, and making them comfortable is the direction we need to go.”

Ole-Petter Hamnvik, MB, BCh, BAO, MMSc, an endocrinologist in the Division of Endocrinology, Diabetes and Hypertension, said he makes it a point to discuss transgender health issues with medical students, residents and fellows during their training. This process often includes meeting a transgender patient who is willing to share their experiences, which can be a powerful moment for trainees, Hamnvik said.

Speakers also discussed the need for more targeted health care for transgender patients. Tobias said that during her transition, she would have loved to receive all of her care at BWH but had to seek some services – including facial feminization surgery, large-volume electrolysis hair removal and sexual assignment surgery – from as far away as Chicago and Scottsdale, Ariz., because they were not offered locally.

Panelists said discussions are underway about launching a dedicated clinic at BWH to address the health needs of transgender patients. Several groups are also working on ways for patients to easily identify which clinicians have expertise in LGBT care.

“As providers, we have the capacity to influence the health care system through our own actions and advocacy, and I think the work we’ve seen here at the Brigham demonstrates that,” said Juan Jaime de Zengotita, MD, medical director of Southern Jamaica Plain Health Center.

Newlyweds Walter Long and Valerie Akins-Long

When Walter Long moved into his new home in Roxbury a few years after completing a tour of duty as a U.S. Navy machinist during the Vietnam War, someone across the street noticed.

That someone was the mother of Valerie Akins, who was then 26 years old, single and recently back home after a relaxing vacation with friends in the Bahamas. “A nice-looking gentleman moved in across the street,” her mother casually noted.

It was a warm spring day when Akins went to sit on her mother’s porch and enjoy the weather. She caught the eye of that handsome gentleman from across the street.

“I want to meet that gal,” Long recalled thinking. He walked over to say hello. It was the start of nearly four decades of love and partnership.

They postponed marriage; life always got in the way, explained Akins, now 65. But together they celebrated times of joy – including the birth of their son, Jonathan, now 30 – and faced challenges. The most poignant of those was when Long, now 69, was diagnosed with terminal metastatic bone cancer. He was recently admitted to the Brigham to receive care as the disease progresses.

Wanting to make the most of their time together, Long and Akins (now Akins-Long) married in the family room on Tower 10B on April 3. Family, friends and members of Long’s care team gathered for a wedding ceremony performed by Bishop Enos Gardiner, MA, BCC, of Spiritual Care Services, and filled with scripture, song and loving vows.

“I give this ring to you with all the love in my heart that I have,” Long said to Akins, speaking from a hospital bed wheeled into the room for the ceremony. “And I give this ring with appreciation to have a woman like you who stood by a guy like me for more than 30 years, for all the tough times and the all good times. You were always there. You believe in me, and I believe in you.”

Through tears, Akins pledged her love in return as she slipped a wedding band on Long’s finger: “Walter, I give you this ring to show all the love I have for you and all the love I’ve ever had.”

After reading from the book of Genesis and leading the room in prayer, Gardiner said it was his privilege to witness and perform the ceremony.

“God has caused them to stay together in spite of any challenges – and that’s what real love will do,” he said. “When the storm comes and the wind blows, when you feel like giving up, there is something known as ‘stickability,’ and they have that.”

Other BWHers who helped organize the ceremony were Farah Abellard, MSN, RN, charge nurse; Pauline Brunache, patient care assistant; Ruth Delfiner, of Spiritual Care Services; and Jennifer Lopes, unit coordinator.

The bride’s sister, Fern Seay, an administrative assistant in the Division of Maternal-Fetal Medicine, attended the wedding and described the couple as inseparable.

“They’ve been together forever,” Seay said. “When you see Val, you see Walter. You see Walter, you see Val. You just associate them together all the time.”

The newlyweds said they were deeply grateful to the Brigham for the exceptional care that its staff has provided – medically and emotionally.

“Walter has been a patient of Brigham and Women’s for so long. He really likes this hospital, so we came here when he needed care,” Akins-Long said. “They take excellent care of us.”

From left: Parents Matt Kyller and Kelli Jones Kyller, and parents Sarah Jones and Ryan Jones, with their newborns. Matt and Sarah are siblings, as are Kelli and Ryan.

It’s safe to say the Jones and Kyllers’ family tree has more intersecting branches than most, with its roots coming from two sets of siblings who married their spouse’s sibling. Two more joyful, overlapping and improbable branches sprouted recently when each family celebrated the birth of a child on the same day at the Brigham.

Kelli Jones and Matt Kyller met while they were students at the College of the Holy Cross in Worcester. In the run-up to their 2009 wedding, Kelli’s younger brother, Ryan Jones, also a Holy Cross alum, was introduced to Matt’s younger sister, Sarah Kyller. Ryan and Sarah fell in love, marrying four years later.

Last year, sisters-in-law Sarah and Kelli – now Kelli Jones Kyller – learned they were pregnant at the same time, with due dates a week apart. Despite being a family whose lives were interwoven in many ways, both moms were stunned by this latest twist, especially after delivering their babies less than 12 hours apart from each other.

“Ryan kept saying we were all going to be in the delivery room at the same time, but we thought, ‘No way is that going to happen,’” said Matt.

But Ryan was adamant throughout the pregnancy that the babies would be born the same day – even predicting correctly that Sarah would give birth a week early.

“I was just convinced that we’d be here at the same time,” he said. “Our families are already pretty close, so this works out for everyone.”

‘This Is Actually Going to Happen’

Ryan double downed on that assertion when the Easton couple welcomed their second son, Colin, to the world that February morning. The Jones grandparents were driving home after visiting Ryan, Sarah and Colin at BWH when they got the phone call: Kelli’s water had broken.

“I just started hysterically laughing,” Kelli said. “I was like, ‘Matt, I think this is actually going to happen.’”

The Milton couple’s third daughter, Reagan, was born that night.

Both moms and babies also have been cared for by some of the same providers, including obstetrician Lisa Lampert, MD, of New England OB/GYN Associates, and pediatrician Lise Johnson, MD, chief of the Division of Newborn Pediatrics. Lampert shared another special link with the families: She is a Holy Cross alum, as well.

“It was a first for me to deliver cousins on the same day and fun that we also all had that Holy Cross Crusader connection,” Lampert said.

The two families recovered on the same floor in the Connors Center. It was comforting to have each other nearby, as a snowstorm had prevented most of their family and friends from visiting that week, Matt said. In addition, Matt and Sarah’s dad, Michael Kyller, MSN, RN, CCRN, CNS-AC, is a nurse educator in BWH’s Cardiovascular Diagnostic and Interventional Center, which made it easy for him to visit.

The couples’ other children, all of whom were born at the Brigham, are excited to welcome home a new sibling and cousin each, Sarah said.

“We’re used to doing a lot of stuff with our siblings and families, so it doesn’t really seem that weird to us,” Matt said. “But then you think about it, and it’s exciting. It was really nice to have our family here.”

Rachel Ovaginian shows her son, Cameron, a valentine made for them by a donor from the Kraft Family Blood Donor Center.

More than 100 donors from the Kraft Family Blood Donor Center at BWH and Dana-Farber Cancer Institute sent their love and well wishes to babies and their families in the Brigham’s NICU this Valentine’s Day.

Donors came to the KFBDC on Feb. 10 and 11 to sign Valentine’s Day cards for NICU patients and families, as well as for pediatric patients receiving care at Dana-Farber’s Jimmy Fund Clinic. The event culminated with a blood and platelet drive at the center on Feb. 11.

BWH nurses distributed the cards – along with handmade ones the unit’s staff had also created – to families on Valentine’s Day.

The holiday season between November and December is a popular time for giving back, but the need for blood and platelet donation is constant, said Justin Solle, blood donor recruiter with the KFBDC.

“We look at Valentine’s Day as a way to connect with our younger patients and get our donors more involved,” Solle said. “The donors give blood and platelets, and they don’t always see the outcomes of the great work they’re doing. This is another way to bring them a little closer to that.”

From left: V-Day speaker and survivor Kalie responds to a question alongside panelists Soheyla Gharib and Ramsey Champagne.

“What’s wrong?” It’s a natural opening question when trying to find out why a patient is in distress.

But those two words, which many patients would find harmless, can cause those who have experienced trauma to shut down during an appointment if they interpret it as judgmental or accusatory, according to speakers who participated in BWH’s second annual event honoring V-Day, held Feb. 10 in Bornstein Amphitheater.

The insight was one of many shared at this year’s event, titled “A Trauma-Informed Care Approach to Treating Campus Sexual Assault Survivors.” During the program, a sexual assault survivor shared her story, followed by a panel discussion with experts from BWH and Harvard University. The event was among the hundreds that took place around the world that day as part of V-Day, a movement aimed at raising awareness about violence against women and girls.

Getting patients who have experienced trauma to feel comfortable opening up to their provider is a slow, gradual process – and one that doesn’t always result in a complete picture, explained panelist Annie Lewis-O’Connor, NP, PhD, founder and director of BWH’s Coordinated Approach to Recovery and Empowerment (C.A.R.E.) Clinic. Establishing trust starts with creating a dialogue that “seeks to understand what happened to you, not what is wrong with you,” she said.

“Sometimes, health care providers feel like they have to ask very pointed questions and get the whole story,” said Lewis-O’Connor, who co-chairs BWH’s V-Day Committee with Jeffrey Katz, MD, MSc, of the Division of Rheumatology, Immunology and Allergy. “What we’ve found out is all the patient needs to tell me is, ‘I’ve had something really bad happen, and I need help.’ And in their time and way, they can share as little or as much as they’re comfortable with.”

Nomi Levy-Carrick, MD, MPhil, of the Division of Medical Psychiatry, agreed that caring for survivors requires a different way of thinking.

“Sometimes what we think is empathic – because of our backgrounds or the way we’ve been taught to speak – actually doesn’t come across that way to other people,” she said. “I am learning every week about how, in different contexts, we can engage different people in ways they feel safe.”

Understanding the Needs of Survivors

What providers and patients say – and how they say it – is only the starting point, speakers said. Patients who have experienced sexual assault may not want to be touched or change into a robe, requiring adjustment to the traditional physical exam.

Kalie, a volunteer at the Boston Area Rape Crisis Center and sexual assault survivor (who used only her first name), said she had a lot of anxiety about seeking care from her primary care provider to address medical concerns resulting from the assault. Her therapist referred her to a clinician who had been trained in trauma-informed care – an approach that recognizes the multiple symptoms and effects of trauma, incorporates that knowledge into practice and procedures, and avoids actions that may retraumatize the patient.

“It was a weight off my shoulders to walk into a room with a doctor and know that if I had a panic attack or got triggered, she wouldn’t be confused by that,” she said. “I could say, ‘This is an injury I’m concerned about,’ and she wouldn’t make me explain in detail how it happened.”

BWH provides trauma-informed care training to any interested staff, Lewis-O’Connor said. The hospital is also a designated Sexual Assault Nurse Examiner (SANE) facility, with Emergency Department nurses specially trained to collect evidence after a sexual assault.

Other panelists at BWH’s V-Day event were Ramsey Champagne, MA, a community advocate at Harvard’s Office of Sexual Assault Prevention and Response, and Soheyla Gharib, MD, chief medical officer at Harvard University Health Services and co-founder of BWH’s Women’s Health Center. The panel was moderated by Mardi Chadwick, JD, director of Violence Intervention and Prevention programs at BWH.

Speaking directly to members of the audience, Kalie thanked providers for wanting to understand the needs of patients like her.

“It’s little things that make a big difference – a slight tweak in language that makes the appointment feel less accusatory and more like you want to know my story,” she said. “You have no idea how it feels to know that I can walk into this hospital and you, as an organization, are supportive of survivors and women’s health. That would make me feel better about coming here and telling another survivor to come here if they needed services. That’s a big deal.”

To learn about training opportunities in trauma-informed care, contact Annie Lewis-O’Connor at aoconnor@partners.org or 617-525-9580.

A BWH care team of nearly 30 people helped a New Hampshire mom deliver healthy quadruplets last week. The babies – two boys and two girls – are staying in the NICU for several more weeks as they grow bigger and stronger. Parents Corrie Cook and Keith Cook, who also have a 3-year-old son, were shocked but elated when they first learned their family of three would become a family of seven. The quadruplets arrived within minutes of each other, each weighing about 3 pounds. View a photo album of the Cook’s quickly growing family.

I have the privilege of observing firsthand the many triumphs – and, sadly, occasional tragedies – that occur across this amazing institution every day. For me, the common in these experiences is the way each person who commits to our precious mission genuinely cares for our patients, their families and one another.

As I reflect on the lives saved, wounds healed, illnesses cured, babies nurtured, innovations developed and the mysteries of science uncovered, it’s the people involved and the relationships they forge that truly touch my heart. One such shining moment occurred this summer, in an OR at BWFH, as Dr. Matt Carty was getting ready to perform a first-of-its-kind amputation. As the patient was about to be anesthetized, Dr. Carty stopped, took the patient’s hand, looked into his eyes and said a few quiet words to him. The patient quietly responded, and as the embrace lingered, I realized I was witnessing in that moment what for me typifies the Brigham Way. It wasn’t about roles or credentials or expertise – it was about human connection and one individual doing everything possible to improve the life of another.

Erin McDonough, MBA
Senior Vice President, Chief Communication Officer, BWHC

A shining moment in 2016 was when I had a patient come in asking for a medication refill. After I helped place the medication refill, he asked if I could call the Pharmacy to see how much it would cost out of pocket. As an immigrant, he had difficulty navigating the health care system. He was also scared because he had lost his health insurance. I know how it feels to not have health insurance and have a serious condition, so I told him to hold on one moment.

I ran to another side of my center and grabbed a good prescription health insurance card that one of our nurse practitioners has in her exam rooms. I gave him instructions, advising that I have used it before, so I know it works. BWH does not accept that insurance plan, so we sent the prescription to his local pharmacy. With this coverage, we saved him 80 percent on the medication.

As he was leaving, he told me that God sent me to him to help. He had been worried how he would pay for his prescription and asked if he could pray for me. I stood there and realized that just going a little out of my way can help one person more than we can imagine. I did not do it for recognition. I did it because I put myself in his shoes and know that some things cannot be controlled, and all we can do is move forward and wish for the best. I always say that I come to work to make a difference in one person’s life a day. If I can help at least one person, my job is done. Thank you, Brigham, for bringing out the best of me!

Kimberly Ruiz
Medical Assistant II, Phyllis Jen Center for Primary Care

I’ve had the privilege of witnessing many shining moments at the Brigham throughout 2016, but one that stands out for me is attending the Heart & Vascular Center’s recent event honoring some of our heart transplant recipients and the milestones they have achieved.

I can’t properly describe the emotions I experienced as I listened to the remarkable narratives of patients who have been living with a donor heart for two decades or more. I can rarely remember feeling more proud than when they described what they referred to as a “second chance at life,” reciting their most meaningful experiences – marriages, anniversaries, graduations, and the birth of grandchildren.

A particularly poignant moment occurred when a donor’s mother shared the story of the unbreakable bond  she has formed with the man who received her son’s heart in 2007. There wasn’t a dry eye in the room when she spoke about what it meant to her family to be able to meet the donor recipient and listen to her son’s heart beat once again.

The event and the patients’ reflections were powerful reminders of why we are here and why each of us has chosen to work in health care. Coming together across disciplines and in many roles, we are able to give people the most precious gift of a second lease on life.   That is the Brigham way.

Ron M. Walls, MD
Executive Vice President and Chief Operating Officer, BWHC

When I was pregnant with my first daughter, I was terrified of the labor and delivery. I like to have control over as much as I can, and childbirth seemed like the least amount of control I would ever have. But I knew I would be at the best hospital and that the doctors would take amazing care of me. Little did I know, it was the nurses who would impact my experience most of all.

The majority of my labor was 7 p.m.-7 a.m., coinciding with nurse Jennifer Mosaheb’s shift. Jenn was phenomenal. She meant business, but cared for me delicately. She was never flustered or rushed, and her overall demeanor allowed me to let her be in control. I delivered my daughter at 7:15 a.m., and I think I hugged Jenn before I held my daughter! I said to her, “I can totally do that again. I’ll see you in 18 months!”

I kept in touch with Jenn, sharing photos of my growing girl, and when I became pregnant nine months later, I told Jenn that she needed to be by my side again.

The days leading up to my second delivery were once again anxiety-ridden. Facing another childbirth experience, I was convinced it could not go as smoothly as my first – that seemed like it would be too lucky. And I had a young toddler at home who had no idea what was in store. I kept in touch with Jenn daily, hoping she would move her shift if needed.

I ended up with a 9 a.m. appointment on May 24 to get induced, so I sent Jenn a note and assumed I wouldn’t see her. Surely, I’d have the baby by 7 p.m., and I thought she probably wasn’t scheduled to work. But 7 p.m. came with no baby, and in walked Jenn. She was just as calm, cool and collected as the first time, and three hours later, she helped me welcome baby girl No. 2.

How lucky was I to not only have two healthy babies, but also to have the same amazing person bring them into this world? Jenn was such an important part of my experience becoming a mom – the two most shining moments in my life.

Rebecca Levin
Assistant Vice President, Strategic Events and Planning, Development

Heart transplant recipient Patrick Sullivan and Patti Campbell, the mother of his donor

Although Patrick Sullivan grew up in Connecticut cheering for the New York Yankees, there will always be a special place in his heart for the Boston Red Sox.

Sullivan, of New Britain, Conn., received a heart transplant at BWH in 2007 after suffering from heart failure for 16 years. These days, he can be found sporting a navy blue Red Sox cap in honor of his donor, Andrew Campbell, who was an avid fan. The hat was given to Sullivan as a special gift from his donor’s mother, Patti Campbell, of Portland, Maine, and Andrew’s two siblings.

“I have a Red Sox heart and a Yankees soul,” Sullivan said. “Whenever I wear my Sox hat, I know Andrew and his family are with me. There aren’t words to express my gratitude to them.”

On Nov. 29, Sullivan and 17 other heart transplant patients – most of whom have been living with a donor heart for two decades or more – gathered to celebrate their milestones. They were joined by family, friends, Brigham staff and the mothers of two organ donors, including Campbell. Hosted by the BWH Heart & Vascular Center, the event, “Heart Transplantation Milestones: Longevity and Experience,” also commemorated the 700-plus heart transplants that have been performed at BWH to date.

“It’s not every day we can come together to celebrate longevity, success, resilience and life – you and your families all represent those things,” said Mandeep R. Mehra, MD, medical director of the Heart & Vascular Center, to the transplant recipients and donor families. “You’re extraordinary.”

‘It Takes a Village’

During the event, Mehra and Michael Givertz, MD, medical director of the Heart Transplant and Mechanical Circulatory Support Program, discussed the history and future of the field. BWH performed the first and second heart transplants in New England in 1984.

The Brigham has also implanted nearly 430 ventricular assist devices, treated more than 13,000 patients with heart failure and introduced many new medications and devices for patients with advanced heart disease. All these achievements are the result of BWH’s culture of excellence in multidisciplinary care, which includes collaboration among Anesthesiology, Perioperative and Pain Medicine; Cardiac Surgery; Cardiology; Nursing; Perioperative Services and others.

“It takes a village to care for our patients,” Givertz said. “Reaching a milestone of performing 700 heart transplants at BWH wouldn’t be possible if it weren’t for the teams from several different departments and specialties who come together every day to care for some of our most vulnerable patients. We’re all in this together.”

Throughout the evening, guests, who came from as far as Bermuda, talked about life after transplant. A slideshow of photos that patients and families submitted showed different milestones that they have experienced, such as running a marathon or celebrating the birth of a grandchild, thanks to the gift of a new heart.

David Hirsowitz said that receiving a heart transplant in 1992 has enabled him to celebrate many wedding anniversaries with his wife and watch his children graduate high school and college.

Carol Shay, who received a heart transplant 21 years ago, takes pleasure in the everyday activities she’s able to do: yard work, walks around her neighborhood and, especially, visits with her seven great-grandchildren.
Cardiac surgeon Steve Singh, MD, surgical director of Heart Transplant and Mechanical Circulatory Support, said it was inspiring to be surrounded by so many patients who’ve been given a second chance at life and thrived for so long. While the availability of any donor organ is difficult to predict, hearts are especially rare, he said.

“It is remarkable to see these patients use their precious gift to accomplish so much with their lives and make new, positive memories with their families,” he said. “The history and success of this program is a testament to the dedication of the institution and to the multidisciplinary surgical, ICU and medical teams that have cared for these patients over the past few decades.”

Nurse Practitioner Debbie Page, APRN-BC, was thankful to see many of the patients she’s cared for at the event. She said one of the best parts of her job is staying in contact with her patients and their families. She frequently receives family photos and invitations to birthday parties, weddings and cookouts.

“Being able to care for a patient in a cardiac surgical ICU when I was a younger nurse to seeing a patient thrive post-transplant after more than 20 years is a remarkable thing,” Page said. “That’s what is really important to me – seeing patients reach important milestones and be happy in life. It makes my job so special.”

At the conclusion of the event, Campbell spoke about her experience as the mother of an organ donor.

“I want all recipients to know what a true gift you are. Whether you’ve met your donor family or not, please know that you are thought of every day,” Campbell said. “I know my son would be proud that, in the end, he gave life to those in need. I cannot put into words how much it has meant to my family and I that we were able to meet Patrick and listen to Andrew’s heart beat once again. It’s a moment I will always hold close to my heart.”

From left: Lynn Nichols, LICSW, panel moderator; Kristen Vella Gray, PA-C; Derek Monette, MD; Annie Lewis-O’Connor, PhD, NP-BC, MPH, FAAN; Isabel Checa, MSW; Deborah Jordan, MSW, LICSW

When an African-American transgender woman arrived at Brigham and Women’s Emergency Department (ED), she showed signs and symptoms of domestic violence, sexual assault and human trafficking.

Race, gender and exposure to trauma were all key considerations as staff prepared to provide her with the best possible care. A panel of five BWHers recounted the patient’s story at Schwartz Rounds on Nov. 8, reflecting on the case as an example of the challenges facing transgender patients who have been sexually abused and the providers who are caring for them.

One challenge the team encountered was in filling a prescription for post-exposure prophylaxis (PEP) medication to prevent HIV infection. When the patient arrived in the ED, she was identified in Partners eCare as male, but under her insurance provider, she was listed as female.

While this error may seem like a simple one to resolve, the care team discovered that it could not easily be changed in Partners eCare without a proof of gender by legal photo ID. Kristen Vella Gray, PA-C, of the Department of Emergency Medicine, made multiple phone calls to registration in order to fix the mistake and was able to successfully get the patient’s prescriptions processed quickly due to the time-sensitive nature of the PEP medication.

If a BWH patient requests that their gender be changed in their medical record, proper legal documentation should be presented to a registration representative.

Another challenge the team faced was in finding a shelter that would be a safe place for a transgender woman of color.

“Safety is not just about being safe from your abuser,” said Isabel Checa, MSW, from Passageway, the Center for Community Health and Health Equity’s domestic violence intervention program. “Safety is many different things.”

Checa noted that there is a lack of domestic violence shelters in the area and across the country that are trans-specific or trans-friendly. Therefore, shelter staff and those staying at the shelter may not provide a safe and welcoming environment or be prepared to provide the type of care and support needed.

The Passageway team found an out-of-state shelter and referred the patient there. Ultimately, the patient left because of concern for her own safety and biases that she experienced at the shelter. She was not able to maintain contact with her BWH care team because her cell phone was broken, eliminating any opportunity for follow-up care.

Annie Lewis-O’Connor, PhD, NP-BC, MPH, FAAN, nurse scientist and founder and director of the Coordinated Approach to Recovery and Empowerment (C.A.R.E.) Clinic at BWH, did not meet the patient, but she did consult with the team on using a trauma-informed care model while the patient was in the hospital.

Trauma-informed care is built on understanding how exposures to trauma, whether intimate partner violence or other forms of intentional violence, and whether as an individual or as a member of a marginalized group, affects access and delivery of care for survivors. Lewis-O’Connor spoke about the team’s empathetic, forward-thinking and compassionate approach to caring for this particular patient, meeting her where she was by giving her the care she needed when she needed it.

“We can take lessons learned from this patient and others like her to help us be better care providers,” said Lewis-O’Connor.

Carrie Braverman, LICSW, a social worker in the Department of Care Coordination and founding chair of the Brigham and Women’s Health Care LGBT and Allies Employee Resource Group, noted the importance of provider education in caring for this patient population.

“As providers striving not only for excellent patient care, but also social justice and the betterment of communities, we have a responsibility to educate ourselves about individuals who identify as trans and non-binary,” says Braverman. “This includes an understanding and comfort with appropriate language, creating safe spaces, and knowing the specific care needs both from a physical and mental health perspective.”

If you are caring for a patient of suspected intimate partner violence, here are some resources that may help:

• BWH C.A.R.E. Clinic
  Visit brighamandwomens.org/careclinic
• BWH Passageway Program
  Visit bwhbulletin.org for a direct link
• “Creating Equal Access to Quality Health Care for Transgender Patients: Transgender-Affirming Hospital Policies”
  Visit bwhbulletin.org for a direct link

From left: Stefan Tullius, Edward Coppinger, Eileen Coppinger and Anil Chandraker, MD, medical director of Renal Transplantation, who presented on the future of kidney transplants at the event

For most patients with end-stage renal disease, a kidney transplant from a living donor offers the best possible treatment for failing kidneys. Last month, BWH’s Kidney Transplant Program honored both donors and recipients at its inaugural Living Donor Appreciation Night, which focused on the life-changing impact of a living donation.

“Patients with a living kidney donor can be transplanted healthier and more quickly, and the transplanted organ remains viable for almost twice as long when compared to a kidney from a deceased donor,” said Stefan Tullius, MD, PhD, FACS, chief of the Division of Transplant Surgery and surgical and program director of Kidney and Pancreas Transplantation. “That is why it is so important that we recognize the wonderful gift that our living donors have provided.”

During the keynote address, Massachusetts state Rep. Edward Coppinger described how receiving a kidney from his sister, Eileen Coppinger, at BWH last year changed his life. The siblings celebrated the one-year anniversary of the transplant by running a five-mile road race together. They also ran a 10K race together in August to raise money for the New England Organ Bank.
“After the transplant, my energy level and my life changed for the better,” Coppinger said.

Following the formal program, attendees – including some from as far as Mississippi and Florida – reunited with their BWH caregivers and swapped stories with fellow patients.

“My gift has now given my dad almost eight years of a good quality of life,” said Joseph Chamberlain, Jr., who donated a kidney to his father in 2009. “I am very honored to be a part of this wonderful, memorable and emotional event.”

The Brigham has a rich history of living kidney donation. The late Joseph E. Murray, MD, completed the world’s first successful human organ transplant here in 1954.

BWH is building on this legacy of excellence and innovation with the founding of the new Brigham and Women’s Living Donor Center, opening in 2017. The center, part of the Kidney Transplant Program, will provide enhanced services to living kidney donors, including more education about transplants and assistance in navigating the donation process. It will also help patients in need of a kidney transplant to identify living donors.