On July 3, I got a sneak peak at the U.S. News & World Report’s Best Hospitals list, and BWH had moved from ninth to sixth place—our all-time high. This is an amazing achievement, even for this very amazing hospital. It is based on ratings by physicians all over the country, our quality and safety scores, our volume and other indicators in 16 specialties. So, essentially, this ranking is the result of the dedication and hard work of nearly everyone in this remarkable institution. I think it was a Shining Moment for us all!

Vicki Amalfitano
Vice President, Marketing and Planning

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On July 7, 2015, while exiting the church stairs at my dad’s funeral, I fell and badly injured my left ankle. I was transported to BWH’s main campus, as paramedics determined it was a trauma case because it was a compound open fracture. From the moment I was wheeled into the Emergency Department, the nurses, technicians and doctors, especially Michael Weaver, MD, my trauma surgeon, could not have been more professional, sympathetic and helpful to my family and me. After surgery, I was transferred to the orthopedic floor, where I had the best nurses and patient care assistants I could have ever needed. My mental healing was just as important to them as my physical healing. My BWFH colleagues later visited me at Spaulding and sent well wishes and cards, which got me through. As an employee of BWFH for 22 years, I have to bring attention to these wonderful people who helped me through one of the most difficult times in my life.

June Pierce
Practice Assistant, BWPO/BWFH

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My Shining Moment was on Saturday, May 30, during rounds after Partners eCare go-live and in the ensuing days. I felt incredibly proud of our clinicians and staff who were working very hard to deliver care to patients using the new system. This was a profound change in technology and, despite the challenges, people were calm and collected and helping each other get through those first tough days.

Allen Smith, MD, MS
President, Brigham and Women’s Physicians Organization

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I’ve never been more proud of our team. One of my patients, who is a mother of two, was unable to interact as she used to. Her one wish was to be able to interact more with her family: read bedtime stories, cheer at a game and chat over dinner.

My Shining Moment was a collaborative effort in caring for a very deserving woman. Our staff worked diligently to make our patient’s wish come true, including securing access to needed medical equipment and selflessly lending their expertise. Making this happen meant several staff members going above and beyond.

This effort was extremely meaningful to the patient. It’s an honor to work with such a hard-working staff who are dedicated to making a difference in the lives of our patients. Our team is thankful to work in a place where we can be of service patients in a special way. Operation bedtime stories: Mission accomplished.

Jayme Dowdall, MD
Laryngologist and Voice Program Co-Director

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My One Shining Moment of 2015 was when a family member called the floor to thank me directly for helping her father pass away peacefully. Her father was very sick and was transitioning into the comfort measures only phase of his illness during my shift. It was my priority to make him and his family as comfortable as possible during this sensitive time. He ended up passing two days later, but I will never forget his daughter’s gratitude. I was honored to be part of this intimate moment in this family’s life.

Cindy Cao, RN, BSN
Nurse, Tower 14AB

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The gym in BWFH’s new orthopedic and spine care unit overlooks Arnold Arboretum.

Inside the new state-of-the-art orthopedic and spine care unit at BWFH, patients are receiving comprehensive orthopedic and spine care services in one convenient location.

After a year of construction, BWFH recently opened the new 7 South unit. The construction was coupled with renovations to the sixth floor operating rooms and the opening of Brigham and Women’s Orthopedic Center and Brigham and Women’s Comprehensive Spine Center.

The new patient unit features sweeping Boston skyline views, with a bright, modern look and feel. Emphasizing a healing environment, all 24 patient rooms are private and geared toward treating patients who are recovering from spine and orthopedic injuries and surgeries. The rooms include large bathrooms with showers, as well as ample space for visitors and rehabilitation equipment.

An exciting addition to the unit is a physical therapy gym, which was designed to offer patients physical and occupational therapy to begin their post-operative rehabilitation course. 

In addition to exercise mats and stationary and recumbent bikes, the gym includes the front seat of a car, a set of stairs and a bathroom to provide patients with training in activities of daily living. The seat of the car has been a great benefit, as getting into a car to drive tends to be one of the first functional activities a patient performs to leave the hospital to go home. 

Lynne Morrison, RN, 7 South nursing director, said that she and her colleagues had the opportunity to participate in the design and construction process from beginning to end, which allowed them to share their thoughts about how the unit should be arranged to best help patients in their recovery.

“This is a wonderful space for patients to heal and gain back their strength,” she said. “We know how difficult it can be to recuperate from an injury and surgery, so it was extremely important to us that we design the space to be comfortable for patients and their families.”

Jean Flanagan Jay, PT, DPT, CLT, director of BWFH Rehabilitation Services, added: “A majority of our patients do not go to a rehabilitation center after surgery. It’s our goal to provide them with the therapy and training necessary for them to get stronger and feel confident that they’ll be able to function safely once they are home.”

In addition to providing therapy to patients, the gym offers a quiet and relaxing environment, featuring large windows overlooking the Arnold Arboretum.

“We are very appreciative to have this wonderful new space to work in,” Flanagan Jay said. “We feel it reflects the professionalism and knowledge of the department staff. We look forward to advancing our program in a space that enhances healing for our patients.”

This week’s Safety & Security Corner is about Security’s presence on inpatient units. As a reminder, if you see something, please say something. Staff should report safety concerns by telling a manager or calling Security at 617-732-6565. For non-urgent concerns, email BWHSafety@partners.org.

BWH is increasing the Security team’s visibility on campus after an in-depth assessment of BWHC’s security program by Healthcare Security Consultants earlier this year. As a result, Security has been piloting a community service officer program, in which Security officer Ryan Carvalho patrols all inpatient units in the Tower, Connors Center for Women and Newborns and Shapiro Cardiovascular Center for the entirety of his shift each day. Security plans to expand the program with additional dedicated officers for the evening and night shifts as well.

“On his daily rounds, Ryan has been reaching out to staff on all floors to see if there is anything he can help with and to hear if they have any concerns from a security standpoint,” said Robert Chicarello, director of Security and Parking. “He is getting to know all of the inpatient teams and what is important to them.”

Another part of Carvalho’s job is testing all inpatient unit panic buttons with the help of staff. Once per month, he makes sure all panic buttons are functioning properly and invites staff to participate by testing the buttons themselves while he is present.

A group of meeting attendees, including BWH and BWFH CDI team members

On Dec. 2, BWH and BWFH hosted a New England-wide meeting of clinical documentation improvement specialists to discuss the recent implementation of the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). The day-long conference welcomed 55 attendees from Massachusetts, Rhode Island and Connecticut, including clinical documentation improvement nurses, program directors and physician advisors.

The meeting, called “Early Lessons from ICD-10 Implementation,” was organized by Cynthia Labins, MSN, RN, CCDS, clinical documentation improvement specialist and co-chair of the Massachusetts chapter of the Association of Clinical Documentation Improvement Specialists (ACDIS), and her BWH and BWFH clinical documentation specialist colleagues. It was held on the heels of the recent national conversion to ICD-10 as mandated by the Centers for Medicare and Medicaid Services. The classification list, which was developed by the World Health Organization (WHO), contains codes for diseases, signs and symptoms, abnormal findings, complaints, social circumstances and external causes of injury or diseases. These aspects of patient care are coded to capture the acuity and resource utilization for each patient visit and submitted for reimbursement. Before the Oct. 1 conversion to ICD-10, ICD-9 had been in use since 1979.

“The meeting was a great opportunity for us to share our own experiences, challenges and best practices from the transition in our respective organizations,” said Labins. “The day yielded much valuable information about how others are faring with ICD-10.”

According to Labins, the structure of codes in ICD-10 is similar to ICD-9, but the transition was valuable because the new system allows for much more specificity about patients’ condition. With ICD-10, the number of diagnostic codes available for coding health care services went from 13,000 to 68,000. This degree of complexity allows BWH and BWFH to better describe the nature of each patient’s diagnosis and treatment. In addition, it allows organizations to capture data about symptoms, risk factors and comorbidities that can be useful in conducting research, analyzing quality and measuring outcomes.

“I am very proud of the Brigham’s implementation of ICD-10,” said Labins. “A great deal of work and preparation went into the conversion across BWH and BWFH. We were fortunate that our director, Andrea M. Kelly, JD, MSN, RN, supported us by providing numerous educational opportunities to become prepared for this transition.”

Added Kelly, program director of Clinical Documentation Improvement (CDI): “By hosting the ACDIS regional meeting, BWH and BWFH demonstrated their ongoing commitment to ensuring that the clinical complexity of our patients is reflected in the coded data. CDI nurses possess both clinical insight and a working knowledge of the new ICD-10 code set. Their leadership and collaboration in preparing for this meeting were evident in the impressive turnout, as well as in the informed and inter-professional dialogue between the nurses and coding professionals.”

The beam features the names of two dozen pediatric patients from the Dana-Farber Cancer Institute, Children’s and BWH Radiation Oncology.

Tucked away on Shattuck Street, facing the windows of a Boston Children’s Hospital building, the names “Brooklyn,” “Nicholas,” “Kevin” and many others are spray-painted in bright orange, light blue, pink and white on a steel beam that will support the future Garden Café @ 75, BWH’s new Cafeteria.

They are the names of about two dozen pediatric patients from the Dana-Farber Cancer Institute (DFCI), Children’s and BWH Radiation Oncology, including 5-year-old Brooklyn, who was the first patient to have her name spray-painted on the 63-ton beam. After seeing a Facebook post written by Brooklyn’s mother, a family friend working on the construction site was inspired to begin spray-painting the children’s names.

“Seeing Brooklyn’s name on that steel beam is a feeling I will never forget,” said Kerrin Dooley, Brooklyn’s mother. “To me, the beam is a symbol of community, caring, support, strength and teamwork—all critical aspects in the fight against cancer.”

After being diagnosed in 2014 with neuroblastoma, a rare and aggressive form of pediatric cancer, Brooklyn underwent chemotherapy, tumor resection surgery, a stem cell transplant and immunotherapy at Children’s and DFCI, as well as 12 days of radiation at BWH. Brooklyn, who is now enjoying kindergarten and dance class, finished treatment last April, and her recent scans were clear of neuroblastoma. She continues to visit the Longwood Medical Area every few months for checkups, and she and her mother always make a point to visit the beam.

Five-year-old Brooklyn, who called the Longwood Medical Area home for 17 months, is now a healthy and strong kindergartner.

“Other parents and I are so moved that the crew from Suffolk Construction was thinking about our little warriors and making them feel so special,” said Dooley, who lives in Woburn. “It helped to keep us going. We will never forget the love and support stemming from the compassionate community here in Boston.”

Courtney Audet, a child life specialist in Radiation Oncology, has worked with several pediatric patients at BWH whose names have been spray-painted on the construction beam. She helps children and families get through radiation, working to make the process less overwhelming and scary. The department has a pediatric waiting area with toys and games, which helps, she says.

Many children, usually under the age of 4, require anesthesia when they undergo radiation because they aren’t able to stay still for the treatment. Audet helps parents and children through this process as well.

“A part of them will always be with the hospital that is working so hard to save them,” said Audet. “Seeing their names is extremely important and empowering because the children and families see that they are not in this fight alone.”

Dooley praised her daughter’s BWH care team, including radiation oncologist Karen Marcus, MD, radiation therapy nurse Cathy Lew, RN, and anesthesiologist Babu Koka, MD, MBBS.

“Dr. Koka made each transition to sleep so easy for Brooklyn and for me,” said Dooley. “The nursing staff and radiation therapists were incredibly compassionate and consistently proved their expertise each and every day. I am so thankful for the care that was provided and will be forever grateful.”

This week’s Safety & Security Corner shares information about Security’s weapons policy. As a reminder, if you see something, please say something. Staff should report safety concerns by telling a manager or calling Security at 617-732-6565. For non-urgent concerns, email BWHSafety@partners.org.

As part of BWH’s commitment to keeping the hospital safe, BWH Security prohibits anyone on hospital property from possessing a weapon, except for three categories: law enforcement officers in the performance of their duties, corrections officers at BWH escorting an inmate or a similar circumstance, and armored car staff members, who are transporting money. No one else—which includes employees, patients, families or visitors—should be armed at any time.

If you observe a patient, visitor or anyone else who is armed, immediately call Security at 617-732-6565. Please do not confront the individual; the BWH Security team will confront the person directly. A member of Security is in the best position to discuss the policy and secure the weapon, said Bob Donaghue, operations manager for Security and Parking.

Donaghue says that occasionally a patient will unknowingly visit the hospital with a legally licensed weapon. In those cases, Security and the Boston Police Department will secure the weapon while the patient is receiving care. Security will later return the weapon after the appointment and ask that the patient not bring it again.

“Someone who is legally licensed to carry a weapon may inadvertently bring it into the hospital,” said Donaghue. “It does not mean they are dangerous, but Security must engage with them, and they must comply with our policy.”

Betsy Nabel surprises the A/V team with the announcement that its cost-savings idea was the first winner of a Bold Ideas, Big Savings award.

Updates on Partners eCare, a new hospital-wide cost-savings program and Cafeteria construction were among the many topics discussed during Town Meeting: An Open Forum for BWHers on Dec. 1. About 200 BWHers gathered in Bornstein Amphitheater and more than 250 joined via webcast to hear about top-of-mind issues from BWHC President Betsy Nabel, MD, and other hospital leaders. Here are some of the highlights from the meeting. You can also view a recording of the webcast and fill out a Town Meeting survey.

Partners eCare

Since Partners eCare (PeC) launched at the end of May, BWHC has resolved more than 600 issues that users have experienced with the new system and currently has fewer than 200 to address, said Shelly Anderson, vice president of Strategy Implementation. PeC analysts, Epic experts and BWHC clinical business analysts began making on-site visits to practices in November for training and to determine opportunities to make workflow improvements. These visits will be ongoing. The Service Desk team has increased its staffing to shorten call wait times and resolve issues with the system as soon as possible. New training courses have been developed for providers that are specialty- and function-specific. They will be piloted this month for further rollout next year.

“What our organization has done to really pull together and move forward with the new system has been incredible, and we still have a long way to go,” said Anderson.

Anderson also talked briefly about recent visits that Epic President Carl Dvorak and Epic staff made to BWHC, where they met with many PeC users and observed what is going well with the system and what improvements still need to be made.

Bold Ideas, Big Savings Program

Nabel discussed the hospital’s budget, emphasizing the importance of identifying cost-savings opportunities as BWH and hospitals around the country face great financial challenges. She announced the launch of BWH’s Bold Ideas, Big Savings program, which rewards staff for creative cost-savings ideas, and surprised the Audiovisual (A/V) team with the program’s first award. The A/V team received a $2,000 check for an idea that is set to save the Brigham about $60,000 in the next year.

Nabel encouraged attendees to participate in the program: “I’m really looking forward to hearing your ideas about how we can achieve cost savings in different areas. Often, our frontline staff are in the best position to help identify new ways to do this.”

Cafeteria Renovation and Traffic Flow

John Pierro, BWHC senior vice president of Facilities and Operations, updated colleagues about two top-of-mind issues: traffic flow on Francis Street and Cafeteria renovations. Cafeteria construction is expected to begin in January, requiring the temporary closure of the Cafeteria. The renovation will feature upgrades to the food preparation and serving areas and will expand and improve the seating area, incorporating natural light and greenery.

A grand reopening is tentatively scheduled for mid-May. During the closure, additional dining options will be available at BWH, including “pop-up” food stations.

Pierro also addressed the ongoing issue of traffic flow on Francis Street. His team is working with a traffic consulting company to help reduce the congestion around BWH. The company is currently collecting data that will guide our improvement efforts, including conducting car and turn counts and surveying traffic.

Fragrance control

During the open forum portion of the meeting, Nabel answered questions from attendees about a number of topics, including one about compliance with the hospital’s fragrance control policy (HR-108). She reminded BWHers that it is the responsibility of every employee to follow the policy and refrain from using fragrant products, such as perfumes and soaps. Fragrances can cause great discomfort, and severe reactions in some cases, for staff and patients with sensitivities, allergies or other medical conditions.

BWH and the Department of Radiology mourn the loss of Anne Mazzella, a radiologic technologist, who died earlier this year. She was 58.

Ms. Mazzella, of Somerville, worked at BWH for more than 15 years, most recently in outpatient Radiology at 850 Boylston St. She received her associate degree in radiologic technology and worked at the former Harvard Community Health Plan prior to joining BWH. Colleagues said she always had a smile on her face.

“Anne put others first,” said Sandy McNamara, a fellow radiology technologist at 850 Boylston, who was friends with Ms. Mazzella for more than 20 years. “She had a big heart and would do anything for anyone.”

Ms. Mazzella’s supervisor, Keri-Leigh Doiron, chief Radiology technologist at 850 Boylston, says she will remember Ms. Mazzella as a hard-working, dedicated employee who always went the extra mile when caring for her patients.

“She would offer a blanket if a patient was cold or walk patients over to another service within the department if they needed directions,” Doiron said. “These small gestures meant a lot to our patients.”

Maryjane Devine also worked with Ms. Mazzella and described her as an exceptional technologist who mentored many peers. “We were all very lucky to have had the opportunity to work with her,” said Devine.

“My sister was always about helping our family and others,” said brother Mark Mazzella. “Even when she was ill, she was thinking about what everyone else was going through. I will always use her as the example as to how to live life.”

In addition to her brother, Ms. Mazzella is survived by many extended family members and friends.

This week’s Safety & Security Corner shares an update on de-escalation training across BWH. Staff should report safety concerns by telling a manager or calling Security at 617-732-6565. For non-urgent concerns, email BWHSafety@partners.org.

As part of BWH’s commitment to keep employees, patients, families and visitors safe, BWH’s Security Department provides de-escalation training to physicians and nurses in inpatient and ambulatory areas. John Pierro, BWHC senior vice president of Facilities and Operations, and Bob Chicarello, director of Security and Parking, are working with Rich Wong (BWH’s full-time de-escalation instructor), industry experts, physicians and staff to further customize and pilot additional modifications to the de-escalation training for ambulatory and off-site locations.

Similar to BWH’s S.A.F.E. program—an evidence-based inpatient clinical response for preventing, managing, de-escalating and responding to events—Security de-escalation training teaches employees how to recognize threatening behavior among patients and family members through didactic and in-person on-site training modules. The training includes protocols, techniques and resources designed to identify when help may be needed, while reducing the intensity of a situation through verbal responses and physical cues. BWH Security is developing a related HealthStream seminar and hopes to train all staff and employees who interact with patients across all ambulatory areas within the next year.

Roughly 240 employees have undergone de-escalation training so far. As rollout continues, if you are interested in offering de-escalation training to your unit or clinic, call 617-525-9313 or email rwong4@partners.org.

Beginning Tuesday, Dec. 1, and continuing through the end of flu season, BWH and BWFH personnel who are not vaccinated for influenza for any reason, including a medical reason, will be required to wear a surgical or procedural mask while they are in patients’ rooms or patient care areas, and whenever there is a reasonable expectation of being within six feet of a patient in a patient care area (such as in a waiting room, patient care unit, family room or clinical research space). Those who fail to comply with this policy will be subject to corrective action.

“One of the simplest and most effective ways that we can protect our community from influenza is by receiving an annual flu vaccination,” said BWHC President Betsy Nabel, MD.

This requirement is in addition to the Massachusetts state requirement that all employees must attest in PeopleSoft (by Dec. 1) to either receiving influenza vaccine or declining to be vaccinated.

Attestation is done automatically for employees who receive vaccine through Occupational Health Services (OHS). Personnel who decline flu vaccine or who receive vaccination at a primary care practice or other non-OHS location must manually attest in PeopleSoft by Dec. 1. Employees can attest by visiting peoplesofthr.partners.org/public from a work or home computer or mobile phone.

OHS continues to offer flu vaccine at no cost to all personnel:

• Monday, Nov. 23, in the Pechet Conference Room, Harvard Institute of Medicine/New Research Building, 1st floor, 9 a.m.–noon
• Monday, Nov. 30, Tuesday, Dec. 1, and Wednesday, Dec. 2, 6:30 a.m.–4:30 p.m., in the Shapiro Center Miller Atrium (2nd floor)
• Monday, Nov. 30, and Tuesday, Dec. 1, 6–8 p.m., on the Shapiro 2nd floor at the bridge
• At the Neville House Clinic by appointment or during walk-in hours (Mondays, Tuesdays and Fridays: 7–9 a.m.; Wednesdays: 2–3 p.m.). Or call 617-732-6034 to make an appointment.
• Through the unit-based Peer-to-Peer Program

All personnel will receive a sticker from OHS that must be worn on their ID badge as verification that they were vaccinated. Those who receive their vaccination elsewhere should obtain their sticker from OHS after attesting in PeopleSoft.

The updated policy and additional resources, such as employee FAQs, are available at BWHPikeNotes.org.

This week’s Safety & Security Corner focuses on infant security at BWH. As always, staff should report safety concerns by telling a manager, calling Security at 617-732-6565 or emailing non-urgent questions to BWHSafety@partners.org.

More than 6,000 babies are born every year at BWH, and it is the responsibility of all employees to keep them safe. Infant security at BWH includes training for all Connors Center for Women and Newborns (CWN) staff, monthly Code Pink drills to test CWN staff awareness and response, parental instructions on infant security issues and additional post-partum education for parents and significant others.

It is important to remember that all employees—not just CWN staff—are an essential part of the infant security program. When a Code Pink is called, employees should know what to do, what to look for and how to report suspicious activity. “A well-trained workforce and well-informed parents are our best defense against infant abduction,” said Bob Donaghue, operations manager for Security and Parking.

During a Code Pink, be vigilant:

• Look for suspicious persons walking through or exiting the hospital. Pay close attention to BWH’s exits, even those far from CWN.
• At BWH, all infants must be carried in a bassinet or carseat, so always be aware of anyone carrying a baby in their arms.
• Should you observe a suspect individual, don’t get into a physical confrontation but attempt to engage the person in conversation, while having a colleague call Security. If possible and safe, follow the suspect, watching his or her direction of exit.
• If the suspect has already left the building, get a good physical description, an exit direction and other pertinent information, such as the vehicle make or license plate, and contact Security at 617-732-6565 immediately.

It is everyone’s responsibility to keep our tiniest patients safe.

Mark Davis

Mark A. Davis, MD, MS, was appointed executive director of Strategic Initiatives and Business Development for BWHC earlier this year. Davis had been an attending physician in BWH’s Department of Emergency Medicine since 2000, and most recently served as medical director of Network Development for BWHC, in addition to his clinical role.

As executive director, Davis will work closely with Steven Thompson, MBA, chief business development officer, to develop and shape the organization’s partnership and investment strategy and work with clinicians, leadership and others to identify, assess and operationalize new business opportunities.

As a founding director for the Institute for International Emergency Medicine and Health at BWH, Davis helped to establish high-quality medical training and systems development programs in the Middle East, frontline health care capacity development in Africa and trauma training in Romania.

Davis graduated from the University of Pennsylvania School of Medicine, as well as its Graduate School of Education.

In this new economic reality where health care organizations are faced with pressures to cut costs and deliver high-quality care, BWHC is focused on ways to ensure financial stability and preserve the hospital’s mission well into the future.

One rapidly developing area that is focused on both “mission and margin” is forming under the leadership of Chief Business Development Officer Steven Thompson, MBA, and a small team charged with assessing potential collaborations with organizations around the world.

“The Brigham receives many inquiries and requests to partner with groups to bring our expertise to other parts of the country and the world,” said Thompson. “Our business development team is able to thoughtfully consider how each opportunity will establish a meaningful clinical, scientific and educational connection to BWH, as well as to generate new sources of revenue.”

In the past few months, four partnerships focusing on different clinical areas have been forged in Miami, Bermuda and China. “These partnerships will help other institutions and groups build their capacity to bring care to patients who need it in a way that is consistent with BWHC’s strategic plans as well,” said Mark A. Davis, MD, MS, executive director for strategic initiatives and business development (see related story on page 2).

An agreement signed with the Bermuda Cancer and Health Centre will help cancer patients receive radiation therapy locally, rather than traveling off the island. The relationship will also facilitate transfers of the most complex patients in need of highly specialized care to the Dana-Farber/Brigham and Women’s Cancer Center (DF/BWCC). Experts from DF/BWCC will advise Bermuda Cancer and Health Centre on the design of a radiation therapy facility, the creation of clinical policies, procedures and safety protocols and the development of a training and education program. BWH will also work with the center to explore research opportunities and a telemedicine program. Partners HealthCare International and BWHC have worked collaboratively with leaders in Bermuda to support outstanding health care services for its citizens.

BWH’s experts in newborn medicine are working to strengthen care for newborns in need of immediate medical interventions after birth in Miami, thanks to a new relationship with Miami Children’s Health System (MCHS). Under the leadership of Terrie Inder, MD, MBChB, chair of Pediatric Newborn Medicine, BWH and MCHS staff will collaborate to explore the development of a comprehensive high-risk fetal and newborn medicine program at MCHS to care for healthy mothers expecting a baby with complex medical issues.

Two separate projects are underway across the globe in China. BWH, along with Partners HealthCare International, is partnering with Jiahui International Hospital in Shanghai to develop a women’s health center program. Discussions have focused on a women’s health affiliation, which includes the development of an integrated Women’s Health program, obstetrics, gynecology, gynecologic oncology and in vitro fertilization, as well as a neonatal ICU.

Recently, BWH also signed a memorandum of understanding with Evergrande Health Industry Group to advance the health care delivery system in China. BWH will advise on health care administration, training, hospital design, interface of research and patient care, and clinical programs.

BWH has seen a tremendous increase in international patients seeking highly specialized care available at BWHC. To help address these needs, BWH is developing integrated, advanced and streamlined programs including specialty destination health programs designed to target individuals who seek the highly specialized diagnostic and treatment services available at BWHC. In addition, a new complex care access program (CCAP), which has been developed in collaboration with BWHC Network Development and Innovations Groups, will facilitate communication between BWH physicians and physicians locally and in other parts of the world to review whether complex patients should be sent to BWH for care.

“It is an exciting time for the Brigham,” said Davis. “We are rapidly increasing our capacity to partner with groups around the world in service of providing outstanding patient care and advancing our research and educational missions. These programs also provide new opportunities to sustain the financial margins needed for long-term BWHC success.”

BWH NICU Medical Director Michael Prendergast cares for a baby who is wrapped in a cooling blanket.

Babies and warm blankets often go hand-in-hand, but for some newborns, a cool blanket plays a part in saving their lives.

Within minutes of delivery, Baby Annie was very weak and unable to breathe on her own and showed signs of an abnormal nervous system. Doctors quickly sprang into action, examining the infant and delivering oxygen to her lungs through a small tube.

This situation came as a shock to Annie’s parents, Heidi and Matt Boucher, because Heidi, who delivered Annie at Newton-Wellesley Hospital, had experienced a full-term pregnancy with no complications. The care team recommended that Annie be transferred to BWH’s NICU for further treatment and evaluation the same day.

After Annie arrived at BWH, her care team explained to the Bouchers the benefits that a cooling blanket therapy, called therapeutic hypothermia, could have on their daughter’s life.

The blanket, or wrap, circulates cool water around a baby, lowering the body’s temperature to 33.5 degrees Celsius (92.3 degrees Fahrenheit). Research has shown that this decrease in temperature essentially cools a baby’s brain and body, reducing the risk of seizures by half and brain injury by 25 to 50 percent, said Terrie Inder, MD, MBChB, chair of the Department of Pediatric Newborn Medicine.

“If it weren’t for the blanket, we don’t know if Annie would be the happy, healthy and playful little girl that she is today,” said Heidi. “We were amazed that a blanket could have such positive effects on a newborn.”

Annie and Matt Boucher

Under the direction of Inder, the NICU has increased its use of cooling therapy in the past two years on babies born at full term who, like Annie, experience hypoxic-ischemic encephalopathy (HIE), a lack of oxygen and blood flow to the brain at or near the time of birth. For several years, Inder, an international leader in neonatal neurology, has been at the forefront of pioneering guidelines for the use of cooling therapy for newborns.

A baby can be wrapped in the blanket within minutes or hours after birth. The blanket is kept on the baby for up to 72 hours during his or her stay in the NICU, after which the baby is slowly re-warmed to natural body temperature. During the course of the therapy, some babies can be held by their parents, which facilitates the important bonding experience.

“Birth is usually a wonderful and healthy event, but unfortunately it can sometimes be complicated by a period of reduced oxygen supply to the brain,” said Michael Prendergast, MD, medical director of BWH’s NICU.

Babies who have been treated in the NICU with the therapy have dramatic improvements in the health of their brain, says Inder. The growing use of this treatment is part of a broader shift in early-infant medical care to brain-centered care, focusing on babies’ long-term health after they leave the NICU, a passion of Inder’s. To date, the therapy has helped more than 80 babies at BWH, and BWH’s NICU is leading the way in maximizing the use of this therapy. The technology is also being used for newborns in hospitals around the country.

Before this technology was available, Inder said there weren’t any options for treating or recovering babies’ brains.

Annie, who is now 17 months old, hasn’t shown any complications since birth. After spending time in the NICU, her care team monitored her for several months at follow-up appointments to make sure she was thriving and meeting her milestones.

Heidi and Matt say they are grateful for the care their daughter received at BWH.

“The team at BWH is outstanding and really took care of us,” said Matt. “Not only did they calm our fears, but they took the time to explain everything that was happening. We are so appreciative of what the Brigham NICU has done for us and our daughter.”

Gertrude Glode

BWH and the Department of Nursing mourn the loss of Gertrude Glode, RN, former nurse manager and longtime BWH volunteer. Ms. Glode died peacefully on Sept. 29, just days after her 99th birthday.

Known for her energy, sense of humor and unwavering devotion to the Brigham, Ms. Glode was a nurse manager who, after her retirement, volunteered in a variety of roles within the department until the age of 94.

“Gert had a wonderful presence,” said Leo Buckley, executive director of business operations for Patient Care Services. “She knew everyone by name and always asked about their families. She touched the hearts of so many people.”

Ms. Glode grew up in Melrose, Mass., and earned her nursing degree from Lawrence Memorial Hospital, where she graduated in 1939. In 1951, she joined the Robert Breck Brigham Hospital staff as a nurse manager in Rheumatology/Orthopedics. She left the hospital briefly from 1958 to 1960, when her husband was stationed in Germany and Maryland. She soon returned to Boston and to her work at the Robert Breck Brigham Hospital and later at BWH, where she worked on Towers 14 and 15. Ms. Glode was a member of the team that worked on developing operating procedures for BWH.

After decades of service as a nurse, Ms. Glode retired in 1981, but she didn’t stay away from her beloved BWH for long. Less than a year later, she returned as a volunteer. She served as the head of the Friends of BWH’s Patient Library, managing the hospital’s book and video donation program for more than 30 years. She also oversaw the Friends’ art cart, which enabled patients to choose framed prints with which to decorate their rooms, and she distributed paychecks every week in the Nursing Administration Office.

“Gert Glode will always be someone I hold close to my heart,” said Rosa Riley, senior administrative assistant in Patient Care Services. “I remember how she was always so polished and put together. More importantly, she was always smiling and laughing. She will be sorely missed.”

Ms. Glode is survived by her brother, John Powers, and his family, as well as many nieces and nephews.

Miriam Erick

With humor, patience and extensive knowledge of both nutrition and women’s health, dietician Miriam Erick, MS, RD, CDE, helps expectant mothers navigate one of the most common challenges of pregnancy: morning sickness.

Every Wednesday, Erick meets with pregnant patients at her Morning Sickness Nutrition Clinic. Together they talk through a variety of factors that may cause nausea, as well as warning signs of a worsening condition. Erick remains in contact with these patients and their other BWH physicians to monitor their health over time, focusing on weight changes and food intake.

“Nausea is an invisible ailment that is difficult to measure,” she said. “In 1891, it was considered psychological, and I think in some ways that mindset has stuck. In my opinion, many women don’t get the sympathy they need. Women who are ill have a hard time keeping up their nutrition, so it’s really important that family members and friends offer support.”

Malnutrition and consequential weight loss, as well as dehydration, are the risks Erick works to reduce before they become dangerous to both mother and baby. Malnourishment decreases major body organ function, and expectant mothers who don’t gain the needed weight during pregnancy can increase their risk for complications such as pre-term delivery or smaller babies. Adequate nutrition is also essential to maintain a mother’s immune system.

“When a woman suffers from nausea and vomiting, she is being robbed of the excitement and fun of impending motherhood,” Erick said. “Losing weight, not eating and not sleeping are also a setup for depression and poor pregnancy outcomes.”

Although the severity varies, morning sickness is a universal problem, affecting 50 to 90 percent of pregnant women. Although most see symptoms fade after week 17, some experience morning sickness through the entirety of their pregnancy. About 1 to 3 percent of U.S. women have very severe morning sickness, known as hyperemesis gravidarum (HG), with an estimated 60,000 women being hospitalized each year due to its symptoms.

Erick took an interest in obstetric health early in her training. She noticed the large number of women suffering from morning sickness, and in 1999, officially started the clinic as a joint initiative between Nutrition and the Department of Obstetrics and Gynecology.

She has written several books about morning sickness, including the first on the topic, “No More Morning Sickness,” which was published in 1993. This year, she released the e-book “Take Two Crackers and Call Me in the Morning: A Real-Life Guide for Surviving Morning Sickness,” an illustrated journey through the trials of morning sickness, with humor and helpful information. For example, Erick recommends using the scent of lemons to help overcome olfaction, a heightened sense of smell that often triggers nausea during periods of morning sickness. She has also found that watermelon can ease nausea and help keep women hydrated.

There is no proven cure for morning sickness. Instead, Erick focuses on three key goals to remedy the nausea: stopping weight loss, settling the stomach and keeping the expectant mother happy.

Learn more, including how to make an appointment.

Joshua Peltz

Joshua Peltz, MBA, BSN, RN-BC, has joined BWH as nursing director of the Cardiovascular Diagnostic and Interventional Center (CDIC).

He is responsible for maintaining the standards of nursing care and practice within the CDIC, as well as fostering optimal patient outcomes and a professional practice environment. More than 4,000 procedures are performed each year in the CDIC’s Cardiac Cath Lab and Electrophysiology Labs, including angioplasties and diagnostic catheterizations.

Peltz began his career as a clinical nurse in cardiology and later became a nurse manager. He worked at Long Island Jewish Medical Center and Boston Children’s Hospital before joining BWH. He earned his BSN at the State University of New York Polytechnic Institute Utica/Rome and his MBA in health care management at the University of Phoenix. He is currently pursuing his MSN at Sacred Heart University.

Families received small stones with words of inspiration at the service.

Earlier this month, more than 125 people gathered in Cabot Atrium for the 12th Connors Center for Women and Newborns (CWN) Service of Remembrance. The service supports families who have experienced the loss of a baby during or after pregnancy and honors the babies who have passed away.

For many years, the CWN Bereavement Committee—a multidisciplinary group consisting of Social Work, Nursing, Spiritual Care Services and physicians—provides compassionate care to families who experience these tender losses. The committee hosts the service, with families and BWH staff gathering to share personal stories and support.

Social worker Claire Welch, MSW, LICSW, of BWH Care Coordination, has attended every service to date, and said it is comforting to reconnect with parents in remembering their babies.

“It’s an honor to be part of a family’s life during this unique loss,” she said. “Some families have made this an annual remembrance of their babies. It is meaningful to all of the staff attending to have been a part of their experience.”

The parents, siblings and other family members who attended this year’s service received forget-me-not flower seed packets and small stones engraved with the words “love,” “hope” and “cherish.” Children received donated toys. Attendees were also given an interdenominational prayer book created by Rev. Katarina Bergh, MDiv, of Spiritual Care Services.

During a poignant part of the ceremony, families placed a star with their child’s name on a felt board depicting a night sky, which BWH Engineering created and donated two years ago. In addition to music provided by harpist Nancy Kleiman, parents were welcomed to the podium to speak about their personal experiences.

BWH Food Services, Audiovisual, VPNE and other departments and teams also helped to make the service possible.

This week’s Safety & Security Corner shares a few security-related updates and statistics from John Pierro, BWHC senior vice president of Facilities and Operations. As always, if you see something, say something. Staff should report safety concerns by telling a manager or calling Security at 617-732-6565. For non-urgent concerns, email BWHSafety@partners.org.

The safety and security of patients, employees and visitors are of paramount importance at Brigham and Women’s. In the last nine months, the hospital has examined its security operations to build upon our tradition of strength in this area.  We have enhanced training, operations and communication efforts, and will continue to do so in the months ahead.

To date, more than 10,000 employees have received active shooter training and more than 3,400 nurses have been trained in S.A.F.E. (Spot a threat; Assess the risk; Formulate a clinical response; Evaluate the outcome), an evidence-based clinical response for preventing, managing, de-escalating and responding to events. Both S.A.F.E. and active shooter trainings are offered through video sessions accessible in HealthStream. In addition, nearly 240 employees have trained in small group settings on workplace violence, de-escalation, security awareness and/or active shooter training scenarios.

Bruce Cohen

Cycling dozens of miles on a route filled with steep hills, winding turns and strong winds may be a daunting challenge, but BWH patient Bruce Cohen says it was a gift to be able to get back on his bike route after suffering a heart attack and undergoing major surgery last year.

“I feel so fortunate that my body has healed and I’ve been able to resume an activity that is so important to my daily life,” said Cohen, who lives in Wayland and logs an average of 7,000 to 8,000 miles on his bike each year. “I thought that after surgery, I wouldn’t be able to ride daily like I had been, but in truth, I’m now riding stronger than ever.”

In early 2014, Cohen, a member of the National Lacrosse Hall of Fame and Jewish Sports Hall of Fame, began feeling shortness of breath while exercising. After seeing his primary care physician for a routine appointment, he was sent to BWH, where severe blockages were discovered in two of his major coronary arteries, which supply blood to the heart. After performing tests, physicians found that Cohen had suffered a heart attack and would need to undergo a procedure called coronary artery bypass graft (CABG) surgery, which would route blood past the blocked arteries and improve blood flow to the heart. A multidisciplinary care team from Cardiac Surgery, Cardiology, Cardiac Anesthesia, Perfusion, Nursing and Physician Assistant Services planned and performed the successful surgery.

CABG, a form of open-heart surgery in which the heart is stopped for a period of time, uses blood vessels taken from veins in the leg or an artery in the chest to create a graft that bypasses the blocked portion of the coronary artery. After the graft is attached during surgery, blood can flow around the blockage to reach the heart more easily.

Since the early 1970s, BWH has performed more than 10,000 CABG surgeries. Approximately 600 CABG surgeries are performed at BWH annually.

Cohen’s cardiologist, Stephen Wiviott, MD, FACC, said that although Cohen led a healthy and active lifestyle before his heart attack, there are many factors that can lead to blocked arteries, including advancing age, being male and genetics. Wiviott said because Cohen took good care of himself through the years, it’s likely that he delayed the onset of a more severe or even fatal heart attack.

“Mr. Cohen’s experience is a great example to encourage people that it is often possible to do the things you love even after suffering a heart attack, particularly if you get appropriate medical care quickly,” Wiviott said.

Earlier this month, Cohen and a group of about 30 other cyclists completed a challenging 65-mile bike ride in the Berkshires. Organized by Cohen for the last several years, the ride consists of several difficult hills and takes place during peak fall foliage time.

Danny Muehlschlegel, MD, MMSc, director of Cardiovascular Anesthesia Research, has known Cohen for nine years and participates in several rides with him each year, including this one. Muehlschlegel, who was also the cardiac anesthesiologist for Cohen’s surgery, said how great it was to see his friend and patient be able to ride again.

“I’m lucky to be alive today,” Cohen said. “The care at BWH was excellent, and I’m fortunate that I’ve been able to return to my normal lifestyle again.”

BWHers and three patients from the Mechanical Circulatory Support program staffed an information table by the Shop on the Pike to raise awareness about ventricular assist devices (VADs) during the hospital’s VAD Awareness Day on Oct. 13. VADs are mechanical pumps that are used to support heart function and blood flow in people who have weakened hearts. Pictured at left, from left are patients Ryan Interlande, Taylor MacLean and Glen Hall. Each have implanted VADs and spoke with passersby about their experiences.

Athena Lacaire

When BWH Obstetrical (OB) Admitting officer Athena Lacaire arrived to work on Oct. 9, she couldn’t have imagined what her morning would bring.

Just before 10:30 a.m., a pregnant patient arrived to OB Admitting in active labor. Not unusual for OB Admitting patients, this situation was something Admitting staff were prepared for. A patient in active labor is typically expedited to the Labor and Delivery Unit; however, Lacaire realized that there was no time to move the patient before she delivered. Remaining calm, Lacaire sprung to action and helped the patient deliver her baby in the waiting area, as colleague Robin Naistadt called a code to alert the OB care team that help was needed immediately.

Lacaire, who started working in OB Admitting two months ago, received the baby with a towel given to her by the patient’s sister and patted the baby’s back until she coughed. Physicians and nurses arrived soon after to care for the baby and patient, and Lacaire later admitted them to the Labor and Delivery Unit. She says the adrenaline-inducing experience left her feeling energized and joyful.

“In these types of high-intensity situations, your instincts dominate,” she said. “I had no prior experience with delivering babies, but I have a duty to protect those that come into my care and knew I needed to take action. Once that beautiful baby landed into my arms, I knew that my final step was to start her breathing. The sound of her first breath was everything I needed to hear. I was in complete awe of her—this miracle that landed right into my arms.”