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The BMC Brief

June 15, 2011                                      Volume 1, Issue 3

BMC's Patient Family Advisory Council 
Top Priority: Reducing Radiation Exposure from CT Scans
BMC Rounds

BMC’s Patient Family Advisory Council

This past October, BMC established the Patient Family Advisory Council (PFAC) to strengthen the communication and partnerships between patients, families, caregivers and staff so that BMC can continue providing exceptional care, without exception. PFAC’s 15 members – six patients, four family members and five staff – meet monthly to address important issues involving members of the BMC community and, with thoughtful collaboration and discussion, develop recommendations on how we can improve the experiences of patients and their families.

PFAC member Marie Jorelle Louis-Dyer with her three children.

One of the major objectives of PFAC is to create patient and family centered care so that patients become active participants in their health-care outcomes. Sheryl Katzanek, director of Patient Advocacy, is the coach of PFAC and chairs the six-member steering committee. “Historically, we have provided care to our patients, not with them,” said Katzanek. “Actively involving patients in their care helps build trust and a sense of shared responsibility between patients and their caregivers.”

PFAC members have worked on a variety of projects during the past seven months. When Shapiro opened in April, PFAC members developed the slogan, “See you in Shapiro in the Springtime,” which was used on posters and buttons to create a buzz about the new building. PFAC members revived the Guide Program on campus to escort patients from the old clinical space to the new space in Shapiro. In addition, council members suggested changes to the brochures that are given to family members of ICU and Trauma patients.

One family member, Marie Jorelle Louis-Dyer, joined PFAC to give back in honor of her youngest son, Fritz Jr. Germain, who passed away at the age of 5 in March. Fritz Jr. was born prematurely at BMC and spent the first seven months of his life in the NICU. “I am so thankful for the care that all of my children, including my son Fritz Jr., received,” said Louis- Dyer. “So many people helped me along the road and my son’s life inspires me to help others going through similar situations.” All three of Louis-Dyer’s children were born at BMC – her daughter will be 18 in September and her other son will be 9 in August.

Council member Patty Doggett’s husband is a BMC patient, and she was asked by her husband’s doctors to join PFAC. “I hope that I can provide some perspective about what it’s like to be a family member of someone undergoing treatment,” said Doggett, who also runs a knitting group for patients with cancer at BMC. Another current PFAC member is an 86-year-old woman who was born at BMC and has received her care here for her entire life.

The insight of PFAC members has been requested in the re-design process of the patient and family waiting rooms in both the Menino and East Newton ORs. Chief Medical Information Officer Dan Newman, MD, has also requested to meet with PFAC about their recommendations on how to revise the discharge paperwork.

Dr. Jane Mendez, Surgical Oncology and Endocrine Surgery, was excited to have the opportunity to help bring the voices of patients and families into the equation as a PFAC member. “Our patients and family members offer a very unique perspective and this council provides a vehicle to advocate for their specific needs,” said Mendez. 

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Top Priority: Reducing Radiation Exposure from CT Scans

International studies have shown that there are significant health risks, including increased risk of cancer, associated with radiation exposure from CT (computerized axial tomography), which has created a global effort focused on reducing radiation doses. BMC has been investigating ways and implementing new guidelines to reduce the radiation doses, and a recent study reflects significant progress.

Dr. Li and colleagues will continue their collaboration on ways to reduce radiation exposure from CT scans.

A two-year retrospective study, which was conducted at BMC under the direction of Stephan Anderson, MD, and Baojun Li, PhD, and Osamu Sakai, MD, PhD, demonstrated up to a 40 percent dose reduction when comparing the doses of 400 patients who had CT scans in 2009 with 400 patients who had CT scans in 2010. Both sets of patients received the same CT scans and were similar in age, demographic and body mass index (BMI) and, most importantly, received an accurate diagnosis based on the CT scan.

“BMC has been ahead of the curve in identifying low-cost novel approaches to ensure that patients receive the lowest radiation doses possible when they have CT scans at BMC,” said Alexander Norbash, MD, Chief of Radiology. “Our commitment is always uniquely focused on our patients and we will continue to make improvements to ensure their safety.”

“As radiologists, we have shifted our focus away from getting the best picture possible, which requires higher amounts of radiation,” said Anderson, Radiology. “Our goal now is to find a balance between reducing the radiation doses while simultaneously maintaining the image quality to ensure that accurate diagnoses can be made.”

Radiologists, physicists, and technologists at BMC utilize the American College of Radiology’s “right exam, at right time, for the right reason” principle, as well as the “as low as reasonably achievable” (ALARA) principle, so patients have been receiving doses well within national guidelines. In fact, BMC average doses are15% lower than national target dose levels. However, the team wanted to take it a step further.

Through a series of studies, they determined the balance between low dose and image quality and have established new guidelines. The team also looked at how they could optimize protocols in certain CT procedures and processes. For example, BMC has reduced doses using a CT technology called automatic tube current modulation to get the lowest effective dose over the past few months. They also have trained fellow physicians and technologists about the new protocols and why they are being used.

“There has been a true collaboration among radiologists, physicists, and technologists that has led to our patients receiving optimal care with the lowest risk,” said Li, from the Office of Medical Physics at Boston University and Radiology at BMC, who previously worked for a leading CT manufacturer and is highly knowledgeable about how CT technologies work. “We will continue training our radiologists and technologists and work to develop novel approaches to deliver optimal image quality with minimal radiation doses for patients requiring CT scans.”

Recognizing our social obligation to the most vulnerable populations, this work is being immediately applied to our pediatric patients to minimize the risks of lifetime inadvertent radiation-related complications.

Other key members of the team include CT supervisor Kelly Bergeron, CT technologists David Palmer and Christine Seay, and research fellow Melissa Pevez, MD. 

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BMC Rounds

Senator Brown spoke with Dr. Ulrich about BMC's emergency services.

US Senator Scott Brown came to BMC on May 13 for a tour of the hospital. Led by President & CEO Kate Walsh, Sen. Brown visited the Emergency Department and spoke with Andrew Ulrich, MD, about our emergency services. He then went to the food pantry, where Megan Sandel, MD, and Latchman Hiralall briefed him on the services that BMC provides to thousands of families each month. Lisa O’Connor, senior vice president for clinical operations and chief nursing officer, took the Senator through the ICU and NICU, and David Seldin, MD, spoke with the Senator about BMC’s Hematology and Oncology services.

Newly-elected Boston City Councilor Tito Jackson toured BMC on May 19. Led by President & CEO Kate Walsh, Jackson visited the Emergency Department, Radiation Oncology and the food pantry. (photos)

The staff of Radiation Oncology has started a unique campaign, named “Strive for 5” campaign to help increase patient satisfaction scores. While patient satisfaction rates have been positive, the department has a goal of achieving a 5 out of 5 score on the Press Ganey satisfaction survey, which patients fill out about their experiences at BMC.  Staff members are wearing buttons saying “Strive for 5,” which has been prompting patients to ask what that means, allowing the staff to educate the patients about the scores. The campaign, which was developed by the department’s six-member leadership team under the direction of Radiation Oncology Chair Lisa Kachnic, MD, kicked off earlier this year. To celebrate the department’s efforts, Radiation Oncology staffers took a Duck Tour ride, which picked them up at BMC on May 18. (see photos)

Richard K. Babayan, MD, Chief and Chair of Urology, was honored by the American Urological Association (AUA) for his contributions to the field of medicine and urology. Babayan received the Distinguished Service Award for outstanding service to the AUA Foundation, AUA Leadership Program and the AUA Board of Directors.

BMC received a $250,000 grant from the Avon Foundation that will strengthen the Avon Safety Net program, of which BMC is a member. The program consists of more than 100 hospitals across the country, all of which ensure women and men who might otherwise fall through the cracks of the healthcare system have access to high quality breast cancer services.

Psychiatry Resident Accolades

A team of three BMC psychiatry residents placed first in the American Psychiatry Association’s (APA) national MindGames competition in Honolulu on May 17. The annual competition consists of a series of timed questions that test players’ knowledge on a range of psychiatry and patient care topics. Ana Ivkovic, MD, Brie Beaudoin, MD, and Mark Oldham, MD, qualified for the final round by placing in the top three among 104 residency programs from across the country in preliminary competition. They were coached along the way by Troy Pulas, MD, BMC psychiatry addiction fellow. In Hawaii, the team beat their two remaining competitors, Cornell University and the University of Pittsburgh, to win first place.

Also, two second-year BMC psychiatry residents were honored at the Massachusetts Psychiatric Society’s (MPS) Annual Meeting on May 9. Isis Burgos-Chapman, MD, won an election to serve as the Member-In-Training to the MPS Council. Michele Durham, MD, MPH, became the first resident to receive the Presidential Award for her contribution to the Society in conducting an analysis of mental health care resources. MPS represents the majority of psychiatrists in Massachusetts and strives to promote outstanding psychiatric care through the accurate diagnosis and comprehensive treatment of mental health and emotional illnesses.

BMC Receives Three Awards

BMC received the Target: Stroke Award from the American Heart Association (AHA) for keeping the amount of time between when a patient is admitted and administered a clot busting medication at less than 60 minutes. Additionally, BMC received the Defect-free Care Award from the Stroke Collaborative Reaching for Excellence (SCORE), which is a voluntary statewide quality improvement collaborative administered by the Massachusetts Department of Public Health (DPH).  This award recognizes the percent of patients receiving all of the interventions for which they were eligible. The third award, the AHA GOLD Plus Award, recognizes BMC’s compliance to quality measures within the “Get With The Guidelines – Stroke” program. Congratulations!

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