December 2007

URMC to Lead International Muscular Dystrophy Research Effort

The University of Rochester Medical Center (URMC) recently announced it received a $7.1 million gift from New York developer and philanthropist Richard T. Fields for neurological research and care. The gift – the largest private donation for a specific disease program in the Medical Center’s history – will create a research and clinical center of excellence for facioscapulohumeral dystrophy (FSHD), a form of muscular dystrophy.

The new Fields Center for FSHD & Neuromuscular Research will be an international collaboration between the Department of Neurology and Leiden University Medical Center in the Netherlands. The long-term, uninterrupted funding will accelerate what has generally been an uncoordinated and fragmented research effort, enabling URMC to become a national referral center for patients with the disease. Professor of Neurology Rabi Tawil, M.D., will direct the Fields Center.

“I want to express my deep gratitude to Richard Fields for his generous gift and his vision to bring together the people and resources necessary to find new ways to understand, treat and perhaps even cure this disease,” said Bradford C. Berk, M.D., Ph.D., CEO of URMC. “Our scientists strongly believe that new breakthroughs are within our grasp and Richard’s support will help catalyze their efforts.”

Fields is chairman and founder of Coastal Development, which co-developed the Seminole Hard Rock Casino and Hotel resorts in Florida. Fields also is an active philanthropist and serves on the boards of the National Center for Missing and Exploited Children and Farm Aid, and is a major donor and supporter of the New York City Police Foundation and Good Shepherd Service.

“I have a personal family connection to FSHD, so I know the impact it has on families throughout the United States and the world,” said Fields. “The physicians at the University of Rochester have long been leaders in muscular dystrophy research, so they were a natural fit to establish a center to focus on genetic and clinical research to FSHD patients. I see this gift as a significant step in giving this disease the medical attention it deserves, and hope that the Fields Center will be a center for leadership and innovation in the field for many years to come.”

FSHD is one of the more common forms of muscular dystrophy. Most symptoms do not appear until the teen years, though the disease can also arise in very young children and infants. The condition, which is genetic in origin, is characterized by a progressive weakness of muscles starting in the face, shoulder blades and upper arms. The age of onset, progression, and severity of FSHD vary and most individuals with the disease have a normal lifespan. However, as the disease progresses it can become debilitating; some 30 percent of patients eventually become wheelchair bound. Over time, the muscle weakness can also spread to other parts of the body.

While the disease is understood to be genetic in origin, the precise mechanism is unknown.

“This is a very difficult disease to figure out in terms of what is going on,” said Tawil. “Research has been hampered by the fact that there are very few centers involved and centers that are don’t have access to patients and resources necessary to move research forward.”

The Fields Center will be the hub of an international network of scientific talent and resources necessary to propel FSHD research through greater coordination, collaboration, financial resources, and access to patients with the disease.

URMC’s Department of Neurology is home to the National Registry of Myotonic and FSHD Patients and Family Members. The registry – which is funded by the National Institutes of Health (NIH) – will enable Fields Center researchers to reach out to a large number of patients and recruit them into research projects.

Health Care Workers Urged to Get the Flu Shot

In late October, Strong Memorial leadership stepped up to the plate to be one of the first at the hospital to get their annual flu shot. Strong Memorial once again is running its InFLUence campaign, which aims to increase influenza vaccination rates among SMH health care workers.

Health care professionals are at risk of both transmitting and being exposed to flu from patients. They also play a special role in preventing the deadliest cases of this disease because they directly interact with those at greatest risk of experiencing serious complications from the flu.

Last year, about half of Strong Memorial employees received the flu shot, putting us above the national average of about 40 percent of health care professionals who routinely receive a flu vaccine. This year, our goal is to increase vaccination rates to 60 percent.

Strong Memorial employees can receive a flu shot through mobile vaccination carts and peer vaccination programs. For more information, visit the InFLUence website off the Medical Center’s intranet.

Wilmot Cancer Center Links with Arnot Health’s Falck Cancer Center

Arnot Health’s Falck Cancer Center in Elmira has established an affiliation with the James P. Wilmot Community Oncology Network, bringing together Rochester’s largest cancer center and the Southern Tier region’s primary cancer center to improve cancer care and research.

“This type of collaboration will benefit our patients who are battling cancer,” said William Muuse, M.D., director of the Falck Cancer Center at Arnot Health. “With teams of oncologists working together to advance research efforts toward a cure, people with cancer in our communities will be better served.”

Through the affiliation, patients at Falck Cancer Center will have access to the newest therapies and cutting-edge treatments and educational programs through Wilmot. In addition, they will opportunities to participate in the hundreds of clinical trials available at the Wilmot Cancer Center through the Southwest Oncology Group, the nation’s largest cooperative research organization. Arnot Health oncologists also may join the University of Rochester School of Medicine and Dentistry faculty and participate in educational and training programs at the Wilmot Cancer Center.

“This is an excellent opportunity for both Wilmot and Arnot Health to work together to provide the quality cancer care that people expect,” said Richard I. Fisher, M.D., director of the Wilmot Cancer Center and vice president for clinical services at the Medical Center. “We have a history of cooperation and collaboration and this solidifies that relationship in the Southern Tier.”

The Wilmot Community Oncology Network, established in 2004, broadens Wilmot’s clinical research efforts and provides cutting-edge care throughout upstate and western New York. Arnot Health’s Falck Cancer Center is the second organization to join the Wilmot Community Oncology Program. Interlakes Oncology and Hematology, P.C., joined the program three years ago. Interlakes provides care in locations from Geneva to Brockport and at Canandaigua’s F.F. Thompson Hospital.

Medical Center Seeks Approval for New Ambulatory Surgical Center

Aiming to provide more appropriate care to the growing number of its patients needing outpatient surgery, the University of Rochester Medical Center’s Strong Memorial Hospital has submitted an application to New York State’s Department of Health to open and operate an off-site ambulatory surgical center (ASC).

If approved, Strong’s ASC would contain 10 operating rooms and two procedure rooms, as well as space for pre- and post-operative care, a materials processing unit for instrument sterilization and preparation, and patient/family waiting room areas. The 52,000-square-foot facility is planned for 180 Sawgrass Drive, just off Westfall Ave.

The proposal has received unanimous backing from both the Finger Lakes Health Systems Agency and the Community Technology Assessment Advisory Board, or CTAAB. The application is now being reviewed by the Department of Health’s State Hospital Review and Planning Council.

According to Strong Memorial Hospital CEO Steven I. Goldstein, like the hospital itself, Strong Memorial’s 33 operating rooms run at capacity each day, making it increasingly difficult to accommodate both its inpatient and outpatient cases.

“As the region’s tertiary and quaternary referral center, regional trauma center, and regional children’s center, about 20 percent of our surgical cases are emergency cases that need to be performed immediately due to patient urgency,” Goldstein said. “As a result, every day we have patients awaiting elective procedures who are being bumped from the schedule, resulting in significant delays for our patients and family members.”

Over the years, Strong has managed the excess demand for its operating rooms by having Medical Center faculty surgeons work out of private surgicenters. In 2006, Strong estimates that its faculty surgeons performed more than 5,000 procedures at such surgicenters. Nationwide, outpatient surgeries continue to climb in number, fueled by new minimally invasive technology and other surgical innovations. In 1980, about 10 percent of all hospital surgeries were outpatient procedures, a number that jumped to 65 percent in 2005. Strong’s surgical cases totaled 24,301 in 2006, with 49 percent of them being outpatient procedures.

Michael Maloney, M.D., associate professor of orthopaedics, who would serve as director of the proposed new surgical center, said that outpatient surgical centers have defined a new standard of care that patients have come to expect.

“Outpatient surgical centers have created an efficient model for handling surgeries in a way that optimizes the care and service for patients,” Maloney said. “Because they handle only elective, pre-scheduled surgeries, they aren’t forced to shift schedules to accommodate emergencies. This allows them to run very efficiently and in a manner that more and more patients are coming to expect.”

Goldstein added that Medical Center faculty provide the majority of specialty care to Medicaid recipients across the region. The new ASC will allow Strong to quickly schedule all types of surgical cases, regardless of type of payer.

“As the largest surgical provider in the region, this is a natural next step for us,” Goldstein said. “If approved, our new ambulatory surgical center will allow us to provide the current standard of care for our patients -- something that cannot be achieved in hospital settings, which are designed and staffed to handle all types of surgeries.”

If the project is approved, Strong will shift cases from its operating rooms and from local surgicenters to the new ASC. Build-out of the new location would take approximately one year, and could begin as early as spring ’08.

Smoke Free Initiative Hits One-Year Mark

November marks the one-year anniversary since the University of Rochester Medical Center became a Smoke FREE institution, and in that time, we have seen very positive changes at our institution.

• We have been successful in achieving our original goal of moving smokers away from our entrances and main access points. We do not have 100 percent compliance, nor did we expect to. Our enforcement efforts are ongoing.

• Many of our employees have used this as an opportunity to reduce their smoking habits or quit altogether. Employee Health Services reported a year ago that 13 percent of our employees listed themselves as using tobacco in their annual health assessments. One year later, only 10 percent of employees report using tobacco.

• We have a process that regularly intervenes with inpatients who smoke, offering them smoking cessation or nicotine replacement therapy during their stay. Our pharmacy has tracked a four-fold increase in our use of nicotine replacement therapy, and on any given day, about 125 inpatients are now using NRT rather than smoking. Studies show that this often provides a jump-start to permanently quitting.

“When we put the new policy in place a year ago, we were realistic that this change would be a process that would take a long-term commitment. As a result, there still are a number of areas in which we continue to work with our employees and visitors who smoke, and our neighbors to develop solutions,” said Kathy Parrinello, Strong Memorial’s chief operating officer and chair of the 30-person taskforce that designed and implemented the new policy.