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The BMC Brief

January 31, 2013 Volume 2, Issue 2

Miara Lecture Showcases Critical Importance of Staff Involvement in Patient Safety

Emergency department nurses develop a new IV device that helps prevent central line infections. A surgical tech creates a new process to ensure that unclean equipment does not make its way into the operating room. A patient scheduler makes a suggestion to improve patient safety in Labor and Delivery that results in a complete overhaul of the triage process.

These were some of the examples Susan Moffatt-Bruce, MD, PhD, Chief Quality and Patient Safety Officer, Ohio State University Wexner Medical Center, gave as part of her keynote address at the eighth annual Raphael Miara Memorial Patient Safety Symposium hosted by BMC’s Quality and Patient Safety Department on Jan. 22. Moffatt-Bruce described her experience working with all members of hospital staff to improve patient safety.

Moffatt-Bruce and Miara family
Susan Moffatt-Bruce with the Miara family

Moffatt-Bruce created departmental councils at Ohio State’s Medical Center that combine the insight of doctors, nurses, administrators and other front-line staff to identify and create change within their own areas to enhance patient safety. The goal, she said, was to evolve the traditional leadership-initiated method of change to include the day-to-day expertise of staff and empower them to be involved in establishing best practice guidelines.

“Rather than having seven, 10 or even a dozen great leaders identifying problems and coming up with solutions, we have 10,000 people identifying problems and helping solve the issues,” said Moffatt-Bruce.

Each department, whether it is Trauma or the neonatal intensive care unit (NICU), works with a quality improvement facilitator to determine improvement initiatives and track their progress via their own “scorecard” that aligns with the overall hospital’s goals.

“We are focused on the purpose of our efforts,” she said. “Then we get the process correct, and the outcomes follow.”

While the improvements have shown promise, Moffett-Bruce acknowledged that her institution still has a way to go to reach its goals.

“We still see opportunity and need to be held accountable to make [health care] an ultra-safe system,” she said. ”But we are on a journey. And we are not there yet.”

Moffat-Bruce’s principles can be adapted and applied to other hospitals as well. She strongly recommends investing in staff education and training to improve patient safety.

“Education gives staff the ability to identify problems and then how to fix it,” she said. “Having that support in place and where to garner that knowledge is absolutely essential to staff engagement.”

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        MLK Celebration Reflects on Half Century of Change

        Dr. Rafael Ortega and Dr. Marcelle Willock
        Dr. Rafael Ortega and Dr. Marcelle Willock

        The celebration began with the sound of a voice. The crowd was silenced by the boom of Dr. Martin Luther King, Jr.'s words in his memorable "I Have a Dream" speech as it resonated within the walls of Hiebert Lounge Jan. 28. Faculty, staff and students from BMC and Boston University’s Medical Campus gathered there to celebrate the life and legacy of Dr. King listened to his speech before the keynote address by Marcelle Willock, MD, former professor and chair, Department of Anesthesiology, BUSM, and former dean, Charles Drew University of Medicine and Science.

        Willock reflected on her experience as an African-American woman pursuing a career in medicine during a tumultuous time in United States history.

        “For so many of you, 50 years is something in the history books,” she said. “But for a few of us, myself included, we experienced these laws and atrocities or knew people who had.”

        Willock said she dreamed of pursuing medicine from an early age. She attended the College of New Rochelle just outside of New York City, where she was informed that getting into medical school would be especially difficult because of her gender and the color of her skin. She was accepted into medical school at Howard University in Washington D.C., a city fraught with segregation and racism at the time.

        No sooner had Willock begun her residency in anesthesia at Columbia-Presbyterian Hospital in New York City in 1963, before she asked the chairman of her program for two days off mid-week to attend a protest for civil rights in Washington D.C. The event, it turned out, would be one of the most memorable of her life.

        “There were 200,000 people peacefully gathered and united in their purpose to demonstrate nonviolently for civil rights, jobs and freedoms,” she said. “And onto the stage came Martin Luther King, Jr. with his ‘I Have a Dream’ speech. His philosophy of brotherhood projected a better America for all its citizens.”

        Willock’s involvement with the civil rights movement and the women’s movement gave her the motivation she needed to overcome the adversity she faced and shaped her career into one that would provide opportunities to minorities in the medical field. Her path brought her to BUSM and BMC, where she became the first minority woman to chair a clinical academic department in the United States.

        “My experiences made me more aware of the injustices and the need for me to speak up and push for equality,” she said.

        Willock concluded her presentation by imploring the audience to think about their commitment to bettering patient care, and to uphold Dr. King’s dream and BMC’s commitment to exceptional care, without exception.

        “We honor Dr. King’s vision for his unselfish commitment to improve the life of all Americans and his observation that our destiny and our freedom as Americans are inextricably bound to each other,” she said.

        BU String Quartet
        BU string quartet

        The presentation was followed by a performance of Antonin Dvorak’s “American Quartet” by a classical string ensemble sponsored by BU College of Fine Arts and Medical Campus Arts Outreach Initiative. A string quartet was chosen because it symbolizes unity -- different voices blend together and through teamwork, create harmony.

        The annual event was sponsored by BMC’s Events Committee, the BUSM Office of Diversity and Multicultural Affairs, the BU Goldman School of Dental Medicine Office of Diversity and the BMC Minority Recruitment Program.

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        Spotlight on Research: Study Gauges Attitudes Toward HPV Vaccination for Boys

        A BMC and Boston University School of Medicine (BUSM) study has found that low-income and minority parents/guardians were receptive to vaccinating boys against Human Papilloma Virus (HPV). However, racial/ethnic differences emerged in attitudes regarding school-entry mandates.

        HPV is a virus that is spread by skin-to-skin contact during sexual activity with another person. It is the main cause of cervical cancer in women and has also been found to cause oropharyngeal cancers in men. The Centers for Disease Control and Prevention (CDC) recommends that girls and boys age 11-12 receive the HPV vaccine before sexual activity begins. 

        HPV Vaccine

        Although low-income and minority men have higher rates of oral HPV infection and are more likely to suffer from HPV-related diseases including penile, anal and oral cancers, few studies have examined parental attitudes after the HPV vaccine was approved for males in 2009.

        This study aimed to provide an in-depth understanding of how low-income and minority parents view HPV vaccination for boys using open-ended interview questions.

        Researchers led by corresponding author, Rebecca Perkins, MD, MSc, Oobstetrics and Gynecology, interviewed 120 parents and legal guardians of boys age 11 to 17 who accompanied them for physician visits. All subjects were read a short educational paragraph explaining HPV and the HPV vaccination prior to answering questions.

        “This study indicates that most parents would accept HPV vaccination for their sons just as readily as for daughters,” says Perkins.

        Although race/ethnicity revealed no differences in parent/guardians’ views toward vaccinating boys, minority study participants were more likely than white participants to support school-entry mandates, requiring children to receive the HPV vaccine.

        Results from this study suggest that low-income and minority parents/guardians are inclined to accept HPV vaccination for boys with the aim of protecting them from cancer and other diseases, but would like more information specifically related to HPV in males. More African-American (73 percent) and Latino (86 percent) than Caucasian (44 percent) participants supported school-entry mandates, but all feel that requirements should apply to both genders.

        “Future research should explore the effects of the 2012 recommendations for routine vaccination for males on parental attitudes and uptake of HPV vaccination among both sexes,” says Perkins.

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        What Do You Do, Barbara Catchings?

        Name: Barbara Catchings
        Title: Director, Community Outreach and School Partnerships
        Department: Human Resources
        Years at BMC: 17

        Barbara Catchings
        Barbara Catchings

        What brought you to BMC?
        Prior to coming to BMC, I worked in both for-profit and non-profit industries as a bank operations officer and a human resources manager in an academic research institute. When an opportunity was presented to me to explore a career in human resources in health care, I decided that this was a great move for me. During my time at BMC, I have worked in several areas within human resources, such as employment, employee relations and workforce diversity. I feel that my prior experience helped to prepare me for my current role, as several of the relationships I have established within the Boston community had been initiated during the time I held these positions.

        What do you do here?
        My role is to help BMC foster relationships with community organizations, professional organizations, schools, and community centers to ensure that the hospital is a respected and integral part of the Boston community and to encourage the support and education of Boston’s youth. Some people also see me as a “go-to” person because if I don’t have the answers, most of the time I am able to point them in the right direction.

        What are some your recent projects?
        BMC was invited to participate in the STEP Student Program, an organization that helps to prepare juniors and seniors from Roxbury’s John D. O’Bryant School for college through educational tours. I have arranged and facilitated educational tours in several departments such as Otolaryngology, Radiation Oncology, Nursing, Rehabilitation Therapies, and Interpreter Services.

        What is your favorite thing about working at BMC?
        I love the work that I do on behalf of BMC. I get a great sense of fulfillment. I love the fast pace and having the opportunity to learn about the many different and unique programs that only BMC has to offer. When I lead a group of students on a department tour, I am still intrigued and proud to share information about BMC’s programs and services. One of the most touching things that happened to me is when I was introduced as a guest speaker at the 2011 STEP Program Graduation program held at the John D. O’Bryant School located in Roxbury, and the student who introduced me said that when I conducted a tour for her group, she made up her mind that day that she wanted to work in health care.

        Why do you think it is important for BMC to have a strong involvement in the community?
        BMC is a leading employer in Boston and many of our patients live in the community and have been coming to BMC for their care for generations. Through our community outreach activities, BMC demonstrates corporate social responsibility by promoting and providing training opportunities to youth who live in and attend schools within city neighborhoods so they may gain a better understanding of the business of health care and help to influence their career choices and their futures. BMC exercises its social responsibility by helping them to prepare for a better life through education, health living, and future employment.

        How do you manage your work/life balance?
        Sometimes it is challenging for me to do. A lot of the community outreach activities occur in the evenings. My solution to balancing the two is to make sure I have some down time on the weekends to spend with my family. Reading is one of my passions. Once I start reading a book, I feel compelled to finish it. I also love to write.

        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

        Letter writing 

        I am writing on behalf of my family about my mom's experience at BMC. My mom was recently diagnosed with ovarian cancer and began to show signs of a possible heart attack. We were lucky to connect with Dr. Raby and he recommended that we have her do her procedure at the cath lab. As I am sure you can imagine, our lives have been quite emotional and hectic since her diagnosis. Well, yesterday, our lives for this one day were a little less stressful because of the cath lab staff. They were fantastic with my mom, with us, and with the discharge plan. Dave (the physician's assistant), Steve (the nurse), and Nancy (the nurse) were incredible. The care, warmth, and professionalism from the beginning to the end was truly amazing. Dave was excellent at explaining and assisting, Steve was funny, caring, and kept us from worrying, and Nancy went above and beyond by retrieving pennies in the bathroom (that my mom thought were a sign from her mother) and placing them in my mom's hand! Please know that you can be extremely proud of the staff in the Cardiac Cath Lab!

        In the end, all turned out well for my mom. She only has apical ballooning syndrome (a "frightened" heart) and she will be fine in six weeks. On that note, there was certainly nothing frightening about your staff, hospital, or cath lab!

        Thank you very much for offering such excellent care. Please know that we will speak highly of your hospital to all that we know.

        Reading, Massachusetts

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        News of Note

        BMC Physician Publishes Book on Alcohol Abuse
        Richard Saitz, MD, MPH, Director, Clinical Addiction Research and Education (CARE) Unit, has published the book, Addressing Unhealthy Alcohol Use in Primary Care. Intended for use by primary care physicians who treat substance abuse in their practice, it is the first resource of its kind developed specifically for this type of clinician. Book topics include assessment, brief counseling interventions, pharmacotherapy, referrals to both specialty care and Alcoholics Anonymous (and other self-help programs), and other information specific to the needs of the primary care clinician.

        MRI installation 
        MRI delivery to Shapiro

        State-of-the-Art MRI Installation Begins in Shapiro
        This month BMC received a special delivery: a new Magnetic Resonance Imaging (MRI) machine for the Shapiro building. The new MRI is double the strength of BMC’s three existing MRI machines, and will provide higher quality images, particularly for neurological, musculoskeletal, oncologic and breast imaging. With the more powerful machine, radiologists will be able to highlight areas of the brain that may be involved in cognition, perception and emotions. The new machine is also larger, which can provide comfort and decreased anxiety to claustrophobic and overweight patients. The machine installation will be completed by early March, with the expectation of imaging patients by mid-April.

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        Awards and Accolades

        Cheryl Tull, RN, and Ketline Edouard, RN, are recipients of 2013 Excellence in Nursing Award from the New England Regional Black Nurses Association (NERBNA) to be presented Feb. 22 at its 25th anniversary celebration. The award recognizes black nurses who consistently excel in their profession and specialty areas.

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