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February 1, 2013

Table of contents

 


Message from Paul Ramsey

Paul G. Ramsey

Institute for Simulation and Interprofessional Studies, a leader in healthcare training 

Dear Colleagues:

The UW Medicine Institute for Simulation and Interprofessional Studies (ISIS) opened in 2005 and quickly became a regional and national leader in utilizing simulation to improve the quality of training for health professionals. Recently I had the opportunity to observe an ISIS presentation of a mock Code Blue training response with students from the schools of medicine, nursing and pharmacy. I was struck by the power of simulation to provide outstanding interprofessional training in a highly realistic setting, with careful measurement and monitoring of individual and team skills.

ISIS has made substantial progress over the past year. In advancing patient safety, quality and team management, ISIS continued implementing the central venous catheter (CVC) simulation-based training and certification, a program entirely developed at ISIS. As a result of this enterprise-wide training program, every health professional inserting a line at UW Medical Center or Harborview Medical Center is now ISIS-certified. Central line-associated bloodstream infections have been reduced in the ICUs at UW Medical Center and Harborview from 8.3 infections per 1,000 catheter days in 2008 to 2.6 in 2011. Over half a million dollars per year was saved in cost avoidance and patient satisfaction increased substantially.

Overall, more than 50,000 learner hours were logged in ISIS at Harborview and UW Medical Center in FY 12. ISIS also continued its collaborations with current partners, including Seattle Children’s and the Boise VA and forged new partnerships. Collaboration with Seattle Children’s was formalized through a memorandum of understanding. Plans for further UW Medicine based ISIS programs are occurring with the Community Health Education & Simulation Center at Northwest Hospital & Medical Center and preliminary discussions are taking place with Valley Medical Center.

ISISsmIn pursuit of the goal to integrate patient safety, quality and efficient team management into the foundation of interprofessional education, leaders of ISIS are participating in the medical school curriculum renewal to advance these areas within the medical school and other health professions curricula. Faculty and staff also developed a revised Code Blue response at UW Medical Center and Harborview Medical Center, standardizing the response across hospital systems, and developed an improved and more comprehensive moderate sedation training program for non-anesthesiology providers, including physicians, physician assistants and nurse practitioners. Additional work has focused on development and implementation of formal training programs for team communication at the student, resident and practicing health professional levels using the national Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) in support of Patients Are First.

Several interprofessional education initiatives began in FY 2012, including an online toolkit for faculty development that has been completed by nearly 850 participants. ISIS also supported standardized training in other educational programs, including the medical student capstone course, airway management training for students at the Boise VA Medical Center via distance learning, and activities in many other locations.

In a new outreach activity, ISIS research and development meetings are now open to the public. The February meeting will be held on February 6, 4:00-5:30 p.m. in ISIS at UW Medical Center (first floor of the Surgery Pavilion, Room SP 1122) and ISIS at Harborview (third floor, Ninth & Jefferson Building, Room 3NJB365). The sites are connected via telemedicine. The main topic for the February meeting is simulation and global health, with presentations from faculty in the departments of global health, surgery, obstetrics/gynecology, medicine and the College of Engineering. I urge those of you who are interested to attend.

ISIS remains one of the preeminent simulation training centers in the nation and has plans to build on its strengths over the coming years. I would like to thank Brian Ross, executive director of ISIS, and Carlos Pellegrini, chairman of the ISIS Board, as well as the many other individuals involved in making ISIS an outstanding resource for UW Medicine with a key role in improving safety, quality, efficiency and cost-effectiveness for healthcare.

Sincerely,

PGRamsey Signature2

 

Paul G. Ramsey, M.D.
CEO, UW Medicine
Executive Vice President for Medical Affairs and
Dean of the School of Medicine,
University of Washington

  


Research  

UW study examines relationship between racial segregation and lung cancer mortality rates 

Leah BackhusLung cancer mortality appears to be higher in black persons and highest in blacks living in the most segregated counties in the United States, regardless of socioeconomic status, according to a report published in the January issue of JAMA Surgery, a JAMA Network publication.

Lung cancer is the leading cause of cancer death in the United States and blacks are disproportionately affected, with the highest incidence and mortality rates.

Leah Backhus (photo, right), UW assistant professor of surgery in the Division of Cardiothoracic Surgery and chief of Thoracic Surgery at the Veterans Administration Puget Sound Health Care System; Awori J. Hayanga, former UW fellow in cardiothoracic surgery;and Steve Zeliadt, UW research assistant professor in the Department of Health Services, School of Public Health, conducted the research. The team examined the relationship between race and lung cancer mortality and the association with residential segregation by using data obtained from the 2009 Area Resource File and Surveillance, Epidemiology and End Results program to conduct a population-based study.

“The overall lung cancer mortality rate between 2003 and 2007 was higher for blacks than for whites (58.9 percent vs. 52.4 percent per 100,000 population),” according to the study results. The authors identified segregation as highest in the Northeast, Midwest and South and lowest in the Northwest. A total 28 percent of the U.S. population lives in counties with low segregation, 40 percent in counties with moderate segregation, and 32 percent in counties with high segregation, according to the study findings.

“Blacks living in counties with the highest levels of segregation had a 10 percent higher mortality rate than those residing in counties with the lowest level of segregation. This increase was not observed among the white population, and, in contradistinction, the mortality rate was 3 percent lower among whites living in the most segregated counties when compared with those living in the least segregated counties,” the authors comment.

The authors note that because they performed a cross-sectional analysis, they were unable to make causal inferences at the individual level.

“The equalization of lung cancer mortality rates between the black and white races might require that counties, or census tracts, of high segregation, with their attendant physical deprivation, social ills, and limited access, receive more attention to address the existing disparities,” the authors conclude. “Public health initiatives, such as smoking cessation and early cancer screening programs, should be prioritized in these counties. Access to screening and expedient referral to specialist care should be optimized to ensure that the benefits of early cancer screening are realized.”

Read the study in JAMA Surgery.

Early signals warn of prolonged sports concussion symptoms

Researchers have found clear, identifiable factors that signal whether an athlete will experience concussive symptoms beyond one week after the initial injury.  

The researchers sought to identify risk factors for prolonged concussion symptoms by examining a large national database of high school athletes’ injuries. Previous concussion studies were limited in scope, focusing only on male football players. The information from this study applies to male and female athletes from a number of different sports.

The concussion research looked at variety of sports, not just football, and included both male and female athletes.

Researchers found that athletes who have four or more symptoms at initial injury were more likely to have persistent concussive symptoms. Drowsiness, concentration difficulties, nausea and sensitivity to light and noise were also associated with longer-lasting concussive symptoms. Because concussions tend to be a common occurrence in football, researchers compared data from football players to other sports, and found that risk factors were different for football and non-football-related concussions.

The results of this study could change how long high school athletes are kept from returning to play after a concussion. Previously, athletes who lost consciousness were held out from playing longer than those who did not lose consciousness, but the study found little correlation between loss of consciousness and persistent symptoms.

Sara Chrisman, an adolescent medicine fellow in the UW Department of Pediatrics, headed the study. She said, “The medical community is becoming more aware that concussions may not be a minor injury and may result in prolonged symptoms. This is a step towards developing evidence-based return to play guidelines.”

Read more in UW Today.    

Quarterly research funding report: October - December 2012

UW Medicine’s top research awards have been listed for October through December 2012. The list draws from all awards, including those for new projects or for an additional installment to an existing project.

Awards granted January through March 2012, April through June 2012 and July through September 2012 are also available online.

 

 

 

Clinical Care  

Stephen Zieniewicz assumes leadership roles in American Heart Association and American College of Healthcare Executives 

Stephen ZieniewiczStephen P. Zieniewicz, executive director of UW Medical Center, has been appointed chairperson of the American Heart Association (AHA) Seattle Puget Sound and elected Washington state regent for the American College of Healthcare Executives (ACHE). Zieniewicz has been executive director of the UW Medical Center since September 2007.

Zieniewicz was appointed to chair the American Heart Association Seattle Puget Sound, the local chapter Western States Affiliate of the national AHA, last month. The AHA’s mission is to build healthier lives, free of cardiovascular diseases and stroke. The organization raises awareness of heart disease and stroke, provides information on how individuals can maintain a healthy lifestyle and prevent heart disease, and raises funding to support research on heart disease and to increase awareness.

UW Medicine participates in many AHA events, including the Go Red for Women Luncheon, AHA Heart Walk and AHA Heart Ball. This year Edward Verrier, professor of surgery and chief of the Division of Cardiothoracic Surgery, will be honored for his work in cardiothoracic surgery at the AHA Heart Ball on April 27. Paul Ramsey, CEO, UW Medicine, Executive Vice President for Medical Affairs, and dean of the UW School of Medicine, has been named the AHA 2014 Heart Walk Event Chair.

Two UW Medicine entitites, UW Medical Center and Harborview Medical Center, have received AHA Fit-Friendly Company Gold Member recognition for their efforts to promote wellness among employees. UWMC became an AHA Fit Friendly Company gold member in October 2011 and HMC was recognized as an AHA Fit Friendly Company Gold Member in October 2012.

Zieniewicz was elected to a three-year term as Washington state regent for the American College of Healthcare Executives , beginning March 9. The American College of Healthcare Executives is an international professional society of more than 40,000 healthcare executives who lead hospitals, healthcare systems and other healthcare organizations. The ACHE is recognized by healthcare executives by offering its prestigious FACHE® credential signifying board certification in healthcare management. ACHE's established network of more than 80 chapters provides access to networking, education and career development at the local level. Zieniewicz, an ACHE board certified hospital administrator, has been a member of the ACHE since May 1995.  

UW Medicine brand campaign features patient stories

UW Medicine is kicking off a new brand campaign featuring patients who tell inspiring stories in their own voices about their care in our health system. The stories describe how the work we do in placing patients first has impacted and often saved their lives.

These stories of care and recovery are running in print ads and radio spots. Commercial radio stations include: 95.7 KJR FM, 100.7 FM The Wolf, 103.7 FM The Mountain, 101.5 FM STAR, 106.9 FM Warm, 102.5 FM KZOK. Additionally, you will see television spots for the UW Neighborhood Clinics on Q13, King 5, KIRO 7, KOMO 4 and KONG 6/16.

Read all of the featured stories at UW Medicine Patient Stories. Patients can also complete the form at Share Your Story to submit new stories about their care at UW Medicine.

 

 


Education and Training 

School of Medicine announces new holders of three endowed faculty positions 

The School of Medicine recently announced the appointment of three new holders of endowed faculty positions. They are:

SKimSara Kim (photo, right), UW research professor of surgery and adjunct research professor of biomedical informatics and medical education, first holder of the George G. B. Bilsten Professorship in the Art of Communication with Peers and Patients.

Heather S. Tick, UW clinical associate professor of family medicine, and anesthesiology and pain medicine, first holder of the Gunn-Loke Endowed Professorship for Integrative Pain Medicine.

Phillip P. Chen, UW professor of ophthalmology, second holder of the Grace E. Hill Chair in Vision Research.

Contact Lara Thurman, assistant director of donor relations, UW Medicine Advancement, at 206.616.4483 or lthurman@uw.edu.

  

UW health  sciences faculty to address 'Gun Violence: A Public Health Crisis,' Feb. 4

Across the nation (and at the White House), Americans are taking a fresh look at gun violence in the aftermath of the Newtown shooting — and the Aurora shooting, and the Portland shooting, and the Seattle shooting. In seeking ways to prevent such tragedies, this forum lays out a public-health approach to gun violence — tracing the extent of the problem, exploring evidence-based solutions, considering mental-health aspects and new alternatives, discussing new policies in Seattle-King County and Washington state — and considering what each of us can do.

On Monday, Feb. 4, from 7:30 to 9 p.m., the UW School of Public Health and Town Hall will host a community meeting on Gun Violence: A Public Health Crisis at Town Hall, 1119 Eighth Ave., Seattle.

After an introduction by Howard Frumkin, dean of the UW School of Public Health, panelists David Fleming, director of Public Health Seattle-King County; Frederick Rivara, professor of pediatrics and epidemiology; Amnon Shoenfeld, director of King County’s Mental Health, Chemical Abuse and Dependency Services Division; Beth Ebel, director of the Harborview Injury Prevention and Research Center; and Seattle City Councilmember Sally Bagshaw will offer local perspectives on a national crisis. The discussion will be moderated by Steve Boyd, of MacDonald Boyd & Associates.

Tickets are $5 at www.townhallseattle.org or 888.377.4510 and at the door beginning at 6:30 pm. 
 

 


   

WWAMI Regional News  

Anacortes family medicine clerkship celebrates 40 years 

Harold ClureThe family medicine clerkship in Anacortes is celebrating more than 40 years of medical education in the Skagit Valley community. For much of this time, family physician Harold Clure has been instrumental in the clerkship’s success.

In 1972, Clure and five other primary care doctors started the clerkship with Fidalgo Medical Associates in Anacortes which, along with teaching sites in Grandview and Omak, was among the first clerkship locations in the WWAMI region. Island Family Medicine joined the group in the 1980s. Site visits from the University of Washington were instituted to maintain similarity between the teaching sites, while visits between the clinics provided opportunities to share operations and management practices. Anacortes has also hosted clinical educators from around the nation and world, including China, Japan and Hungary.

Clure believes doctors have a responsibility to teach medical students. He says he takes satisfaction in the relationship between the WWAMI program and local physicians.

Clure says, "Numerous physicians in the Skagit Valley area have rotated through the Anacortes family medicine clerkship.”  

Over the years, Clure witnessed many changes in medical education, from documentation requirements to technology involvement. Shawna Laursen became the clerkship coordinator in 1998, and Clure retired in 2002. The current site coordinator is Jason Hogge.

Western Washington WWAMI has seen significant expansion of clerkship sites in the last 40 years and several new clerkship sites are joining the list. These sites are internal medicine in Olympia and Port Townsend; psychiatry in Olympia and Northwest Hospital; and obstetrics and gynecology in Bellingham, with additional clerkships being developed in the Bremerton and Vancouver areas.

As Clure and his colleagues have proven in the Skagit Valley, student and resident exposure to clerkship sites in western Washington can meet the workforce needs of Washington’s rural and underserved communities.

 


 

Upcoming Events  

The following events may be of interest to the UW Medicine community:  

Graduate Medical Education Grand Rounds, Feb. 5   

Time Management for Physicians: Reducing Stress and Improving Productivity, 5:30 to 7:00 p.m., Wednesday, Feb. 5, Turner Auditorium, Room D-209. Christina Surawicz, UW professor of medicine in the Department of Gastroenterology and assistant dean for faculty development, will present a combination of effective time management practices and practical ways to minimize stress and improve overall quality of life.  Register online.  This event will be streamed live and recorded for future viewing. If you intend to view this remotely, please register and note the “remote viewing” option in the comments section. A link will be sent to you prior to the event. Contact Shawn Banta at sbanta@uw.edu or 206-616-8286 for more information.

2013 Mini-Medical School, Feb. 5 – March 12

UW Medicine’s 2013 Mini-Medical School takes place at 7 p.m. on consecutive Tuesdays from Feb. 5 to March 12 in Hogness Auditorium at the Warren G. Magnuson Health Sciences Center. This free lecture series is open to the public. The Feb. 5 lecture, Providing a Pathway to Serve the Underserved, will explore how UW Medicine medical students prepare for diverse careers and develop knowledge and skills tailored to working with vulnerable populations in the United States and abroad. UW School of Medicine presenters are Lawrence Robinson, vice dean for clinical affairs and graduate medical education; Sharon Dobie, director of the Underserved Pathway; and Judd Walson, assistant professor of  medicine, global health and pediatrics.  For a complete listing of sessions and presenters, visit the UW Mini-Medical School website.

Paul Ramsey’s annual address to the UW Medicine community, Feb. 7

Paul Ramsey, CEO, UW Medicine, executive vice president for medical affairs and dean of the School of Medicine, University of Washington, will review progress at UW Medicine over the past year and cover challenges and opportunities for the upcoming year. The address will be held from 4 to 5 p.m., Thursday, Feb. 7, in Hogness Auditorium in the UW Health Sciences Building. The talk will be simulcast to the Orin Smith Auditorium at South Lake Union.  A reception will follow in each location. The address will be recorded and available starting Friday, Feb. 8, on the UW Medicine website for those who cannot attend. For more information, contact Julie Monteith at jspiro@uw.edu or 206.543.7718.

Genome Sciences 11th Annual Symposium, Feb. 20

Primate Genomics, all-day event, Wednesday, Feb. 20, Foege Auditorium. Speakers are Svante Paabo, director, Department of Genetics, Max Planck Institute for Evolutionary Anthropology, Leipzig; Anne Yoder, professor of biology, Duke University; Katy Gonder, assistant professor of biological sciences, University at Albany, State University of New York; Jeff Rogers, associate professor, Human Genome Sequencing Center, Baylor College of Medicine; and Yoave Gilad, associate professor, Department of Human Genetics, University of Chicago. Svante Paabo presents the Laurence Sandler Public Lecture, Archaic Genomics, at 7 p.m. in Kane Hall, Room 120. No registration necessary. For more information, visit the symposium website or contact Carlene Cross at cross2@uw.edu.

Continuing Medical Education 

Visit Continuing Medical Education for information on upcoming classes.

 

 


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