Moving Forward | More news

Boost for geriatric medicine
Emory Healthcare recruits
Regenerating nerves
Pain discrimination
Milestones
As good as it gets
Timely gift
Web think
Seeing red takes on new meaning
Never too old?

 


Boost for geriatric medicine


As the number and percentage of Americans over 65 continues to grow, the nation's need for physicians trained to care for the elderly is mushrooming as well. "Caring for people who are in their 80s and 90s is different in many important ways from medical care for middle-aged and younger people," says Joseph Ouslander, director of the Emory Center for Health in Aging. "Physicians must be prepared to identify and manage the unique and complex needs of the elderly. Because of the tremendous growth in the older population and their extensive use of a wide variety of medical and surgical services, training in geriatrics is critical for all physicians."

Emory School of Medicine plans to respond to those changing demographics with the support of a nearly $2 million grant from the Las Vegas-based Donald W. Reynolds Foundation, creating a new initiative called the Reynolds Foundation Program to Strengthen Physician Training in Geriatrics. Emory is one of 10 sites awarded geriatric training grants by the foundation this year.

Geriatrics training will be integrated into the curricula of more than 700 medical students and residents annually. The program will also support broad-based faculty training in geriatrics, and up to 16 faculty scholars will develop curricula for trainees in their respective departments. Methods of teaching include case-based learning, web technology, and interactions with older adults, such as bedside teaching rounds and seniors trained to serve as simulated patients.

"The Reynolds Foundation grant will provide greatly needed new and mandatory training experiences in geriatrics, which will not only benefit our medical students, residents, and faculty, but also our patients," says Thomas Lawley, dean of the medical school.

The Center for Health in Aging at Emory is devoted to research, teaching, and public education to enhance the clinical care provided to older adults. Its mission is to help people age in healthy, affordable, ethical, and enjoyable ways.

 



Emory Healthcare kicked up recruitment efforts in January, launching an aggressive advertising campaign that brands Emory as an innovative, cutting edge, compassionate healer. Like other health care organizations throughout the nation, Emory needs to fill jobs throughout our health care enterprise but in particular is recruiting nurses, pharmacists, and radiology technicians.

It helps that Emory Healthcare was named in October by the Atlanta Business Chronicle as one of the best places to work in Atlanta. The newspaper evaluated nearly 200 businesses against a variety of benefits criteria. Random and confidential employee attitude surveys were completed by e-mail and phone.

For more information, see www.emoryhealthcare.org/careers.

 

 

 


Regenerating nerves

Severe car accidents often cause damage to fibers in peripheral nerves. Thousands of individual fibers called axons extend from the spinal cord to targets in the periphery such as muscle and skin. When a peripheral nerve is damaged, axons between the injury site and muscle or skin degenerate, and function is lost. Although peripheral nerve axons are capable of regenerating after such injuries, growth-inhibiting substances called proteoglycans limit this regeneration.

While there is currently no clinical treatment for peripheral nerve damage, some Emory scientists have succeeded in significantly enhancing the regrowth of damaged peripheral nerves in mice by treating them with enzymes that counteract the growth-blocking mechanism. Enzyme-treated tissues fostered the regeneration of axons much more effectively than nontreated tissues, says cell biologist Alex English, who led a recent study. And the regenerated axons in the treated tissue extended more than twice as far. The research offers the potential for improving functional recovery after peripheral nerve injuries.

 

 

 

Pain discrimination?

When the Hispanic man broke his arm and was sent to the emergency room for treatment, he left without a prescription for pain medication. Why? Was there a language difference? A lack of proper health insurance? Not likely, according to a review of more than 180 pain-related studies from a broad range of specialties.

Top pain experts found that minority ethnic and racial groups are given less treatment for pain. Rollins School of Public Health professor Knox Todd, co-author of the study, says that Hispanics with broken arms or legs were twice as likely as non-Hispanic whites to go without pain medication in their emergency department visits, even after differences in language, gender, and insurance status were taken into account.

To make things worse, while examining ethnic and racial differences in pain sensitivity and pain response, the researchers found that African-Americans and Hispanics tend to have lower thresholds of pain tolerance. On the other hand, participants from Nepal and India had higher pain tolerances than western counterparts.

Taken together, these findings suggest that something in the brain's pain-processing and pain-killing systems may vary by race and ethnicity, writes co-author Roger Fillingim of the University of Florida. But much more research is needed to find why certain ethnic and racial groups are undertreated for pain.

 

Milestones

 

 


"Lucky 100"

These were the first words uttered by Li-Ching Brown after becoming the 100th lung transplant recipient at the Andrew J. McKelvey Lung Transplantation Center. The state's only lung transplant program has averaged 10 transplants a year at Emory University Hospital since its inception a decade ago, but with the addition of a third transplant specialist, Seth Force, those numbers are expected to double over the next five years.


Research dollars top $300 million

Our good news keeps getting better. The fall issue of Momentum reported that research funding at the Woodruff Health Sciences Center (WHSC) rose 16% from the previous year to $295.5 million for fiscal year 2003. Now it turns out the WHSC did even better. After all the records were reconciled and all dollars counted, the WHSC had additional research contributions of $4.7 million from its General Clinical Research Center. That boosted research income at the WHSC to $300.2 million for last year.


Bioengineering under one roof

Joining forces with Georgia Tech, Emory helped dedicate the 90,000-square-foot U.A. Whitaker Building on the Georgia Tech campus. It houses instruction space, laboratories, and offices for Emory School of Medicine faculty and Georgia Tech engineering faculty in the joint Wallace H. Coulter Department of Biomedical Engineering.


New space for Grady docs

Recently completed on time and $1 million under budget is the Emory School of Medicine faculty and clinical education building at Grady Memorial Hospital. The medical school, the university, and the Emory Medical Care Foundation (which is funded by Emory physicians at Grady) covered the $15 million price tag of the new building.


Walkers take heart

Since Emory is recognized worldwide for its leadership in cardiovascular care and training, it stands to reason that Emory continues to be a leader in the American Heart Association Heart Walk. In our fifth year of participation and second year as a major sponsor of the walk, almost 2,000 Emory Healthcare employees raised more than $427,400 to fight heart disease. That was the most raised in the Southeast and the second most in the nation.


Commercial research earnings in top 10

Getting into that exclusive circle of the nation's top 10 research universities has long been a goal at Emory, and now it's happened, according to one indicator. The Association of University Technology Managers (AUTM) recently ranked Emory 10th in earnings from the commercialization of research inventions. Emory collected $29.6 million in the survey year (FY 2002), most from three licensing arrangements for antiviral drugs, such as Emtriva.

Also in FY02, Emory reported 28 new licenses and options executed, four new start-up companies, 88 new US patent applications filed, and 25 US patents issued. The top institution in the AUTM survey was Columbia University with $155.7 million. In the #10 slot, Emory surpassed MIT, Harvard, Cal Tech, Johns Hopkins, Duke, and Vanderbilt. In 2001, Emory reported licensing revenues of approximately $3.6 million.

Emory's program in research commercialization promises to gain strength with the recent appointment of Todd Sherer (pictured above) as director of technology transfer. Before joining Emory, Sherer was director of technology and research collaborations at Oregon Health and Science University in Portland.

The goal of Emory's technology transfer program is to bring the results of biomedical research more rapidly to patients by bringing discoveries to the marketplace and to provide additional revenue to support continued research.

 

 

As good as it gets

Patient satisfaction scores at Emory have risen steadily over the past three years, during which time Emory has participated in a national benchmark survey. The scores reflect our growing focus on patients' experiences here in addition to our long-standing focus on providing unbeatable clinical treatment. In the most recent score reports (for the period March 1 through August 31), one unit stood out in particular: the Rollins Pavilion in Emory University Hospital ranked in the 99th percentile of all participating medical-surgical units in the nation -- the highest possible ranking. The Rollins Pavilion combines high-quality medical care with the ambience of a luxury hotel, while protecting privacy and confidentiality. Since its first suites opened in 1996, the pavilion has welcomed more than 3,000 patients, including former presidents, CEOs of Fortune 500 companies, sports stars, and dignitaries from around the world.

But there are no lasting laurels in this business. New patient satisfaction surveys about the Rollins Pavilion experience, as well as those for every other unit in Emory Healthcare, pour into Press Ganey Associates scoring system every week.

Here's how the surveys work:

Every Monday, Redge Hanna, director of service performance for Emory Healthcare, sends Press Ganey encrypted data so the company can mail surveys to randomly selected patients seen that week throughout Emory Healthcare, asking them how satisfied they were with their experience as an Emory patient. No one at Emory knows which patients received surveys, much less which ones complete them. When responses come back, Press Ganey compares them to responses from patients seen at comparable entities, units, or services across the country.

Every six months, Emory gets the results for our programs, "benchmarked" against all programs participating in the Press Ganey survey. That's a lot of comparison, since Press Ganey is the nation's largest satisfaction survey for health care, with 40% of American hospitals of more than 100 beds participating as well as a growing number of clinical practices across the nation.

"We want patients to know they are receiving the best medical care available and that we care what is happening to them, from the moment they call for an appointment to the time their bill arrives and is settled," says Hanna. "That's why a lot of people get part of the credit for the Rollins Pavilion's scores. Patient satisfaction is created by every single person involved in the patient's experience with Emory Healthcare."

More clinicians, administrators, and staff are setting higher and higher goals, he adds. "It's good to have patients reporting they are just as satisfied with their experience at Emory as patients seen in other leading institutions. But we want to be the absolute best."

 

 

Timely gift

Are you a history or photography buff? A time traveler? Or do you enjoy insights into the good work we do everyday to make people healthy?

There's that and more in the 2004 Woodruff Health Sciences Center calendar, which was distributed to all employees and friends late last year. "We hope this calendar will remind you throughout the year just how much your efforts are appreciated," says Michael Johns, CEO of the health sciences center.

The calendar, which features Emory faculty, staff, students, patients, and various facilities, also celebrates a slew of historic milestones coming in 2004 and 2005:

  • 150th anniversary of the Emory School of Medicine (2004)
  • 100th anniversary of Emory University Hospital (2004) and the Nell Hodgson Woodruff School of Nursing (2005)
  • 75th anniversary of Yerkes National Primate Research Center (2005)
  • 50th Anniversary of Wesley Woods Center (2004)

If you haven't received a copy of the calendar or would like extras, contact Kara_Stark@emoryhealthcare.org.

 

 

Web think

Web referrals of new patients have more than offset Emory Healthcare's investment in the web. Since Emory Healthcare's website -- www.Emoryhealthcare.org -- went live just two years ago, Emory Healthcare has tracked return on investment to develop and advertise the site. "We found that the web has brought in more than 1,300 new patients to the clinic in the past year," says Una Newman, senior director of marketing. "That's the equivalent of $2.5 million in invoices for patient services or more than double Emory Healthcare's web budget for three years."

The worth of the site goes far beyond a dollar value. When it premiered in 2001, the site included information on seven specialties. Today, visitors can learn about more than 50 Emory specialties. Content for the remaining 25 will be available in 2004. The site is interactive too: visitors seeking answers to specific health care questions can click on a "button" to prompt a phone call from an Emory HealthConnection nurse. Last year, those nurses fielded more than 10,000 calls from the website.

The more than 100,000 visitors who went to the site in 2003 (about a 150% increase over the previous year) found information on what they need to know to be a patient at Emory, about our 900 Emory physicians, maps and directions, as well as job opportunities, news and events, even photos of new babies and how to eat right.

The potential is huge, Newman says, since there are still a lot of people inside and outside Emory who don't know about www.emoryhealthcare.org. Currently the website, with its 3,000 pages of content, reaches only 1.5% of the 4.2 million people in the Atlanta metropolitan area, so creating more awareness is tops on Newman's to-do list. An internal campaign called Web Think helps users learn how their departments can get involved in the website and create their own content on an easy-to-use template.

In the meantime, marketing suggests one simple way to get the word out about the power of the EmoryHealthcare website. Make sure that this address -- www.emoryhealthcare.org -- is on all information about Emory Healthcare.

For more information about the website, contact Newman at una_newman@emoryhealthcare.org.

 



Allison Brown, clinic ambassador

 

Seeing red takes on new meaning

Being a patient at Emory can be complex and overwhelming, especially if you don't feel well. But the patient experience has improved tremendously in The Emory Clinic over the past two years, according to recent measures of patient satisfaction. Much of the credit may belong to a new corp of proactive problem solvers, who help physicians, front- and back-office staff, and administrators move patients in and through the clinics with greater efficiency and care.

On an average day, four clinic ambassadors suited in red blazers tend to the needs and challenges of more than 600 patients and their families who arrive for appointments at Clinic A. Ambassadors monitor how long patients have been waiting, expedite patient flow, and coordinate other activities with the clinic managers, intervening when patients have complaints or problems and assisting in their resolution. They also help keep patient relations in full view of physicians and staff by providing daily feedback regarding patient flow and satisfaction.

The clinic ambassador project - the brainchild of clinic COO Don Brunn - began as an experiment two years ago. Brunn wanted to see if personal attention by individuals focused exclusively on customer service would both improve the patient's perception of and satisfaction with our services. "Our patient satisfaction surveys repeatedly reminded us that our patients want to be informed about waits and delays, to know their problems are being taken seriously, and to feel that our staff cares about them," Brunn says.

Hiring the right people was key. The first ambassador, Allison Brown, who works on the fourth floor of Building A, came on board two years ago and has helped shape the program. Kimberly Parker manages the third floor, Denise Jacobson, the second floor, and Orlando Reyes, the first. The new ambassadors brought with them high standards in customer service from their backgrounds at Walt Disney World, The Ritz Carlton, real estate, social work, and international business relations, says Reid Willingham, operations and planning coordinator, who oversees the ambassador project as part of her responsibilities to improve patient access and capacity management and make the clinic more patient friendly.

The experiment has been so successful in fact that the clinic is exploring expanding the program into Clinic B and the Winship Cancer Institute.

 

In this issue

From the CEO / Letters
No fear
Consummate chemistry
Moving forward
Noteworthy
On Point:
  The toughest decision
Last Word:
  Your voice counts in tort reform

 

 

Never too old?

If you were vaccinated against smallpox before its vaccination program ended in 1972, you still may be protected. Immune memory after smallpox vaccination persists for at least 60 years in immunized individuals, say scientists at the Emory Vaccine Research Center and the School of Medicine.

In the Nov. 15 issue of the Journal of Immunology, Rafi Ahmed, director of the vaccine center, and his co-authors explain how they developed a new blood test to assess human antigen-specific immunity. They measured memory B cell responses in three groups: people recently vaccinated with smallpox vaccine, unvaccinated people, and people vaccinated between three months and 60 years earlier. The recently vaccinated group showed a significant virus-specific response to vaccinia, while the unvaccinated group showed no response. Vaccinia virus-specific B cells were detected in most of the previously vaccinated people.

"The antibody response to this viral protein in people vaccinated years earlier demonstrates the potency of memory B cells for decades after vaccination," notes first author Shane Crotty, formerly at Emory medical school and now at La Jolla Institute for Allergy and Immunology. In addition, the researchers found that vaccinia virus-specific T cells were also present even decades after immunization in most study subjects.

"Immune memory to smallpox vaccination is an excellent benchmark to help us understand the mechanisms of good vaccines and the longevity and stability of immune memory in the absence of revaccination or disease," says Ahmed. The team's findings may help health authorities decide whether to update or change the smallpox vaccination program. "Our work has not shown that these people would be protected because that cannot be directly tested. But our study does show that people maintain immune memory against smallpox for many decades. We hope those levels of immune memory provide at least some amount of protection against smallpox."

 


Copyright © Emory University, 2004. All Rights Reserved.
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Web version by Jaime Henriquez.