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Signaling its commitment to the practice of primary care, the Medical Center is creating a new Center for Primary Care, a move that will unite the work of the hundreds of Medical Center and Strong-Health affiliated community internists, primary care, family medicine and general medicine practitioners.
Medical Center CEO C. McCollister Evarts, M.D. said that the new Center will strengthen the work of all faculty and staff by increasing the integration and coordination of primary care practices across the Medical Center.
“Primary care physicians are at the heart of any clinical enterprise. By creating the Center for Primary Care, we are uniting all of our different general and family medicine entities, and providing them with opportunities and support to help them further their careers, improve their practices, and create a more seamless approach to patient care,” he said.
The Center for Primary Care comes at a critical juncture in the primary care field here in Rochester and across the nation. Fewer and fewer medical students are opting to specialize in primary care, while a significant number of practicing physicians are expected to retire in the next decade, setting the stage for a shortage.
“It is in our own interest, and in fact, our responsibility to this community, to proactively create an effective primary care practice model that not only will be interesting and challenging to medical students and physicians alike, but delivers superior patient care,” Evarts said.
Mayewski Directs Effort
Heading up the new Center will be Raymond J. Mayewski, M.D., who will continue in his role as vice president and chief medical officer for Strong Health, but step down as director of the University of Rochester Medical Faculty Group (URMFG). A process is currently underway to identify a successor for URMFG.
Over the next year, Mayewski will build the Center’s infrastructure, focusing on educational opportunities for medical students and residents, research programs for patients and staff, and improvements in the delivery of patient care.
“This new Primary Care Center will help us to create an environment where primary care practitioners can work and thrive and find great personal satisfaction,” Mayewski said. “It will provide many of our physicians with great opportunities for teaching and mentoring, and generate an energy and enthusiasm to help our medical students become interested in the field of primary care practice.”
“By linking these groups together, we will take the collective strengths of our different practices, and create a process so that all can learn and benefit from the best practices of each other,” he said. “Our focus will be on evidenced-based treatment protocols and standards of practice that will ultimately result in better care for patients and better experiences for the physician.”
Strong and Rural/Metro Bring State-of-the-Art Adult Transport to Region
As technology has increased the quantity and quality of life-saving techniques available to care for critically ill patients, so too have the challenges in transporting these extremely sick patients between hospitals. To decrease potential risks while continuing complicated care for critically ill cardiac, burn and trauma adult patients while en route, Strong Health is introducing an adult Critical Care Transport Service to the region. A similar service for pediatrics already exists.
At the heart of this service is a customized vehicle designed and created in partnership with Rural/Metro Medical Services. Strong Health’s cardiac, trauma and burn physicians and nurses collaborated with specially trained Rural/Metro paramedics and engineers to custom-design all aspects of the vehicle, from its size, to its GPS navigation system, to the number of shelves in its interior cabin.
The result is a state-of-the-art vehicle that accommodates up to six health care professionals inside the cabin, and is equipped with specialized electrical power and multiple redundant systems needed to run advanced life support equipment that is typically available only at major hospitals. In effect, the new transport provides the space and capacity of an advanced adult ICU room. Rural/Metro estimates that there are only a handful of such vehicles nationwide, usually operating out of major metro areas, or in regions with an academic medical center.
According to Steven I. Goldstein, CEO of Strong Memorial Hospital, the need for such a vehicle grew dramatically over the last several years as the number of specialty services increased at Strong Memorial, such as the heart failure and transplantation program, solid organ transplant programs, and the expanded trauma and burn service. In addition, overall advances in care now allow regional physicians to stabilize acute trauma and burn patients so that they are able to be transported to Strong Memorial.
“Technology has rapidly advanced the ability of hospitals to provide care for critically ill patients,” Goldstein said. “Our new Critical Care Transport allows us to safely transport the sickest of the sick patients, along with all of the extremely sophisticated equipment that is keeping them alive, in a manner that gives them the best chance for survival.”
Full-Service Ambulance and Crew
At 13 feet long and 8 feet wide, the interior cabin space is double that found in other ambulances, an important advantage when caring for patients on advanced life support equipment such as ventilators and various types of heart pumps, including ventricular assist devices (VADs) and intra-aortic balloon pumps.
Where before only emergency medical technicians (EMTs) and perhaps a nurse could fit safely in a traditional ambulance along with the patient and equipment, now a cardiac care nurse, perfusionist, respiratory therapist, and a physician can travel with paramedics. The ability to transport these advanced life support professionals as a team to outlying hospitals permits them to provide specialized care the moment they arrive, and continue that care while en route to Strong.
The Critical Care Transport contains a specialized electrical system that provides the “clean” energy necessary to run sophisticated equipment. In case of mechanical failure, a 7.5 kilowatt generator is available, along with a customized ventilator and compressed air systems. Another important element of the new transport is the custom-designed lift. Built eight inches longer than a traditional lift, the new system can simultaneously raise the patient, gurney, and life support equipment. This is especially important when transferring a patient on a VAD, which relies on gravity to help pump the blood back through the heart, and therefore can never be positioned lower than the patient.
The organization largely responsible for accrediting and monitoring medical residency programs across the nation recently selected the director of the pediatric residency training program at the University of Rochester Medical Center and Golisano Children's Hospital at Strong to receive the prestigious 2004 Parker J. Palmer Award.
Peter Harris, M.D., a pediatric cardiologist, is only one of 10 residency program directors from a pool of more than 100 to receive this honor from the Accreditation Council for Graduate Medical Education. Harris oversees 45 to 50 pediatric residents annually, and works with Brett Robbins, M.D., to supervise another 28 to 30 Med/Peds residents.
“As a dedicated teacher, Peter is largely responsible for the success of our pediatric residency training program, constantly improving the quality of the residents' education, while skillfully adjusting the program to meet frequently changing regulatory requirements. This results in the recruitment of the best and the brightest medical students to our program,” Thomas K. McInerny, M.D., associate chair of clinical affairs at Golisano Children's Hospital, said.
The Parker J. Palmer award is given annually to medical residency program directors in an effort to recognize their commitment to teaching and development of innovative approaches for educating physicians in training. It is named after Parker J. Palmer, Ph.D., a noted educator, sociologist and author of The Courage to Teach . The winners, selected at the council's board of directors meeting from 115 nominees, will be honored at the group's winter meeting in February 2004. They also will be invited to attend a retreat at the Fetzer Institute in Kalamazoo, Mich., next summer.
David C. Leach, M.D., the organization's executive director, praised the Parker Palmer award recipients for their dedication to teaching and nurturing residents as they move along the path toward becoming caring, highly competent physicians.
“Good learning requires that the whole person shows up,” Leach says. “The awardees have demonstrated their capacity to be fully present to residents and patients, thereby providing a model for all of us.”
The ACGME is a private, non-profit council that accredits 7,800 residency programs in 27 specialties affecting 100,000 residents. Its mission is to improve the quality of health care in the United States by ensuring and improving the quality of graduate medical education for physicians in training.
It was a sight for sore eyes as 20 faculty and staff donned fabulous fashions to raise money for Strong Memorial’s Rotenberg Patient Advocacy Fund. Local designer Andrea Geer’s 2004 clothing line was available for viewing on the female Strong Memorial models scattered throughout the Artisan Works space, while gallery artwork was sold via silent auction. All told, Friends of Strong’s Patient Advocacy Fund, which provides emergency funds for needy patients and their families, raised approximately $10,000.
From L. to R.: Darby Leyden, nurse practitioner, Cardiology; Peg Consadine, C.S.W, senior social worker; and Heather Cronmiller, senior information analyst model design ware by Lavant Garbe’s Andrea Geer.
Beginning in December, departments ordering new computers will be selecting from Dell products instead of IBM. After an extensive review, ISD and Computer Sales selected Dell because it offers faster order turnaround, better pricing and more flexibility in the models available for purchase.
According to Gary Kobel, manager of support services for ISD, Dell will deliver computers to the Medical Center approximately one week faster, and prices on average will be 10 to 15 percent less.
"We are constantly reviewing our technology and processes for ordering to ensure the best customer service. For example, last year we changed our procurement vendor and moved all ordering and sales of software and hardware to ITS Computer Sales because we believed it would better suit the needs of Medical Center and Strong Health faculty and staff," Kobel said. "In 2003, we began to notice slow downs in deliveries from IBM, prompting a review of vendors. Dell came through with better customer service, delivery times and pricing."
Kobel added that departments can now go on-line and customize computer configurations within Medical Center standards for their needs using a very simple and easy-to-use website. ITS Computer Sales staff is also available for consulting and order processing. For more information, call the ITS Computer Sales, URMC Strong Health support line at 275-0580 or go to www.rochester.edu/its/css/urmc.html.