January 2007

Strong Memorial Copes with Hospital Overcrowding

Work is nearing completion on 8-3600, one of many ICUs on the eighth floor undergoing renovations this year to help increase the number of critical care beds available at Strong Memorial.

A series of actions is being unveiled throughout Strong Memorial Hospital in an attempt to ease its significant capacity issues. For the past several months, Strong Memorial has been experiencing increasingly serious overcrowding, and as a result, patients who are admitted are backing up in our Emergency Department and recovery room (PACU), experiencing long waits for a bed on inpatient units.

While Strong’s Emergency Department does an outstanding job of caring for all types of emergencies, the ED was never intended – nor is it equipped or staffed – to handle large numbers of admitted patients.

"Even though our ED staff is working very hard to provide care and comfort, they are being asked to do double-duty as an emergency department and as one of the hospital’s largest inpatient units," said Steven I. Goldstein, president of Strong Memorial. "We deeply regret the inconvenience that this situation is causing our patients. Finding a solution to this problem is a top priority for us."

A number of interim steps have been taken in the ED to decompress the situation immediately, including:

• aggressively recruiting ED staff to improve the nurse/patient ratio,
• stationing a dedicated physician in triage to expedite treat-and-release patients, and
• launching an ED Guest Services Department to provide comforts and information to patients and families during their wait.

A number of initiatives also are underway throughout the hospital to try and ease overall bed demand including:

• Our facilities staff is working as quickly as possible to renovate areas of the Hospital that will allow us to open 17 new beds (a 10-bed unit on 1-9300 and seven new ICU beds on 8-1400).
• Continue to work with Highland Hospital to identify services that can be shifted there to make even more beds available at Strong.
• We are working with other regional hospitals on programs that will allow us to discharge some patients earlier, freeing up beds faster for incoming patients.
• We are relocating some office space on the ED’s second floor and will renovate that space to make room for 20 additional observation beds, which will allow more patients to move out of the ED either while a decision is being made whether or not to admit them, or as additional space for admitted patients. We expect this will be complete in November of 2007.
• Later in 2007, we’ll renovate another unit (4-1200) to add six more medical beds.

"We recognize that these actions, though helpful, may not be sufficient over time," Goldstein added. "We will continue to explore and look at additional options to help solve this issue."

Rosier Steps Down as Chair of Orthopaedics; O’Keefe Identified as Likely Next Chair

Regis J. O’Keefe, M.D., Ph.D.

Wehle Professor and Chair of Orthopaedics Randy N. Rosier, M.D., Ph.D., recently announced he will step down as department Chair to focus on an expanding research portfolio, which has experienced unprecedented growth in the past two years. Regis J. O’Keefe, M.D., Ph.D., professor of orthopaedics and director of the Center for Musculoskeletal Research, is expected to take over the helm of the thriving department. The transition will take place on or before Mar. 1, pending University of Rochester Board of Trustees approval.

"I have been honored to lead a department steeped in excellence in all areas – research, education and patient care," Rosier said. "With the incredible advances we have made over the last six years, especially in the research realm, it has become increasingly clear to me that I can now best serve the department by dedicating significantly more time to our collective research efforts. I am deeply grateful to the tremendous faculty and staff support I have had as chair, and I look forward to continue working side-by-side with them in the coming years."

Rosier said he plans to oversee the $7.8 million Center of Research Translation (CORT) grant recently received by the Orthopaedics Department from the National Institute of Arthritis and Musculoskeletal and Skin Diseases, as well as play an active role in the new $40 million Clinical and Translational Science Institute. He also will continue with his clinical orothopaedic oncology practice.

Named chair in May 2000, Rosier led Orthopaedics to achieve monumental milestones in less than seven years. One of his first moves as chair was to establish the Center for Musculoskeletal Research to coordinate all intra- and inter-departmental research. This focused approach has paid dividends for the Department, which just earned the No. 1 ranking spot based on funding by the National Institutes of Health (NIH) in 2005, surpassing some of the nation’s top-rated research institutions including Yale University, Washington University, Thomas Jefferson Medical School and the University of Pennsylvania. NIH’s 2006 rankings will likely show the Orthopaedics Department outpacing the No. 2 program’s funding by several-fold.

Rosier also drove significant changes in the department’s clinical enterprise, overseeing the relocation of all orthopaedic and rehabilitation clinical services into one location at Clinton Crossings in 2001. Since that time, patient visits to the faculty orthopaedics practice have doubled, and full-time clinical faculty now number 36, offering every sub-specialty service available in orthopaedics. This success now serves as a model for many other Medical Center clinical services moving off-campus.

Randy N. Rosier, M.D., Ph.D.

"Dr. Rosier ushered in the golden era for orthopaedics here at the Medical Center, with our clinical, research and education missions poised to reach new heights," said Medical Center CEO Bradford C. Berk, M.D., Ph.D. "While we will miss his focused and insightful approach at the administrative level, this is the right moment for him to apply his leadership and scientific skills to burgeoning research."

According to Berk, no search will be necessary in the selection of Rosier’s successor. Medical School Dean David S. Guzick, M.D., Ph.D., and he are already working through the process to appoint O’Keefe.

"The long tradition of outstanding leaders in orthopaedics, which have included Dr. McCollister Evarts, Dr. Richard Burton, and of course, Dr. Rosier, has created a culture of excellence in clinical care, research and teaching in the department," Guzick said. "In a department infused with such talent, we did not have to look far or long to select Dr. O’Keefe to continue this legacy. With his research, clinical and academic experience, Regis has been courted to chair the finest Departments in the country. He is extraordinarily well suited to chair the department and I look forward to working with him."

A member of the Department of Orthopaedics since 1993, O’Keefe maintains an active clinical orthopaedic practice, while directing the Center for Musculoskeletal Research. As such, he oversees the research of 16 faculty and two dozen graduate students and post-doctoral fellows. O’Keefe’s NIH grant support has consistently placed him among the most highly funded orthopaedic surgeon-clinician scientists in the United States.

O’Keefe has and continues to serve in leadership positions with a number of national orthopaedic organizations including the American Academy of Orthopaedic Surgeons, the Orthopaedic Research and Education Foundation, the United States Bone and Joint Decade, and the Skeletal Biology and Skeletal Regeneration Study Section for the NIH’s Center for Scientific Review.

His medical education and training includes a medical degree from Harvard Medical School, and residency and/or fellowships at Harvard, the New England Deaconess Hospital and the University of Rochester Medical Center. He received a doctorate from the University of Rochester Department of Biochemistry.

"I am honored and humbled to head a department that has been served by some of orthopaedics’ most accomplished scientists and practitioners," O’Keefe said. "I intend to maintain the level of excellence that has characterized our department’s activities for more than four decades."

First Clinical 3T MRI Lands in Rochester

With the new 3T MRI, radiologist Sven Ekholm, M.D., will be able to introduce Functional MRIs to Rochester.

The region’s first 3 Tesla magnetic resonance scanner (MRI) is now available for clinical use in Rochester. Located at the Medical Center’s University Imaging at Science Park, the new MRI brings with it important tools to help physicians improve the accuracy of diagnoses and treatments of broad categories of diseases including stroke, brain tumors, epilepsy, musculoskeletal and heart disease.

With a magnet strength of 3 Tesla, or 3T, the new MRI is the most powerful scanner available to patients today in routine clinical use. The technology has been eagerly awaited by physicians in the Rochester region, who often refer patients to Syracuse or even Detroit for more sophisticated imaging when needed.

David Waldman, M.D., chair of the Department of Imaging Sciences, compares the images produced by the 3T scanner to how people might view a television show on high definition television. And it is this precise imaging that will help physicians pinpoint disease earlier, especially for certain types of cancer and multiple sclerosis.

"We are proud to continue to bring to Rochester the newest advances in imaging techniques," Waldman said. "The outstanding image quality captured by the 3T MRI will help to provide more accurate and timely diagnoses, quicker scans for patients, less likelihood of rescans, and allow us to introduce new and important services such as Functional Imaging."

MRIs use a magnetic field and radio waves to create cross-sectional images of anatomy. The magnet strength is the key to image clarity – the stronger the magnet, the more clear the image. How strong is the magnet in a 3T MRI? Magnets that pick up junk cars have a strength of about 1.5T. Or, put another way, the 3T is 60,000 times as powerful as the earth's magnetic field.

The new scanner also will allow radiologists at the Medical Center to introduce a relatively new type of imaging called Functional MRI, or fMRI. fMRI allows physicians to non-invasively conduct "brain mapping," or, pinpoint to millimeters, areas of the brain that generate specific actions, like speech or movement. This information is critical when planning any type of brain surgery (for epilepsy or tumors, among others) that may impact brain tissue near vital movement or thought areas.

University Imaging at Science Park is now home to the most advanced imaging available in the community. In addition to the 3T MRI, the facility also houses the region’s first permanent PET/CT Scanner.

Fisher to Head Clinical Services

Richard I. Fisher, M.D., director of the James P. Wilmot Cancer Center and director of Cancer Services at Strong Health, has been appointed vice president for Clinical Services for the University of Rochester Medical Center (URMC) and its patient care network, Strong Health. The appointment is effective Jan. 1, said Medical Center CEO Bradford C. Berk, M.D., Ph.D.

An internationally known expert on the biology and treatment of lymphoma, Fisher also serves as chief of the Hematology/Oncology Unit and is the Samuel E. Durand professor of Medicine. He will continue in his current roles as he assumes new administrative responsibility as a member of the Medical Center’s leadership team.

Since his recruitment from Loyola University’s Cardinal Bernardin Cancer Center in 2001, Fisher has integrated the Medical Center’s cancer services, recruited 17 scientists/clinicians, and formulated a strategic plan to help the Wilmot Cancer Center capture National Cancer Institute-designation. Key to his strategy is a new, four-story cancer research and treatment center which is under construction, expected to open in spring of 2008.

"Rich Fisher has a remarkable track record of achievement both at Loyola and here at the Medical Center. He can formulate a compelling vision and inspire others to work in unison toward common goals," Berk said. "He brings a very patient-centric philosophy that will add value throughout the Medical Center’s services." Since Fisher has come to Rochester, the Wilmot Cancer Center has seen double-digit growth in the numbers of patients it serves and a four-fold increase in research funding, Berk notes.

As vice president for Clinical Services, Fisher will help organize the Medical Center’s patient care programs along service lines – a process that clusters services around specific diseases, such as cardiac care, cancer treatment, organ transplants, brain and nervous system disorders and orthopaedic conditions. The goal is for members of each patient’s care team – physicians, nurses, technicians, and support staff – to work together to streamline and coordinate care.

"The way we’ve organized ourselves in the past – within distinct departments – is too limiting, yet there is no one-size-fits-all way to organize clinical service lines," Fisher said. "My job will be to think strategically from the patient’s perspective, to propose solutions from within a spectrum of models to structure our resources in a way that allows us to truly manage disease."

In organizing service lines, Fisher will work closely with Steven I. Goldstein, CEO of Strong Memorial and Highland hospitals, as well as the hospitals’ leadership teams. Fisher also will collaborate with School of Medicine and Dentistry Dean David Guzick, M.D., Ph.D., to advance clinical research, and with Center for Community Health director Nancy Bennett, M.D.

Taubman Named Editor of American Heart Association Journal

Mark Taubman, M.D.

Mark Taubman, M.D., chief of the Cardiology Division and director of the Cardiovascular Research Institute at the Medical Center, has been named editor-in-chief of the journal Arteriosclerosis, Thrombosis and Vascular Biology (ATVB), one of five medical journals produced by the American Heart Association (AHA). In conjunction with the appointment, the journal offices will move to the University of Rochester and will help focus national and international attention on the University and the region as a major center for the study of cardiovascular diseases.

ATVB is considered the leading journal in the fields of vascular biology and atherosclerosis and ranks competitively in terms of its measured impact with other major scientific journals. It has offices in Europe and Asia, as well as in the United States, and is read by leading physicians and scientists throughout the world.

As editor-in-chief, Taubman will be responsible for overseeing the activities of all three offices.

"I am greatly honored to be chosen as editor for such an important publication," said Taubman. "I look forward to working with the cardiovascular disease community to provide an ideal forum in which to share new ideas and discoveries that advance the treatment and understanding of cardiovascular disease and improve patients' lives."

A search committee composed of scientists and senior AHA leaders considered a list of candidates, whom each submitted statements of their vision for the journal’s future. In his vision statement, Taubman expressed interest in better using the journal as a teaching tool and as a forum for the establishment of treatment guidelines in new areas of the covered fields. Along with his vision, broad expertise in each of the areas covered by the journal, and the fact that he has held several posts with AHA over the years had much to do with his being chosen, Taubman said.

As editor, Taubman will for the next four years oversee an international team of editors and reviewers that will chose for publication 500 scientific papers per year from approximately 2,500 submissions. In addition, he will choose associate editors, building a team of professionals that will oversee the review of all the submitted manuscripts in the United States, Europe and Asia.

Finger Lakes Donor Recovery Network Names New Executive Director

Rob Kochik

Rob Kochik has been appointed executive director of the Finger Lakes Donor Recovery Network (FLDRN), the organ procurement organization affiliated with the Medical Center and SUNY Upstate Medical University that serves 39 hospitals in the Finger Lakes and Central New York regions. He begins this month.

Kochik has extensive experience with organ procurement organizations, most recently serving with downstate’s New York Organ Donor Network as director of donor referral and recovery services, and prior to that as the group’s director of clinical operations. He also has worked with the Musculoskeletal Transplant Foundation and the Delaware Valley Transplant Program (now the Gift of Life Donor Program).

"We are pleased to welcome Rob to upstate New York," said Kathy Parrinello, chief operating officer for Strong Memorial Hospital and head of the search committee that chose Kochik. "His valuable experience in organ procurement will benefit the organization, which helps so many people each year who need life-saving transplants."

As executive director of FLDRN, Kochik will be responsible for the overall direction, leadership and administration of the organization. He will work closely with medical directors and administrators at regional hospitals to ensure programs, processes and procedures are implemented to maximize and increase donation.

Medal of Honor

Success with collaborative programs conducted by the Finger Lakes Donor Recovery Network and regional hospitals resulted in recognition by the U.S. Department of Health and Human Services. Initiatives implemented increased organ donation.

Kochik joins the organization at a time when it is achieving success in boosting organ donation rates. Recently, FLDRN was honored with two U.S. Department of Health and Human Services Organ Donation Medals of Honor. In receiving the awards, FLDRN was joined by two community hospitals - Arnot Ogden Medical Center in Elmira and Rochester General Hospital - that collaborated with the organization in an effort to increase donation numbers. Strong Memorial Hospital of the University of Rochester Medical Center and FLDRN together received the same award in 2005.

The Medal of Honor is given as part of a Health and Human Services program - the Organ Donation Breakthrough Collaborative - created to generate significant, measurable increases in organ donation by helping organ procurement organizations and hospitals to quickly identify, learn, adapt, replicate and embrace “breakthrough” practices.

The collaborative challenged the nation’s largest hospitals to increase their donation rate from the previous national average of 50 percent. Arnot Ogden, Rochester General and FLDRN received the medals for achieving 75 percent “conversion” of eligible organ donors to actual donors for a sustained 12-month period.

FLDRN covers 19 counties with a population of 2.4 million, and serves 39 hospitals and the University of Rochester Medical Center and SUNY Upstate Medical University transplant centers.

Grant to Explore Best Ways to Communicate with Patients who Speak Limited English

Strong Memorial Hospital has been selected as one of 10 hospitals nationwide to participate in Speaking Together: National Language Services Network, a national program to improve the quality of health care provided to patients with limited English proficiency (LEP). The hospitals will participate in a high-level national learning collaborative aimed at helping to develop tested language services programs that provide more effective and timely communications to patients with LEP.

Research shows that when patients have difficulty communicating with their health care providers, they are far less likely to understand their conditions, adequately communicate symptoms or adhere to treatment recommendations. While all hospitals nationwide are legally required to provide language services to patients who speak limited English, there are no federal guidelines on the most effective ways to communicate with these patients.

"Hospitals like Strong Memorial have had interpreter services for decades," said Kathleen Parrinello, Strong Memorial Hospital chief operating officer. "Through the Speaking Together collaborative, we can take this a step further, developing best practices and demonstrating the link between improved communication and improved outcomes. We look forward to working in collaboration with other hospitals to help improve care and reduce disparities for patients in Rochester, and ultimately across the nation."

The $60,000 grant will be used to help examine how hospitals communicate with non-English-speaking patients, and determine ways hospital staff can better structure and manage language services programs in order to have effective, efficient and timely communications with LEP patients. Strong will focus it efforts on testing improvements in language interpretation services among patients with diabetes in its Internal Medicine faculty practice and among patients admitted to its cardiology unit. Parrinello expects that improvements made at Strong and at other Speaking Together partners will be deployed throughout the Strong Health patient care network.

Proven best practices learned from Strong Memorial and other Speaking Together partners will be shared with health professionals across the nation, giving hospitals with linguistically diverse patients concrete and tested examples of effective language services programs and interventions that they can adopt.

Strong’s Speaking Together team is led by Kathy Miraglia, M.S.,C.S.C., manager, Interpreter Services, Andrew Williams, M.D., assistant professor of Medicine in the General Medicine Unit, Victoria Ramos-Rodriguez B.A., supervisor, Spanish Interpreters, Susan Saunders, L.M.S.W. director, Strong Health Care Management, and Marina Marchioli, M.B.A., director of Administrative Services, Strong Health Care Management.

Help Us "Keep it Real"

In preparation for the upcoming 2007 United Way campaign, the University’s United Way campaign office is looking to hear from faculty, staff or students who have or are receiving assistance from one or more of the many programs and services funded by the United Way of Greater Rochester.

With your permission, your story may be shared across the campus to help remind faculty and staff how vital their support is not just to the Rochester community, but right here at the University of Rochester.

To share your story, please contact Cathy Densieski in the University's United Way Campaign Office, ext. 3-4722, or by e-mail at cathy.densieski@rochester.edu.