04.06.12
MGHHOTLINE
A PUBLICATION FOR EMPLOYEES AND STAFF OF THE MASSACHUSETTS GENERAL HOSPITAL
a d vances
Study reveals grid-like
structure within the brain
courtesy of Van Wedeen, MD
COLORFUL CONNECTIONS:
An image of a primate’s brain shows
the structure of neural pathways.
Roger Farrington Photography
How do you build a brain? In the March 30
issue of Science a team of investigators reports the
discovery of a remarkably simple organizational
structure in the brains of humans and other primates.
Using advanced imaging technology, the
researchers found that pathways carrying neural
signals through the brain are arranged not in a
disorganized tangle but in a curved, three-dimensional
grid. The diffusion spectrum magnetic resonance
image below shows this fabric-like, three-dimensional
structure in the brain of a rhesus monkey. The
same grid-like pattern – in which neural fibers
form sheet-like structures that always cross at
right angles – also was seen throughout the white
matter of the brains of owl monkeys, marmosets,
galagos and in human volunteers.
“I don’t think anyone suspected the brain would
have this sort of pervasive geometric pattern,”
says Van Wedeen, MD, of the Martinos Center for
Biomedical Imaging at the MGH, who led the study.
“Although our findings could be described as a
new longitude and latitude for the brain, they’re
also leading us to an entirely new understanding of
how and why the brain is organized the way it is.” Additional co-authors of the Science article are
Ruopeng Wang and Guangping Dai, PhD, of
the Martinos Center, as well as researchers from
Boston University Medical Center, the University of
Lausanne in Switzerland,Vanderbilt University and
the National Taiwan University College of Medicine. health is beauty: From left, Kroes, Huffington, Herzog and Sozzani
Embracing ourselves
T
Harris Center hosts 15th annual forum
on eating disorders
The influence the fashion industry and the media can have on body image was the
focus of the 15th annual public forum hosted by the Harris Center for Education and
Advocacy in Eating Disorders at the MGH. Approximately 700 guests attended the
event, “Health is Beauty: Defining Ourselves,” which was held April 2 at the Memorial
Church at Harvard University and featured panelists David B. Herzog, MD, director of
the Harris Center, Arianna Huffington, president and editor-in-chief of the Huffington
Post Media Group, Doutzen Kroes, a Dutch model and actress, and Franca Sozzani,
editor-in-chief of Vogue Italia.
The panelists discussed recent legislation in Israel to ban underweight models from
runways. Herzog emphasized the importance of the health of young models, regardless
of their body type. “I would encourage agencies to have individuals in good health
when they start modeling, no matter if their BMI is 18.2 or 18.7,” Herzog said.
But few are immune to the pressure to look perfect. Kroes, best known as a Victoria’s
Secret model, admitted that she experiences bouts of insecurity. She cautioned people
not to compare themselves to models in magazines: “I get a picture taken, and I don’t
look the same in real life,” Kroes said. “There is good lighting, there’s a photographer
and there’s retouching after.”
Huffington revealed that her two college-age daughters have both struggled with
eating disorders. She repeated the mantra first stated by Sozzani: “We not only have to
accept ourselves, we have to embrace ourselves.”
The event helped raise more than $250,000 for the Harris Center, which is dedicated
to research, education and advocacy for eating disorders and offers clinical assessment
and treatment for children, adolescents, adults and families affected by these diseases.
For more information, visit www.harriscentermgh.org. n
04.06.12
raising awareness: Members of the MGH LGBT Employee Resource Group
‘Come Out for Health’
According to the Centers for Disease Control and Prevention, members
of the lesbian, gay, bisexual and transgender (LGBT) community are at
increased risk for certain health issues compared with their heterosexual
counterparts. These disparities are not necessarily linked to differences in
sexual behavior and may be the result of factors such as the stigma LGBT
individuals sometimes face. To increase awareness about the unique health
concerns of LGBT patients, the MGH LGBT Employee Resource Group
hosted a series of events in honor of National LGBT Health Awareness
Week March 26 through 30. The theme for the week was “Come Out for
Health.”
Members of the resource group staffed a table March 27 in the White
Corridor to provide a one-stop shop for LGBT patients and their loved
ones. Resources also were available for caregivers, including reference
cards with examples of disparities in LGBT health care; clear definitions
related to gender and sexuality; tips to ensure LGBT patients feel
safe, comfortable and respected, for example, by using gender-neutral
language; and online resources for additional information.
Other awareness events included a screening of “Beginners,” a film
about a young man whose elderly father reveals he is gay, and a social
outing to Club Café. Additional activities are planned for Boston Pride
Week June 3 through 12. For more information about the LGBT Employee
Resource Group or to obtain resources about caring for LGBT patients,
email [email protected]. n
Understanding the performance improvement process
Last month, four areas – medication
reconciliation, universal protocol, infection
prevention and care redesign/the Innovation
Units – were identified as top hospitalwide
priorities for performance improvement. When
Joint Commission representatives arrive for
an unannounced five-day survey at any point
between now and August, they will expect staff
members to be aware of these four priorities
and to understand their personal role in all
performance improvement efforts at the hospital.
“All MGH employees are involved in
performance improvement – a term we use to
describe the process of improving care by measuring
performance and then using our findings
to implement change,” says John Belknap,
director of Corporate Compliance.
Information about performance
improvement efforts flows back and
forth through quality and safety groups
at every level of the hospital (see chart
at left). Each clinical department has a quality
assurance chairperson as well a quality and
safety committee. These departmental resources
share quality- and safety-related information
with two interdisciplinary groups: the Quality
and Patient Safety Committee, made up of all
the quality assurance chairpersons, and the
Quality Oversight Committee, which comprises
leadership from various MGH departments, who
review high-priority projects throughout the year.
These committees report to the MGH/MGPO
Boards Subcommittee on Quality, a group that
includes trustees and quality and safety leadership.
The subcommittee in turn shares key information
with the MGH/MGPO Boards of Trustees.
“Regardless of the focus of a particular
performance improvement project, each one is
implemented in the same format: plan, do, check
and act, or PDCA,” says Belknap. “Everyone can
probably think of an example of how
they or their department have used this
method – or perhaps a similar version –
to successfully implement change.”
Planning is the stage at which an
opportunity for improvement is identified,
current performance is measured and
an improvement plan is developed; doing is when
the plan is implemented; checking is the measurement
of whether or not the plan worked; and acting
means the plan is modified if need be, standardized
and then monitored to sustain the improvement.
For more information about performance
improvement and other important quality and
safety topics, access http://intranet.massgeneral.org/
excellenceeveryday.
MGHHOTLINE
Departments collaborate to transform care for senior patients
Upon a patient’s arrival in the Emergency Department, one of two
Two MGH departments have joined together to redesign the way care
GIFTS physicians – Joel Bauman, MD, or Bernardo Reyes, MD – work with
is offered to senior patients with bone fractures.
the Orthopædic Trauma Service to evaluate and determine the best course
Members of the Departments of Medicine and Orthopædic Surgery
of treatment. Patients whose coexisting medical issues are determined to
have been working together since September through a new interdisciplinary
be secondary to their orthopædic injury are admitted to the Department
service called Geriatric Inpatient Fracture Service (GIFTS), which helps care
of Orthopædics to be
for patients 65 years and
managed by the GIFTS
older who are hospitalized
team. Patients whose other
because of orthopædic
medical conditions are
injuries. As part of the new
more pressing or severe
program, physicians from
than their orthopædic
the Geriatric Medicine Unit
injuries are admitted to the
work closely with physicians
Department of Medicine
from the Orthopædic
with an orthopædic consult.
Trauma Service – along
They can then be transferred
with staff from Nursing,
to the GIFTS team once
Anesthesia, Physical Therapy,
their medical issues become
and Nutrition and Food
less acute.
Services – to help patients
“Along with more
avoid complications
specialized care, the
following surgery, address
GIFTS GROUP: From left, Reyes; Dennis Ausiello, MD, chief of the Department of Medicine; Harry Rubash, MD, program also decreases
underlying medical needs,
chief of the Department of Orthopædic Surgery; Vrahas; Kathleen Burns, ACNP, Orthopædic Trauma
wait time for surgery,
strengthen overall health
Service; Kathleen Myers, MSN, RN, nursing director, White 6 and Ellison 6, Orthopædics; and Bauman
reduces length of stay in the
and provide patient- and
hospital for fracture care and improves geriatric-specific communication
family-centered education.
with families and receiving rehabilitation facilities,” says Ken Minaker, MD,
“This program aims to better manage patients who are admitted to
chief of the Geriatric Medicine Unit.
the hospital with orthopædic injuries, such as hip fractures, but who often
Adds Mark Vrahas, MD, chief of the Partners Orthopædic Trauma
have additional medical issues as well,” says Suzanne Morrison, program
Service, “Our goal is to restore the quality of life of our patients. This
director for the Partners Orthopædic Trauma Service, which works with
model allows patients to receive the right care at the right time from the
the MGH Orthopædic Trauma Service.
right providers.”
“GIFTS allows us to provide the best possible care throughout
For more information about GIFTS, contact Morrison at 617-643-3652
hospitalization and during the rehabilitation process,” adds Shelley Amira,
or [email protected].
administrative director of the Geriatric Medicine Unit.
Knight Simulation Program offers real-life education
Every day, the Knight Simulation Program in The Institute for Patient Care provides experiential learning opportunities for MGH clinicians. For
the past four weeks, however, Wednesday afternoons also were dedicated to teaching 11th grade students from the MGH Youth Scholars program
how the respiratory system functions under different scenarios. The program is designed to allow students to apply their science curriculum to
real-life clinical situations caused by asthma, alcohol intoxication or the use of inhalants. The 16 participants observed clinicians and learned how to
safely care for a simulated patient with respiratory issues.
“The Knight Simulation Program developed a classroom model for this
pilot program for high school students,” says Brian French, RN, director of
the Knight Simulation Program and the Maxwell and Eleanor Blum Patient
and Family Learning Center. “We met with biology, chemistry and anatomy
teachers and others from Boston schools to make sure the knowledge from
the students’ courses could be applied in the health care setting. We chose to
develop scenarios that focused on social problems in the community, such as
substance abuse.”
Christy Egun, director of Boston Partnerships in the MGH Center for
Community Health Improvement, says the program demonstrates how MGH
departments can expand the work they do to support the community. “We are
HANDS-ON learning: Youth Scholars Jocelyn Santos, of East Boston High
thrilled to have a partner as dedicated to our work as the Knight Simulation
School, and Alex Ortiz, of the Edward M. Kennedy Academy for Health Careers, work with
Program is in taking its involvement with our students to the next level.” n
Mary O’Brien, RN, MSN, professional development specialist in the Knight Nursing Center.
04.06.12
W H AT ’ S H A P P E N I N G
Ethics Forum
An Ethics Forum discussion, “Difficult
Interactions at the End of Life:
Caring for Patients and Families that
Challenge Us,” with speaker Guy
Maytal, MD, of MGH Psychiatry, will
be held April 13 from noon to 1 pm
in the Sweet Conference Room,
Gray-Bigelow 4. For more information,
email [email protected].
Boston Marathon CPR sessions
In preparation for the April 16
marathon volunteers are sought to
help teach “hands-only” CPR sessions
on April 14 and 15 from 9 am to 3 pm
at the Boston Marathon Health and
Fitness Expo at the World Trade
Center. Clinical nursing or prior
CPR instructor/certified teaching
experience preferred. For more
information, contact abaggish@
partners.org.
Submit news tips
and story ideas
to MGH Hotline
editor
Emily Lemiska
617-724-2753
assistant editor
Colleen Marshall
617-726-0275
designer
Aldona Charlton
617-726-7539
email
[email protected]
mail
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Suite 830
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MGH Hotline is published weekly
by the MGH Public Affairs Office.
Photos by MGH Photography
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Find MGH Hotline on the web at
www.massgeneral.org/news/hotline
MGH Senior HealthWISE
MGHHOTLINE
MGH Senior HealthWISE will host
a lecture for seniors age 60 years
or older, “My Feet Hurt! Do I Need
Orthotics?” April 19 from 11 am
to noon in the Haber Conference
Room with guest speaker Vikram V.
Thakar, DPM, MGH Podiatry resident.
For more information, call
617-724-6756.
Nurses night at Bloomingdale’s
Bloomingdale’s will host a night of
pampering for MGH nurses April 26
from 6 to 8:30 pm in the cosmetics
department of its Chestnut Hill
location. Nurses will be treated to
the latest beauty tips from experts,
samples and one-on-one consultations.
Mini-massages, manicures and light
snacks will be available. For more
information, call 617-630-6740.
Patient Care Services Awards
Nominations will be accepted through
April 27 at 5 pm for the annual
Institute of Patient Care Awards:
Anthony Kirvilaitis Jr., Partnership in
Caring Award; Brian M. McEachern
Extraordinary Care Award; Jean M.
Nardini, RN, Nurse Leader of
Distinction Award; Marie C. Petrilli
Oncology Nursing Award; Norman
Knight Clinical Support Excellence
Award; Norman Knight Preceptor of
Distinction Award; and Stephanie M.
Macaluso, RN, Excellence in Clinical
Practice Award. For more information,
email [email protected] or fax
nominations to 617-724-3754.
Cancer Center conference
The MGH Cancer Center will host
a free conference, “Cancer in the
Family: Living with Uncertainty,”
April 28 from 9 am to 3 pm. The
event includes sessions featuring
clinicians, patients and family members
discussing their experiences, genetic
markers and targeted therapy, and
insights and tools for coping with
cancer. To register or for more
information, call 617-724-1822 or
email [email protected].
‘A Cappella Palooza’
The MGH Cancer Center will host
a fundraiser, “A Cappella Palooza,”
April 29 at 6 pm at the Agganis
Arena at Boston University. The event
features contestants from NBC’s
“The Sing Off,” including 2011 season
GOAL GETTERS: Members of the Imaging Department, from left, Katrina
Ulcickas, William Donovan, Doreen Scola and Rosa O'Brien, with phlebotomist
Josue Castillo
Drive draws new record
mgh Imaging donated more than 100 units of blood to the MGH
Blood Donor Center during March, surpassing its goal and making
it the most successful first-time department drive in the center’s
history. The Imaging Blood Drive Challenge included 105 donors,
which represents 32 percent of its staff. “Each donation can
potentially save up to three lives, which means the Imaging Blood
Drive Challenge helped about 300 patients,” says Meredith Wentworth
of the Blood Donor Center.
The center also is offering several promotions during April. On
April 13, one blood donor will win a pair of tickets to a June Red Sox
game.Throughout the month, blood donors will be entered to win
a party for 25 people at Lansdowne Pub near Fenway Park, and blood
donors who “like” the MGH Blood Donor Center on Facebook will
be entered to win a pair of tickets to the Blue Man Group at the
Charles Playhouse. For more information, visit the center’s Facebook
page at www.facebook.com/MGHBloodDonor or call 617-726-8177.
winner Pentatonix, who will perform
with musician and judge Ben Folds.
For more information, visit
www.acappellapalooza.org or contact
Jenn Ryan at 617-643-6785.
IN GENERAL
Sagar Nigwekar, MD, a clinical and
research fellow in the MGH Renal
Division, was awarded the American
Kidney Fund Sanofi Clinical Scientist
in Nephrology Fellowship. Nigwekar’s
research will examine “Calciphylaxis:
Role of Vitamin D Analogues and
Evaluation of Serum Biomarker.”
Michael R. Hamblin, PhD,
principal investigator at the Wellman
Center for Photomedicine, has been
named as a fellow of the International
Society for Optics and Photonics.
Hamblin was recognized for making
significant scientific and technical
contributions in the area of
photodynamic therapy for the
treatment of cancer and infections,
fluorescence diagnosis of diseases
and low-level light therapy.
Suzanne Koven, MD, a primary
care physician at the MGH, was
honored with the 2012 Will Solimene
Award for Excellence in Medical
Writing from the American Medical
Writers Association for her column
“In Practice” in The Boston Globe. The
award recognizes outstanding work
in medical, biomedical and health
communication by New England
residents.