The BMC Brief

December 21, 2011 Volume 1, Issue 16

• 2011: A Year in Review
• BMC Saves Patient Impaled by Nail Gun
• Researchers Find Misinformation about Emergency Contraception Common in Low-Income Neighborhoods
• What Do You Do, Malissa Danforth?
• In Their Words
• News of Note
• Awards and Accolades

2011: A Year in Review

From raising a record-setting $2.5 million at the BMC Gala to the BMC HealthNet Plan launching in the commercial market, 2011 was a year of “firsts” for the hospital. Take a look back on highlights at Boston Medical Center during 2011.

January

• BMC secures additional Medicaid waiver funding.

February

• BMC partners with the YMCA of Greater Boston to form the Exercise and Nutrition to Decrease Diabetes (END Diabetes) Program. The goal of the program is to show that with lifestyle changes and modest weight reduction, the risk of cardiovascular disease can be reduced.

March

• 60 percent of staff participate in BMC’s first-ever Employee Engagement Survey.

April

• The Carl J. and Ruth Shapiro Ambulatory Care Center opens. The 250,000 square-foot state-of-the-art facility consolidates outpatient clinical services and maximizes patient comfort and operational efficiency.
  
  
• BMC launches its Cancer Care Center. The multidisciplinary Center is designed to make oncology clinical and support services more accessible for patients and their families.
  
  
• BMC celebrates the Red Sox Home Opener with ballpark fare in the cafeterias and a Red Sox ticket raffle. Staff donned Sox shirts and hats to display their team spirit.

May

• BMC raises a record-breaking $2.5 million at its annual Gala. The Gala honored former vice chair of the BMC Board of Trustees Alan Solomont and his wife Susan Solomont. Part of the proceeds raised will support BMC’s new clinical simulation and nursing education center, which will be named for the Solomonts.
  
  
• U.S. Senator Scott Brown tours BMC.

June

• BMC celebrates its 15th anniversary with an ice cream social.

July

• BMC is nationally ranked No. 33 in geriatric care and No. 39 in pulmonology in a U.S News & World Report survey. The medical center is also recognized as high performing – in the top 25 percent of hospitals across the country – in cancer, diabetes and endocrinology, gynecology, nephrology and rheumatology.
  
  
• BMC launches its Addiction Medicine Residency Training Program, becoming one of just 10 medical institutions in the country to offer post-graduate addiction medicine residencies for physicians.
  
  
• BMC receives the Founding Hospitals Recognition Award from the National Association of Public Hospitals and Health Systems (NAPH). BMC is one of the five founding members of NAPH, which advocates for improved coverage, access, and the general well-being of the most vulnerable patients in the American health system.

August

• BMC researchers find that the quality – not just the quantity – of fat tissue is a significant contributing factor in the development of inflammation and vascular disease in obese individuals. It is compelling evidence that the answer to treating cardiovascular disease and other obesity-related disorders, such as type 2 diabetes and cancer, may be found in the fat tissue itself.
  
  
• BMC is awarded more than $1 million from the Massachusetts Department of Public Health to expand HIV/AIDS patient care services.
  
  
• Researchers identify a potential new biomarker and therapeutic target for melanoma.
  
  
• Researchers receive a $9 million grant from the National Heart, Lung and Blood Institute to investigate a new treatment for sickle cell disease.

September

Nick Heald received TORS treatment to defeat his throat cancer

• BMC is the first hospital in New England to use a minimally-invasive robotic procedure called transoral robotic surgery (TORS) to treat benign and cancerous tumors of the throat, larynx and neck.
  
  
• BMC is one of first hospitals in Boston to receive certification for its inpatient Electronic Health Record (EHR) suite of applications.
  
  
• BMC scores in the top 20 percent in the annual Leapfrog Hospital Recognition Program which scores hospitals on their quality, resource use and value.

October

• Preventive Food Pantry celebrates its 10th anniversary.
  
  
• BMC brings its Outpatient Pharmacy in house, a move that will save the hospital significant funds.
  
  
• Neonatal Intensive Care Unit (NICU) launches Donor Breast Milk Program.
  
  
• More than 50 departments and groups participate in a Pumpkin Non-Carving Contest.

November

• Avrum Spira, MD, MSc, Chief, BMC Computational Medicine, receives a $13.6 million grant to develop novel technologies for the early detection of lung cancer.
  
  
• Researchers find that U.S. primary care providers fail to report a substantial number of cases of child maltreatment.
  
  
• The BMC HealthNet Plan enters the commercial market for the first time in its 15 year history. The plan is available to individuals and families throughout the Commonwealth who purchase health insurance on their own as well as small businesses. Plan coverage begins January 2012.
  
  
• BMC rolls out its Be Exceptional Strategic Plan.
  
  
• BMC announces it is going smoke free, inside and out, on April 16, 2012.

December

• 67 BMC physicians are listed as “tops” in their field in Boston Magazine’s annual Top Docs issue.
  
  
• Elders Living at Home Program celebrates its 25th anniversary.

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BMC Saves Patient Impaled by Nail Gun

Patrick Matheson was working on a new house on Nantucket Dec. 1, nailing plywood on the second floor, when he made what he calls a “rookie mistake.”

An X-ray of the nail in Matheson

“I was holding the gun at an angle when I shot it and the nail bounced off the wood,” says the 31-year-old carpenter. “I felt the nail hit me but there was no blood. I couldn’t see it and I could breathe and talk. I slowly climbed down the ladder, alerted my coworkers and then walked out to the end of the road to wait for the ambulance to arrive.”

What Matheson didn’t know was the three-and-a-half-inch nail had entered the base of his neck and plunged directly into his chest.

Matheson was rushed to Nantucket Cottage Hospital and then quickly transported by MedFlight helicopter to Boston Medical Center. He arrived in the Emergency Department (ED) where he says staff made sure he was very comfortable, before meeting the man who would be his surgeon, Michael Ebright, MD, Cardiothoracic Surgery.

Ebright’s first task was to determine the extent of the injury. The nail, which had been traveling at 1,400 feet per second when it entered Matheson’s chest, had pierced his trachea and esophagus before lodging in his vertebral column.

“My chief concern was whether the nail had injured any of the large arteries branching directly from the aorta above the heart,” says Ebright.

Ebright obtained an arteriogram that revealed the nail had miraculously, and narrowly, missed the large arteries sitting within the trajectory of the nail. In fact, a large artery supplying the brain and right arm actually was nudged over to the side, yet remained intact.

In surgery, Ebright discovered just how close to death Matheson had come. Had the nail entered his chest just a millimeter to the right, it would have severed this major artery and he would likely have bled to death at the construction site. And had the nail been just one inch longer, it would have pierced his spinal cord, possibly leaving him a paraplegic.

Patrick Matheson

Ebright also discovered something else: the nail lodged in Matheson had barbs coming off the shaft, making its removal past the artery it was nestled against that much trickier.

“We operated through an incision at the base of the neck and were able to tease the major artery off the nail,” says Ebright. “We wanted to make sure the barb didn’t catch the artery, so we put a gauze buffer between the nail and the artery. There was no major bleeding, no problems, and we repaired the trachea and esophagus.

“Patrick is very lucky to be alive and walking,” he adds.

Following his two-hour surgery, Matheson recuperated on 8 East Newton Pavilion for a week. He says his whole experience at BMC has been terrific.

“Everyone has been amazing,” he says. “Nurses have been checking on me even when they have a lot going on. Dr. Ebright has stopped by every day. The level of care and professional, from top to bottom, has been terrific. It’s really lifted my spirits.”

He looks forward to going home and spending time with his girlfriend and baby. And he plans to take a few weeks off from the construction business.

BMC operates the longest, continuously verified Level 1 Trauma Center in New England. Read some of its patient success stories.

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Researchers Find Misinformation about Emergency Contraception Common in Low-Income Neighborhoods

BMC and Boston University School of Medicine (BUSM) researchers have found that misinformation about access to emergency contraception is common in low-income neighborhoods. These findings appear as a research letter in the Dec. 19 online issue of the Journal of the American Medical Association.

In 2009, the U.S. Food and Drug Administration facilitated access to emergency contraception among adolescents by making it available over-the-counter to individuals age 17 and older.

For the study, female research assistants posed as adolescents who recently had unprotected intercourse. They randomly called every commercial pharmacy in Nashville, Tenn.; Philadelphia; Cleveland; Austin, Texas; and Portland, Ore., between September and December 2010. The cities were chosen in geographically diverse states without pharmacy access laws that supersede uniform federal regulations. The callers followed standardized scripts to simulate real-world calls and elicit specific information on emergency contraception availability and access.

Researchers then examined same-day availability of emergency contraception, (regardless of reason), whether emergency contraception could be accessed by the caller, and whether the pharmacy communicated the correct age at which emergency contraception was accessible over-the-counter.

Although the researchers found the availability of emergency contraception did not differ based on neighborhood income, in 19 percent of calls the adolescent was told she could not obtain emergency contraception under any circumstance. This misinformation occurred more often (23.7 percent compared to 14.6 percent) among pharmacies in low-income neighborhoods.

When callers queried the age threshold for over-the-counter access, they were given the correct age less often by pharmacies in low-income neighborhoods (50 percent compared to 62.8 percent). In all but 11 calls, the incorrect age was stated as erroneously too high, potentially restricting access.

“Even though we found approximately 80 percent same-day availability of emergency contraception in these metropolitan cities, misinformation regarding access was common-particularly in low-income neighborhoods,” says lead author Tracey Wilkinson, MD, MPH, a Fellow in the Division of General Pediatrics pediatrician at BMC/BUSM.

While the study design did not determine why disparities in access to emergency contraception exists, the researcher believes possible explanations include differences in pharmacy staffing or training, frequency of requests for information or organizational cultures around customer service. “Our study assessed only telephone calling and not in-person visits. Despite this limitation, the finding that misinformation regarding emergency contraception access is more common in neighborhoods with the highest teen pregnancy rates suggests that targeted consumer or provider education for consumers and pharmacy staff may be necessary,” she says.

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What Do You Do, Malissa Danforth?

Name: Malissa Danforth, RT (R), BSN
Title: Manager, Diagnostic Radiology and Film Library
Department: Radiology
Years at BMC: 16

Malissa Danforth

What brought you to BMC?
I was introduced to the hospital in 1993 when I started my clinical rotation here as an X-ray student from Northeastern University. At that time, Boston Medical Center was Boston City Hospital. I became an employee in 1995, when I was hired as a radiological technologist. I’ve held various roles within Radiology over the years including staff/operating room tech, clinical instructor, day supervisor, chief tech and now I manage the department.

What do you do here?
I manage the operations of the department at all of our locations. I focus on ensuring we have an effective workflow and that we function within budget, while supporting staff to deliver the highest quality patient care.

You’ve held a few roles here over the years. Has BMC supported your job growth?
Yes, absolutely. I’ve been fortunate to have great career development support from my managers, as well as personal support from my parents and husband. I’ve also seen many of my own staff grow and move on to other areas. It’s bittersweet to see them go, but I feel great pride in seeing them grow.

What do you like about working here?
I really enjoy the challenge of working at a fast-paced trauma center. I also love my colleagues. Radiology is a big department, but we are a tight-knit group. I believe in a work/life balance and I strive to be a manager who puts my employees’ needs first whenever possible. To accomplish this, we try to instill fun in the workplace by decorating for the holidays, celebrating our staff and raising money to give back to our patients. I also enjoy serving on the hospital’s events committee and smoke-free task force.

What do you do in your free time?
I enjoy spending time with family and friends. We’re usually busy with my three children’s activities, like baseball, gymnastics and Girl Scouts. I enjoy being an assistant Girl Scout Troop leader, an active member of two Parent Teacher Associations (PTAs) and home decorating.

Do you know a staff member who should be profiled? Send your suggestions to communications@bmc.org.

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In Their Words

Patients share their BMC experience

Yesterday I received a call from the Office of the Chief Medical Examiner (OCME). The office was reaching out for help to deliver some extremely delicate news to a Mandarin-speaking family regarding the tragic death of their young daughter.

Fortunately, I connected with Sigfredo Salguero in Interpreter Services. Mr. Salguero stepped up and owned it. He quickly contacted Yina Chen, a Mandarin interpreter, who reported to the OCME to deliver the difficult news. Ms. Chen was described as incredibly empathetic and compassionate in explaining to the parents the circumstances surrounding the death. The family was comforted by Ms. Chen's demeanor and the fluency at which she shared the information.

Sharing information of this kind with a grieving family is always a difficult task, as anyone in my profession will attest. Ms. Chen’s interaction with this bereaved family was remarkable and extraordinary. She truly went above and beyond the call of duty.

Sincerely,
Christian Kiriakos
Pathology

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News of Note

Child Witness to Violence Project receives federal funding
The Massachusetts Department of Children and Families (DCF) will receive $3.2 million in federal funding over the next five years to support the development of the Massachusetts Child Trauma Project, an initiative to address the impact of traumatic experiences on children served by the department. With this funding, the DCF will partner with four institutions, including the Child Witness to Violence Project at BMC, to build the capacity of behavioral health, mental health, and support and stabilization service providers to utilize trauma-informed approaches in meeting the needs of children and families.

Francis Farraye, MD

Farraye named a leading gastroenterologist
Francis Farraye, MD, MSc, FACP, FACG, has been named a leading gastroenterologist by Becker’s ASC Review. The publication, which features analysis and insight for specialties including bariatrics, orthopedics/spine, gastroenterology, neurosurgery and pain management, names the top gastroenterologists in health care organizations across the country in its “125 Leading Gastroenterologists in America.” Physicians are named to the list based on the awards they receive from major organizations in the field, their leadership in these organizations, work on professional publications and positions of service. See the full list.

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Awards and Accolades

Trysha Ahern, Section Administrator, Pediatric Infectious Diseases, recently received the third annual Barbara Levy Caring Award. Barbara Levy was the first volunteer coordinator for Pediatrics and this award is given to a member of the pediatric staff who exemplifies Barbara's caring spirit and commitment to BMC’s youngest patients. Ahern was nominated for her “years of dedication and effectiveness as an advocate of the special needs children at the SPARK Center.”