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June 16, 2016 Volume 5, Issue 6

Comprehensive Care for Adolescents with Substance Use Disorders

Boston Medical Center is well-known for the wide range of services the hospital provides to people with substance use disorders. However, at BMC programs are targeted largely to adult patients. One team is trying to change that, by establishing services specifically for adolescents and young adults with substance use disorders.

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BMC’s adolescent and young adult substance use disorder program, known as CATALYST (Center for Addiction Treatment for AdoLescents/Young adults who use SubsTances), was started by Sarah Bagley, MD. Bagley serves as program director and is an attending physician in the departments of Pediatrics and Medicine at BMC. After completing a fellowship in addiction medicine at BMC last year, Bagley decided to target her practice to adolescents and young adults.

“Adolescents and young adults commonly engage in more risky behavior. Some of that risk taking is appropriate and is part of becoming an independent adult, but when risk taking includes using substances that increase risk of injury, unsafe driving, and unsafe sexual practices, as well as potential for developing an addiction, then we have to intervene and help this age group stay safe and healthy,” says Bagley. “Right now in Massachusetts, we are experiencing increasing opioid related overdose deaths. In 2015, 15-24 year olds made up two percent of total deaths, but 10 percent of opioid related overdose deaths. In addition, we know that during this time, adolescents tend to transition from misuse of prescription opioids to heroin. Our goal is to provide this age group with developmentally appropriate care that provides the resources younger patients often have a hard time accessing, particularly medications that effectively treat opioid and alcohol use disorders.”

Patients in the program must be under 25 years old and will be seen in both the Adolescent Center and in General Internal Medicine. For the first phase of the program, Bagley anticipates that most patients will be referred from BMC providers, but the program also plans to work with community organizations and programs for later referrals. Once the volume of patients from within the BMC community and the needs of those patients are established, the program may expand its reach.

The program provides a range of services, including assessment/diagnosis of substance use disorders, medication treatment for disorders where it’s appropriate, therapy, access to primary care, HIV, and hepatitis screening, linkage to treatment, harm reduction education, overdose education, and access to naloxone. The team also hopes to facilitate support groups for both patients and families. A dedicated outreach worker and patient navigator will work to help ensure patients come to regularly scheduled appointments and provide concrete support to patients outside the clinic setting. The team is also fostering connections with community resources so that they can refer patients as necessary.

“Being able to provide continuity of care around times of transitions is very important,” says Bagley. “Patients, whether they have a substance use disorder or not, may stop going to primary care when they are too old to see their pediatrician- , but by working in both Pediatrics and General Internal Medicine, we can provide continuity with the same team during this vulnerable time. In addition, by treating patients in primary care settings, we can provide them with better access to other health services and help destigmatize substance use disorders and their treatment.”

In order to facilitate treating adolescents, Bagley and the program have received funding from the Jack Satter Foundation and the Massachusetts Department of Public Health. In addition to Bagley, the CATALYST program includes a clinical social worker, a nurse care manager, an outreach worker to make connections and provide support in communities, a patient navigator, and a program manager. The team is also collaborating with Child and Adult Psychiatry so that patients with co-occurring mental disorders can be treated appropriately.

“We’re not detox or an intensive outpatient program or an inpatient program,” says Bagley. “We know that some patients will need other levels of care. Our goal is to be a home for patients to help navigate the complex treatment system, no matter where they are on the continuum of what care they need. Addiction is a dynamic, chronic illness and we’re committed to meeting patients where they are and being flexible based on their needs.”

To refer a patient to the program, call 617-414-6655.

What do you do, Sharmecka Horton and John Archibald?

Names: Sharmecka Horton, RN, CCM and John Archibald, LCSW
Titles: Sharmecka: Case manager, Hematology and Oncology and John: Social worker, adult inpatient and geriatrics
Time at BMC: Sharmecka: Three years and John: Three and a half years

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Sharmecka Horton, RN, CCM and John Archibald, LCSW

What brought you to BMC?
Sharmecka: I’ve always wanted to work at BMC. I’m a Roxbury resident and this is the hospital that’s in my community. I thought that I could help a lot of people here. I started as a weekend case manager, working every weekend, and once a full-time position opened I moved into that.

John: I knew a doctor who worked here at BMC and he would tell me about the great people here. It made me really excited to work in this community. I applied, and now I work on the adult inpatient and geriatric unit.

What does the care management team do? How do you work together?
Care management is the general name for the department that deals with discharge planning to make sure patients’ needs are met after they leave the hospital. We also try to help keep patients healthy to prevent readmissions to the hospital. Care Management is made up of both case managers and social workers. Case managers are nurses who help to set up medical services for after discharge. Social workers help with social needs post-discharge, and provide education and resources for areas inclusive of housing, employment, safety, finances, and substance abuse. The two groups work together closely.

Sharmecka: Since I work with cancer patients, I deal with a lot of end-of-life care. I also place people into hospice facilities and make sure they have all the services they’ll need at home.

John: As the social worker, my job is to assess the needs of patients and try to support their goals to remain healthy. The patient drives what their goals are. I offer support and collaborate with the patient to achieve those goals. This may mean providing employment resources for job-seekers, educational program info for patients returning to school, or additional resources for what they may need. Additionally, we make plans to ensure patients can get to appointments, are taking their medication, can see their primary care physician, and so on. I closely partner with case managers to meet those goals. We really try to pull in any other hospital programs that may be beneficial to the patients we serve.

What’s one thing about working in care management that people might not guess?
Sharmecka: A lot of people don’t realize that case management is also part of the Finance Department. We determine if patients are inpatient appropriate or observation appropriate and make sure that the hospital gets the appropriate reimbursement based on level of care. We’re also the ones that focus on patients’ insurance – we make sure they have insurance, that the outpatient services they need are covered by insurance, and often give our population the bad news that they don’t have insurance. In these cases, social workers take over to help patients get insurance. We have patients come from all walks of life and all over the world, and a lot of our patients don’t have insurance. This makes it very hard for case management to even get them care outside of BMC.

John: For social work, even though I engage in many serious conversations and time can be limited, it can be a lot of fun. It’s exciting for me to partner with BMC patients and to generate a plan and vision regarding their health needs and for whatever else they hope to achieve. It’s a lot of fun to get to know the patients and hear their stories, and help them plan for what their path might be.

What do you like most about working at BMC?
Sharmecka: What I like is having the opportunity to make sure that end-of-life is good not just for the patient, but also for the family. End-of-life is not just for the patient. The patient has to go through this, but the family still has to live with it afterwards. If I can make that transition smoother, that’s one of the things that I really like about my position and my particular team.

I also like that BMC is up the street from where I live. It’s a nice stroll to get clear before you get here and then leave it all behind when you leave.

John: I really appreciate when the patients are able to feel supported, satisfied, and knowledgeable about the next steps to take. If our patients can leave here feeling satisfied and with a plan for next steps, it’s very rewarding for me.

What do you do for fun outside of work?
Sharmecka: I love traveling. I’m also really involved in my church. I have two teenagers at home, so that’s a lot of fun sometimes, depending on how much I’m driving them around.

John: I love spending time with my wife and my dog, especially going on walks with them. It’s so pleasant to be outside and getting fresh air. I also love anything that’s related to Boston sports.

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

BMC Reaches Fundraising Milestones, Launches New Philanthropic Campaign

As a nonprofit hospital dedicated to providing exceptional care without exception, philanthropy is essential to BMC. Donations from the community, patients, families, friends, and staff of BMC help the hospital provide a comprehensive range of services to everyone who needs them. The Development Office is responsible for overseeing these donations, as well as other fundraising activities for the hospital, and has recently reached several milestones.

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The 2016 BMC Gala, held on May 14, celebrated BMC’s 20th anniversary and raised a record-breaking $4 million. More than 1,100 guests filled the Seaport World Trade Center to celebrate Boston Medical Center. The evening also honored chairman of the board Ted English, who is stepping down from his leadership role. English, executive chairman at Bob’s Discount Furniture, joined BMC’s board in 2006 and has been chairman for seven years. Martha Samuelson, president and chief executive officer of Analysis Group, will be the new chairman of the board.

The gala success came on the heels of Boston Medical Center crossing the threshold of $500 million in total funds raised since 1996. For the third year in a row, the Development Office is on track to surpass its $50 million annual goal to reach this milestone—a momentous and rare milestone for a safety-net hospital.

“Our accomplishments as an organization are notable and profound, especially in a city filled with world-renowned medical institutions, among the best in the fundraising arena,” says Norman Stein, senior vice president of development and chief development officer. “We are proud that BMC’s mission and the extraordinary talent of our clinicians and staff receives such significant recognition from the Boston philanthropic community. The Development team works tirelessly to garner donations to advance the mission of the hospital, and in doing so, support the many services, programs, capital projects and research that solely rely on philanthropic funding.”

The Development Office has also launched a branding campaign to strengthen the hospital’s presence as a philanthropic organization in Boston. Launched in September 2015, the campaign follows seven patients—including Boston Marathon bombing survivor Jeff Bauman—who share their BMC experiences and stories of perseverance. Other patients in the campaign include Dante, who was born weighing less than two pounds and suffering from the effects of pre-natal drug exposure, and Selena, who was treated for colon cancer and Lynch syndrome, a rare genetic condition, at BMC. Dante was treated in the neonatal intensive care unit and in the Comprehensive Care Program, and is now a thriving 10-year-old.

“Our success directly reflects the caring and compassionate nature of our BMC trustees and friends,” concludes Stein. “They understand the integral role BMC plays in the health and future of our community, and they push us to think outside of the box and continue to implement effective, clever ways to grow as a nonprofit."

News of Note

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Elaine Alpert Delivers Seventh Annual Lynne Stevens Memorial Lecture
On May 24, the Department of Family Medicine hosted the Seventh Annual Lynne Stevens Memorial Lecture, delivered by Elaine Alpert, MD, MPH, a scholar in family violence, sexual assault, and human trafficking at the University of British Columbia (UBC). Alpert also consults internationally regarding education, policy, public health and prevention.

Alpert described the scope, presentation, and health effects of human trafficking and outlined strategies for identification and response. She also discussed how to facilitate collaboration between health care and other sectors of society. Up to 88 percent of trafficking survivors reported encounters with health care providers while being trafficked in a variety of settings. Alpert noted that health providers’ barriers to effective care included insufficient prior education, lack of practical experience, not knowing how to respond, and no private space, insufficient time or reimbursement. She explained that with knowledge of key principles for trauma-sensitive practice, effective inquiry can begin the process of intervention to help trafficking victims. After the lecture the audience discussed ways that providers can make patients comfortable enough to share their struggles with being coerced or abused; the next critical step is knowing how to offer and refer the patient to appropriate assistance.

This annual memorial lecture is in honor of Lynne Stevens, LICSW, BCD (1946-2009), the director of the Responding to Violence Against Women Program and an assistant professor in the Department of Family Medicine. She was a clinician, activist and researcher who worked locally, nationally, and internationally, specializing in evaluation of the quality of care offered to women who were victims of violence.

Boston Medical Center Board of Trustees Names New Chair, Trustees
The BMC Board of Trustees has elected Martha Samuelson as its Chair. Samuelson has served on the BMC Board of Trustees since 2008 and on the BMC Health System Board of Trustees since its inception in 2013. Samuelson succeeds Ted English, who served as Board Chair for seven years. English will continue to serve as a member of BMC’s Board of Trustees.

Samuelson, the president and chief executive officer of the Analysis Group, has served on a number of BMC Board committees, including Investment (Chair), Audit & Compliance, and the Campus Redesign Financing Subcommittee. She is an expert in antitrust, finance, and damages analyses, combining training in finance and economics with five years as a practicing trial attorney. She has also served as an expert in many phases of litigation, including development of economic and financial models; preparation of testimony; development, presentation and review of pretrial discovery; and critique of analyses of opposing experts.

The Board of Trustees also named Barry Bock, RN; Pierre Cremieux, PhD; and Karen Kames as new BMC trustees.

Bock is chief executive officer of the Boston Health Care for the Homeless Program (BHCHP) and has worked in homeless health care since 1979. He joined BHCHP in 1990 and has served as chief executive officer since 2013; prior to becoming CEO, he served as chief operating officer. He was one of three nurses to develop the Morning Nurses' Clinic at Pine Street Inn in Boston in 1986 and also served as director of the Barbara McInnis House when it opened in 1993.

Cremieux is a Managing Principal of the Analysis Group. His work has included analyses of liability and damages in wide variety of cases involving various parties in the health care system from insurance companies to providers and pharmaceuticals. Cremieux is an adjunct professor at the University of Quebec at Montreal. Cremieux also serves as a trustee of Boston Medical Center Health Plan.

Kames has been an active volunteer with numerous BMC programs and initiatives, ranging from patient communications to BMC’s Refugee Center and SPARK Center for high risk children. She serves on the Board of Trustees at The Learning Prep School in Newton, Mass., where she co-headed the search committee for a new Head of School in 2015. She is also on the parent advisory committee at The Wheelock Family Theater. She worked on the Planned Parenthood Crisis Hotline from 2005 to 2012 and prior to that as an elementary and high school teacher and as a textbook editor at Houghton Mifflin.

Marie-Helene Saint-Hilaire Named Chief of Neurology
Marie-Helene Saint-Hilaire, MD, FRCPC, FAAN, Associate Professor of Neurology, has been appointed Chief of Neurology at Boston Medical Center and Chair of the Department of Neurology at Boston University School of Medicine ad interim effective immediately.

Saint-Hilaire, who has been at BMC since 1988, directs the BMC Parkinson’s Disease and Movement Disorders Center and the American Parkinson Disease Association Advanced Center for Parkinson Research at BUSM.

Saint-Hilaire received her MD from the Universite de Montreal. She completed her neurology residency at the Montreal Neurological Institute (MNI), followed by a three-year fellowship (one year each) in Paris with Pr. Yves Agid, at Columbia Presbyterian Hospital with Dr. Stanley Fahn, and at Boston University with Dr. Robert Feldman.

Department of Emergency Medicine Names New Director, Associate Director of Research
Patricia Mitchell, RN, currently the Assistant Director of Research in the Department of Emergency Medicine, will assume the title of Director of Emergency Medicine Research Operations. Mitchell will continue to oversee all daily research activities and supervise all research personnel, as well as manage grant- related research activities and budget negotiations. She will also continue the required role of clinical research nurse, managing all regulatory responsibilities for NIH and industry- sponsored studies.

Elissa Perkins, MD, MPH, an attending physician in the Emergency Department, will assume the title of Associate Director of Emergency Medicine Research. Perkins will oversee the research section budget, including the development of a formal process to provide pilot funding to encourage research. She will also work with the Vice Chair of Research to establish research goals, priorities and new initiatives to enhance the academic productivity of the research section. Additionally, she will collaborate with the Injury Prevention faculty to develop integrated research initiatives. She will serve as a mentor for faculty, residents, and student researchers. Perkins will also continue her research in infectious diseases in the Emergency Department.

Awards and Accolades

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BMC Honors Public Safety Officers, Supervisors
On June 7, BMC’s annual Public Safety Awards, honored Public Safety employees who have performed exceptional work.

William Gibbons, Director of Public Safety, opened the awards, saying that “the ceremony is a great opportunity to acknowledge the good work Public Safety does and it is special to do it in front of family and friends. Public Safety is a highly intelligent, professional, and motivated group. I am proud of the passion you have for your work in making people feel welcome and safe at BMC.”

Gibbons was followed by Kate Walsh, President and CEO of BMC, who said she was “honored to be here to recognize the outstanding service you provide to the community.”

“Your role is central to the mission to provide exceptional care without exception,” Walsh continued. “Every day you remind us that it’s not just doctors and nurses that save lives here. I really want to thank you for the small, quiet moments that can completely change someone’s experience at the hospital, like a smile or providing directions. I’m proud and you should be too. I’m also very grateful.”

The keynote speaker at the awards ceremony was Chief William G. Brooks III, Chief of the Norwood Police Department, who spoke about the work of the Innocence Project and its relationship to the work Public Safety does.

Forty three staff members were recognized at the ceremony:

  • Bartholomew Connors: Medal of Valor, commendation
  • Matthew Lynch: Medal of Valor
  • Michael Loud: Medal of Valor, Life Saving, two commendations
  • David Zuller: Medal of Valor, Life Saving, commendation
  • Matthew Hayes: Life Saving, commendation
  • Sheffrey Thornton: Life Saving
  • Kristin Oberlander: Life Saving, two commendations
  • Charnee Alkins: Commendation
  • David Haggerty: Commendation
  • William Denish: Commendation
  • Sgt. Daniel Healy: Commendation
  • Thomas Donovan: Commendation
  • Eddy Jeannot: Commendation
  • Michael Forbes: Two commendations
  • Paul Juliano: Commendation
  • Anthony Giardina: Commendation (F)
  • Alexa Juris: Commendation
  • Leonard Graf: Five commendations
  • Shannon Keating: Two commendations
  • Thomas Greenwood: Commendation
  • Evan Kelleher: Commendation
  • Nicholas Keough: Commendation
  • David O’Brien: Three commendations
  • Gregory Leblanc: Commendation
  • Mikel Panajoti: Commendation
  • John Seay: Commendation
  • Zachary MacInnis: Two commendations (F)
  • Harris Tracy: Commendation
  • Brendan Marlow: Commendation
  • Ryan Walshe: Commendation
  • Luke Manning: Commendation
  • Ashely Woodman: Commendation (F)
  • Dilio Martinez: Commendation
  • Melanie Chamber: Citizen commendation
  • Daniella Sisniega: Citizen commendation
  • Joseph Chavis, CNA: Citizen commendation
  • Moral Tahouni, MD: Citizen commendation
  • Paul Devenzia: Citizen commendation
  • Thomas Smith: Citizen commendation
  • Mulu Gedlu, RN: Citizen commendation
  • Periklis Vlahopoulos: Citizen commendation
  • Lauren Netwich, MD: Citizen commendation
  • Jason Worcester: Citizen commendation

Supervisor Patricia Brutus was given the William J. Flaherty Distinguished Service Award. In addition, awards were presented for years of service:

  • 40 years: Eddie Jackson
  • 30 years: Sternie Williams
  • 20 years: Michael Tofuri, Ryan Walshe
  • 15 years: James Huggins, Leroy Lynch, Denzil Beaumont
  • 10 years: Lionel Clements, Mikel Panajoti, Matthew Hayes, Justyna Wells
  • 5 years: Nikoleta Asllani, Evan Kelleher, Nathalie Edmund, Ryan Linehan, Cassandra Everett, Jacob Saad, Alexa Juris

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BMC Honored with Greenhealth Emerald Award
BMC was awarded the Greenhealth Emerald Award by Practice Greenhealth, the nation’s leading health care community dedicated to transforming health care worldwide so that it reduces its environmental footprint, becomes a community anchor for sustainability and a leader in the global movement for environmental health and justice. The Practice Greenhealth Environmental Excellence Awards recognize health care facilities, businesses and organizational members for their demonstrated commitment to environmental practices and sustainability. BMC was the only hospital in Boston and one of three in Massachusetts to win this award.

BMC Receives Get With The Guidelines Award from the American Heart Association
BMC has received the American Heart Association/American Stroke Association’s Get With The Guidelines®-Stroke Gold Plus Achievement Award with Target: StrokeSM Honor Roll Elite Plus. The award recognizes the hospital’s commitment to providing the most appropriate stroke treatment according to nationally recognized, research-based guidelines based on the latest scientific evidence. Hospitals must achieve 85 percent or higher adherence to all Get With The Guidelines-Stroke achievement indicators for two or more consecutive 12-month periods and achieve 75 percent or higher compliance with five of eight Get With The Guidelines-Stroke Quality measures to receive the Gold Plus Quality Achievement Award.

Karsten Lunze Receives Two Humanitarian Awards
Karsten Lunze, MD, DrPH, MPH, FACPM, FAAP, a preventive medicine physician at BMC, recently received two awards in recognition of his humanitarian efforts in medicine.

Most recently, he and his wife, Fatima Lunze, MD, ScD, PhD, FASE, a pediatrician at Boston Children’s Hospital, were awarded a United Nations (UN) Humanitarian Medal for delivering advanced health services and provider trainings for victims of war and terrorism in an area in Russia known as the North Caucasus. Following the 2004 tragedy in Beslan, Russia, where 330 hostages – including 186 children – were killed in a school siege, the couple established “Health for the Caucasus,” a non-profit dedicated to providing humanitarian assistance to refugees and victims of war and terror. For more than a decade, they have led efforts to improve the region’s health sector troubled by recent violent conflicts and helped foster international collaborations. The Lunzes were honored for leading international capacity-building efforts on both sides of the conflicts to strengthen local health systems and for serving people in the Caucasus who were directly and indirectly affected by the violent conflicts.

In addition, Lunze received the American College of Preventive Medicine’s (ACPM) Arnold P. Gold Foundation Humanism in Medicine Award for his outstanding achievements and contributions in the field. The award recognizes his global health work demonstrating how public health can contribute to and facilitate humanism in medicine. The award also highlights his work on individuals with substance use issues and his engagement for victims of war and terror.

BMC Resident and Fellow Inducted into Alpha Omega Alpha National Medical Honor Society
Lisa M. Caroll, MD, MPH, and Jose Rafael Zuzuarregui, MD, have been inducted into the Alpha Omega Alpha National Medical Honor Society. Carroll is a third-year resident in obstetrics and gynecology at BMC and Zuzuarregui is a movement disorders fellow in the Department of Neurology at BMC. Alpha Omega Alpha, which is the only national honor medical society in the world, aims to promote scholarship and research in medical schools, encourage high standards of character and conduct among medical students and graduates, and recognizes high attainment in medical sciences, practice, and related fields.

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