June 2013 Volume 1, Issue 1
As President and CEO of Boston Medical Center, I couldn’t be more proud of the response of our staff to the tragedy at the Boston Marathon. As a preeminent Level I Trauma Center, our caregivers are uniquely positioned to respond to even the most inconceivable tragedies. Rising to the occasion, providing support and care for the injured and their loved ones, BMC employees displayed great strength, skill and compassion providing exceptional care to those who needed it most. Let me share a brief snapshot.
At 2:50 p.m. on Patriots Day, the first of two bombs exploded at the Marathon finish line. Hundreds were wounded and medical personnel rushed victims to hospitals around the city, including BMC. Within 10 minutes ambulances arrived, patients poured into the BMC ED, and staff sprang into action. The ED quickly became a scene of organized chaos, with off-duty staff and employees from all areas of the hospital coming to assist.
“Patients were bloody and in shock physiologically and psychologically,” says Joseph Bellabona, RN, a BMC Nurse Manager. “They had multiple shrapnel wounds and were being treated as though they had just been removed from the front lines of a war zone in Bosnia, Iraq or Afghanistan; instead, unbelievably, they were coming from only a few miles away in Boston’s Copley Square.
“I saw so many doctors, nurses and other staff covered in blood, whose faces were filled with bewilderment and frustration,” he continued. “You could see them struggling, asking themselves, who and why, but they were professional and focused on the task at hand and did the extraordinary.”
Years of disaster drills became a reality as our renowned trauma team worked on 16 patients in 11 operating rooms and other support systems shifted into high gear.
Meanwhile, a Family Resource Center for the victims’ loved ones was in full swing by about 4:30 p.m., just 90 minutes after the bombs went off. More than 100 people had access to food, cell phone chargers, computers and phones lines. Social workers, chaplains, patient advocates and volunteers from all areas of the hospital worked with families to meet their every need, including serving as liaisons to the clinical teams caring for the victims.
Like hospitals around the city, BMC’s phenomenal efforts in the face of tragedy have captured the hearts of people all over the country, with support pouring in commending staff on their heroic response.
“The thousands of individuals who are a part of your organization are heroes,” read one letter. “While I recognize your organization saves lives on a regular basis, on April 15 your preparation, responsiveness and diligence saved dozens of lives. As an American, I thank you.”
Our Marathon patients have left BMC to continue their healing journeys, leaving our staff touched forever by their strength and the experience of providing their care. I am so proud of BMC, of our fellow caregivers at other hospitals and of our city. Together, we brought rays of hope to one of Boston’s darkest days.
Anyone who hears about the BMC Preventive Food Pantry quickly learns that what may at first sound like a traditional food support program is in fact a key tool for improving health — and a national model for cost-saving preventive care. This innovative approach earned the Preventive Food Pantry and Demonstration Kitchen the Dartmouth-Hitchcock Medical Center 2012 James W. Varnum National Health Care Award. Presented every two years, the prestigious award honors outstanding, innovative national leaders in health care quality improvement and is intended to spotlight simple solutions that bring about remarkable change.
The BMC Preventive Food Pantry and Demonstration Kitchen are essential to the well-being of patients with a wide range of illnesses — including cancer, HIV/AIDS, heart disease, diabetes, obesity, food allergies and other chronic conditions — whose food insecurity stands between them and better health. The Food Pantry, the first in-hospital pantry in the nation established in 2002 and now a model that is being replicated throughout the country, serves more 80,000 patients and their families a year, nearly half of whom are children. These patients receive a specific “prescription” from their physician for nutritious food tailored to their particular health needs. At the Demonstration Kitchen they then learn to prepare healthful meals using the prescription food provided.
"The Preventive Food Pantry and Demonstration Kitchen gets at one of the main issues in addressing population health: preventive care," said Dartmouth-Hitchcock Chief Quality and Value Officer George T. Blike, MD in presenting the Varnum Award. "The creative approach taken by BMC in making nutritious food and education readily available to patients is a terrific example of providing value at relatively low cost, putting patients on the road to a healthier lifestyle and helping prevent costlier care later in their lives."
The program has enhanced access to healthy food for thousands of patients, improving their diet and overall health. Surveys show that 98 percent of users rated the variety and quality of food and program services as good or excellent. Physicians report patients losing 20-40 pounds, reducing cholesterol levels and controlling diabetes. They have seen undernourished children reaching a healthy weight after parents began supplementing their diet with food from the pantry. Today, what began with a few BMC physicians collecting canned food for hungry patients is a central ingredient in the recipe for good health for families throughout the Boston area.
BMC is one of a handful of hospitals nationwide to be named a Top Hospital by the Leapfrog Group, an independent national nonprofit organization that works to improve the safety, quality and affordability of health care for Americans. Leapfrog focuses on three critical areas of hospital care: how patients fare, resources used to care for patients, and management practices that promote safety and quality.
As one of 67 hospitals out of 1200 around the country to receive the elite distinction, BMC scored high across all areas of quality, patient safety and resource use. Results of the survey are available at http://www.leapfroggroup.org/cp.
BMC also has the distinction of receiving an "A" Hospital Safety Score, the highest achievable grade, from Leapfrog last month. It is the third consecutive year that BMC has received the A score for achieving excellent performance on preventing medication errors and infection, appropriate intensive care unit (ICU) staffing, taking steps to avoid harm and managing serious errors.
Joining together for one of the city’s largest and most popular health events, more than 450 BMC health-care providers are volunteering their time and sharing their expertise at the 2013 Health & Fitness Expo as the lead partner with WHDH Channel 7, Boston’s NBC affiliate, and CW56.
BMC physicians, nurses, respiratory therapists, nutritionists and other health-care providers will offer a variety of free interactive health education activities including participatory demonstrations, lectures and forums, and medical screenings during the two-day event. Topics include: screenings for prostate health, breast and thyroid cancer; managing household and environmental triggers of asthma; caring for the caregiver; hypertension prevention and management; maintaining a healthy pregnancy; healthy cooking demonstrations; chair massages and yoga classes; and a distracted driving simulator.
“The Expo is a great way for us to be accessible to the community, showcase the wide range of services that we provide and share our enthusiasm, energy and commitment to the patient. We can share all the ways that BMC helps to keep people healthy,” said Ravin Davidoff, MD, BMC’s Chief Medical Officer. Now in its sixth year, more than 70,000 people visit the Expo annually and participate in health screenings, fitness assessments, interactive fitness games and demonstrations.
The Health & Fitness Expo will be held June 22-23 at the Hynes Convention Center in Boston. It is free and open to the public. For a schedule of events, exhibits, speakers and celebrity appearances, visit http://bmc.org/expo.htm.
Boston Medical Center is at the forefront of a groundbreaking service that provides newly diagnosed cancer patients with support that enables care to be as seamless and simple as possible — and thereby ensures they complete treatment. BMC has been providing these “patient navigation” services for nearly a decade and was one of the first hospitals to do so. Now a national model, in 2012 the American College of Surgeons’ (ACoS) Commission on Cancer created a new standard that requires ACoS-accredited cancer centers to develop patient navigation services for all patients with barriers to care.
Trained professional “navigators,” employees of BMC, provide a consistent point of connection for patients and help coordinate care, including keeping track of diagnoses, tests and appointments throughout treatment. This service is provided at no charge to patients.
Patients using navigation services may be facing barriers including financial challenges, language and cultural differences, psychological illness, or communication difficulties. BMC has found that patients trust navigators and rely on them to share knowledge about the health-care system. Patient navigation helps ensure that patients receive culturally competent care that is confidential, respectful, compassionate and as effective as possible.
Results for BMC patients using navigation services are significant. During calendar year 2012, BMC found that patients with navigators achieved a 9.3 percent “no-show” rate for visits with their oncologist, well below the average rate of 13 percent for patients without navigation services. In addition a five-year national research study, which reviewed BMC data between 2004-2008, showed that using patient navigators helped decrease the time to diagnosis for female patients who received an abnormal result from a breast or cervical cancer screening.
According to the study director Tracy Battaglia, MD, MPH, director of the Women's Health Unit at BMC and associate professor of medicine at Boston University School of Medicine, “Patients receiving navigation services were diagnosed in significantly less time and were more likely to complete their care compared to similar patients without support. Patient navigation improves early diagnosis and treatment of cancer and increases access to care among BMC’s populations, thereby improving health and welfare.”
The horrific events at Sandy Hook Elementary School in Newtown, Conn., in December 2012, which resulted in the mass murder of 26 children and adults, has ignited a national debate on gun violence. In the wake of the tragedy, BMC physicians have emerged as key voices in the dialogue, based on years of leadership developing and championing innovative responses to the impact of gun violence on young lives and whole communities.
BMC pediatrician and clinical professor of pediatrics and public health at Boston University Sean Palfrey, MD, and his wife Judith S. Palfrey, MD, argued for reinstatement of the ban on assault weapons, limited ammunition magazine capacity, and increased mental health efforts to identify individuals at risk for committing violent acts in a January 2013 editorial in the New England Journal of Medicine in response to the Sandy Hook massacre. Gun injuries, they noted, kill an average of 18 children and young adults daily in the US, accounting for the second-leading cause of death after accidents.
Robert D. Sege, MD, PhD, division director of ambulatory pediatrics and director of the division of family and child advocacy at BMC and professor of pediatrics at Boston University School of Medicine, co-led development of the American Academy of Pediatrics policy statement on firearm-related injuries affecting the pediatric population. “There's new, better data that although the safest home for children is a home without guns, that parents can protect their child simply by keeping a gun unloaded and locked, with the ammunition locked separately,” Sege says.
BMC emergency medicine physician and associate professor of emergency medicine at Boston University School of Medicine Thea James, MD, leads BMC’s Violence Intervention Advocacy Program (VIAP). VIAP addresses the larger sociobehavioral needs of violent trauma victims, providing case management, medical system navigation, mental health coordination, legal support, financial literacy and financial/housing assistance. Since its inception in 2007, VIAP has helped 3,176 victims of violence, primarily young gunshot and stabbing victims, get their lives on track. With VIAP as a leader in a growing national network, James was named to US Attorney General Eric Holder’s 13-member multidisciplinary Defending Childhood Task Force, which examined the extent and nature of childhood exposure to violence and identified policies and practices to address the issue.
As leading advocates for prevention of violent pediatric trauma in the community, these BMC experts share one goal: to prevent violence-related cases from ever reaching hospital emergency departments.
How we as a society provide medical care for people with developmental disabilities is a growing issue, with this population too often unable get critical medical care through routine channels. Vision care is one important example. Diminished vision clouds the connection developmentally disabled patients have with the physical world, creating significant stress and anxiety. Recognizing the huge need these patients have for specialized services, BMC ophthalmologist Susannah Rowe, MD, established BMC’s Exceptional Vision Service to make sure developmentally disabled patients have access to vision care they need.
“This work fulfills me professionally in the way that nothing else I do does. I feel so fortunate to be able to take a skill that I have and use to dramatically improve people’s lives,” explained Rowe. The key she says is identifying the unique obstacles for each patient and creating a specialized treatment plan with the team of providers.
She recently performed a life-changing cataract surgery on Kevin Fitzgerald, a severely autistic man, whose blindness had left him even more cut off from the world around him. Rowe and her team devised a tailored approach to Kevin’s special needs. This entailed a four hour surgical procedure, while a typical cataract procedure can be completed in about 30 minutes. Today, Kevin’s quality of life is restored and he is back to being able to enjoy the things he loves. Learn more about Kevin’s story as profiled recently on WBUR-FM radio here.