Grand Rounds January on Arkansas Medical News Inc.

Grand Rounds January

Saline Memorial Recognized by Governor's Quality Award Program for Performance Excellence

BENTON — Saline Memorial Hospital (SMH) was recently recognized by the Governor's Quality Award Program for Performance Excellence during the 14th Annual Awards Celebration at the Statehouse Convention Center in Little Rock. More than 250 business and civic leaders from throughout Arkansas attended the celebration.

"We are excited to be one of a small number of hospitals to be recognized for the second consecutive year in a row," said Randy Fortner, SMH President and CEO. "Co-workers at every level of the organization have been focusing on performance excellence. I'm proud of our achievement and pleased that the effort has demonstrated real results that enhance our service to this community."

The awards ceremony included four award levels of Performance Excellence (in descending order of qualifications): the "Governor's Quality Award," the "Achievement Award," the "Commitment Award" and the "Challenge Award."

The Governor's Quality Award program uses the same application criteria, as does the Malcolm Aldridge National Quality Award program. These criteria cover seven areas of doing business: 1) Leadership; 2) Strategic Planning; 3) Customer and Market Focus; 4) Measurement, Analysis and Knowledge Management; 5) Human Resource Focus; 6) Process Management; and 7) Results.

As well as the recognition, SMH received an in-depth evaluation of management systems and a written feedback report citing strengths and areas for improvement.

UAMS' Upreti Awarded Arkansas' First Postdoctoral Fellowship from American Cancer Society

LITTLE ROCK -— Meenakshi Upreti, Ph.D., research assistant professor in the Department of Biochemistry and Molecular Biology at the University of Arkansas for Medical Sciences (UAMS), has been awarded the first-ever postdoctoral fellowship award to a researcher in Arkansas by the American Cancer Society.

The fellowship carries with it an award of $50,000 to further Upreti's research of a particular class of anticancer drugs known as microtubule inhibitors. These drugs cause very specific changes in Bcl-2 proteins, a certain group of proteins present in all cells that are important in controlling the programmed cell death known as apoptosis that occurs during chemotherapy.

"Our long-term goal is to induce cell death specifically in tumor cells, while sparing normal cells. This will make chemotherapy much more tolerable and effective in the treatment of cancer," she said.

Upreti will pursue this study under the guidance of Timothy Chambers, Ph.D., professor and vice chairman of the UAMS Department of Biochemistry and Molecular Biology. She was promoted from postdoctoral fellow to research assistant professor in July 2008.

"The effectiveness of these drugs as anti-tumor agents depends on their ability to damage certain key molecules in the cancer cell that leads the cell to self-destruct and die," Upreti said. "In many cases, failures in cancer therapy are due to defects in these apoptotic pathways."

The main objective of her research is to define the role of Bcl-2 proteins in the mechanism of action of microtubule inhibitors, which could lead to new insights into drug resistance and identify new molecular targets for the development of more specific cancer therapies.

St. Edward Mercy Medical Center Unveils Neurosurgery Suite

FORT SMITH — St. Edward Mercy Medical Center will unveil its new neurosurgery suite at a dedication at 10:30 a.m. on Thursday, November 20 in the new suite. Members of the media are invited to attend.

The neurosurgery suite is specially designed to accommodate cranial tumors and biopsies using Stealth (image guided navigation system), spinal cord tumors using Stealth, cervical laminectomy, lumbar laminectomy with fusion using the anterior or posterior approach, discectomy, and microdiscectomy. St. Edward Mercy Medical Center anticipates performing 350 to 400 neurosurgeries in the first year.

With the new equipment, imaging technology and the PACS system, the neurosurgery room needed more space and a better layout. The operating room is fully-integrated. The additional neurosurgery suite allows the Medical Center to perform two neurosurgeries at one time.

The neurosurgery suite is specially designed to accommodate neurosurgery. The suite was built to invest in the latest technology to better utilize all components involved in neurosurgery.

"This suite is important because it helps the entire surgical team retrieve and analyze vital patient data while performing the surgery," said Michelle Gasaway, director of surgery.

All digital X-ray studies including digital CT scans and MRI studies can be accessed and utilized during the surgical procedure which helps the procedure go much more efficiently. Also, the Medtronic Stealth, OEC C-arm and Zeiss microscope images can be viewed much more easily during the surgical procedure which allows even more information gathering to ensure excellent outcomes.

The suite has state-of-the-art equipment including Skytron Skyvision Integration, Skytron 3600B top slide surgical table, Zeiss Microscpoe, Medtronic Stealth, Digital PACS radiology system.

St. Edward Mercy Medical Center performed the first surgery in the new suite in October.

Six-story Psychiatric Research Institute Opens at UAMS

LITTLE ROCK — Individuals with psychiatric problems ranging from drug addiction to depression now have an extensive array of inpatient and outpatient services in one location. The Psychiatric Research Institute at the University of Arkansas for Medical Sciences (UAMS) was built not only to improve treatment but to devise new and innovative methods of overcoming mental health issues.

The Institute, which held a grand-opening ceremony today at its new location on the UAMS campus, was eight years in the making. Arkansas first lady Ginger Beebe helped preside over the opening and cut the ribbon. The $32 million facility, whose six stories encompass 110,000 square feet, is one of only nine institutions in the country combining research and education with inpatient and outpatient care. It marks the first time in 30 years that UAMS has been able to provide inpatient psychiatric care.

Located adjacent to the new UAMS hospital slated to open in January, the Psychiatric Research Institute has 40 beds dedicated to psychiatric patients in need of hospitalization, divided evenly among the children's unit, the geriatric unit, the acute-care for adults unit and the unit treating patients who also have medical needs. The Institute plans to begin admitting patients Feb. 3.

The inpatient areas are on the fifth and sixth floors and will offer state-of-the-art care in high-quality surroundings, with private rooms, standard-setting safety features and other amenities.

The building's first three floors, home to the building's administration, support staff and research divisions, are linked by a grand staircase that runs adjacent to the building's western face. The tall glass façade and the naturally lit atrium on the first floor symbolize an enlightened approach to mental health, Smith said.

The Walker Family Clinic, located on the second floor, is the outpatient service area. It will host the Institute's specialty programs, including treatment for addictive, eating, anxiety, depressive and post-traumatic stress disorders. The clinic expects more than 50,000 visitors each year.

The next floor includes the Center for Addiction Research and the Substance Abuse Treatment Clinic.

The recently installed a 3 Tesla magnetic resonance imaging (MRI) system on the lower level will provide an important tool in the research of brain-related activity. Part of the Institute's neuroimaging center, the $3 million, 10,000-pound device is twice as powerful as standard MRI machines. A tesla is a measure of magnetic field strength. One of only two such systems in Arkansas (a similar unit is used by the UAMS Department of Radiology); the new MRI is capable of capturing detailed images of blood flow and brain activity. It also will process those images faster than standard MRI systems, providing improved diagnostic capabilities.

Two at UAMS Elected to International Association Positions

LITTLE ROCK — Two University of Arkansas for Medical Sciences (UAMS) employees have been elected to positions with the international Association of Standardized Patient Educators.

Renee Flynn, financial director for the UAMS Center for Clinical Skills Education and Standardized Patient Program, was elected vice president of finance for the Association of Standardized Patient Educators.

Sherry Johnson, standardized patient educator for the Standardized Patient Program at UAMS, has been elected member at large for the Association of Standardized Patient Educators.

The association is an international organization with more than 650 members from 19 countries. Flynn and Johnson will serve on the board for two years.

QSource awarded contract by Arkansas Department of Human Services Division of Medical Services

LITTLE ROCK — QSource has been awarded a contract by the Arkansas Department of Human Services (ADHS) Division of Medical Services (DMS) to assist in the evaluation and contract management services for a health management pilot and regional quality initiative (RQI), as well as provide technical support for policy development.

The health management pilot focuses on high-risk pregnant women and infants up to one year of age in Northeast Arkansas. QSource will be responsible for coordinating activities between the DMS and the current health management contractor, U.S. Care Management Services, Inc. To ensure effective oversight of all contracted activities, QSource will utilize its experience in both the clinical aspects of health management and the qualitative and quantitative aspects of program evaluation.

As part of the RQI, QSource will facilitate meetings for a comprehensive, and potentially growing, group of Arkansas healthcare stakeholders. The RQI initiative funded Medicaid programs to convene healthcare stakeholders including commercial insurers, employers, providers, and consumer organizations in a collaborative to improve care for people with chronic conditions.

QSource will collect and analyze Arkansas clinical performance measure data and provide healthcare data reports from multiple payers and present finding to the RQI steering committee. This committee is responsible for driving coordinated quality improvement efforts.

In addition, QSource will assist the DMS by expanding its capacity to analyze trends and plan future initiatives by providing technical assistance for projects related to data and clinical analysis of local and national policy initiatives.

"QSource is committed to creating transformational change in healthcare and measuring success through improvement in the health of the communities that we serve," said Nancy Archer, RN, QSource of Arkansas executive director.

St. Edward Mercy Medical Center Awarded CARF-CCAC Accreditation

FORT SMITH — St. Edward Mercy Medical Center's Rehabilitation Center has been awarded a three-year term of accreditation by the Commission on Rehabilitation Facilities (CARF) – Continuing Care Accreditation Commission (CCAC). The Medical Center celebrated the accreditation at a ceremony to on Tuesday, November 18 at Sicard Education Center in the Centers of Excellence.

St. Edward Mercy's Rehabilitation Center has been CARF – CCAC accredited since 1998 with the most recent accreditation being awarded in June 2005.

"St. Edward Mercy is so proud to continue to offer quality care to our patients through our accredited rehab program," said Dr. Larry Pearce, vice president of medical affairs. "Our team has been relentless in achieving this high standard to ensure that our patients are getting the best possible care."

St. Edward Mercy is the only inpatient rehabilitation center in the region that is CARF - CCAC accredited. Only seven facilities in Arkansas hold this accreditation with the next closest facility being located in Hot Springs. St. Edward Mercy voluntarily put itself through the rigorous peer review process and demonstrated to the CARF surveyors during the on-site survey that it is committed to conforming to CARF - CCAC's accreditation conditions and standards.

According to the accreditation report, St. Edward Mercy's Rehabilitation Center demonstrated "exemplary conformance to the standards" and has shown a "continued quality of care" for patients.

The following areas were addressed during the on-site survey: leadership, strategic integrated planning, input of patients & other stakeholders, legal requirements, financial planning & management, risk management, health & safety, human resources, technology, rights of persons served, accessibility, information measurement & management, and performance improvement.

"This achievement is an indication of your organization's dedication and commitment to improving the quality of the lives of the person served," said Dr. Brian J. Boon, president and CEO of CARF.

AFMC Employee Receives State Award

LITTLE ROCK — Carol Compas, manager of quality programs at the Arkansas Foundation for Medical Care, was honored recently with the 2008 Arkansas Long-Term Care Ombudsman Superior Citizen Empowerment Award for her work promoting the program statewide.

Long-term care ombudsmen are specially trained people to work on behalf of residents of nursing homes and residential care facilities. They visit residents regularly to hear their concerns, and investigate and resolve complaints from residents and their families. The issues they deal with range from finances and Medicaid eligibility to use of physical restraints, food quality and social activities. The Arkansas Long-Term Care Ombudsman program is a part of the Department of Human Services' Division of Aging and Adult Services.

UAMS dedicates Tommy May ALS Research Center

LITTLE ROCK — The University of Arkansas for Medical Sciences (UAMS) recently dedicated laboratories where researchers are working toward new treatments for a crippling neurodegenerative disease.

The J. Thomas May Center for Amyotrophic Lateral Sclerosis (ALS) Research, named for a Pine Bluff banker diagnosed with the disease, has a focus on translational medicine, meaning that it seeks to move new treatments quickly from the laboratory to the clinic. The new center includes three laboratories, scientists and staff devoted to ALS research.

The center is supported by more than $1 million in gifts to UAMS from friends and colleagues of May, who is chairman and chief executive officer of Simmons First National Corp. in Pine Bluff and Simmons First National Bank.

Amyotrophic Lateral Sclerosis (ALS or "Lou Gehrig's Disease") is a neurodegeneration disease that typically strikes otherwise healthy people and robs them of all voluntary muscle function, Crow said. Once symptoms begin, it usually progresses rapidly and has no effective treatment, he said.

Currently, UAMS researchers are testing combinations of agents to find an effective drug "cocktail." Crow said they are looking at drugs that are already approved by the Food and Drug Administration, combined with substances derived from dietary supplements – so-called "nutraceuticals."

Two California-based drug companies are continuing formal drug development on two compounds first identified by Crow in 2003. Both of these compounds dramatically enhanced survival of ALS mice and preserved near-normal muscle function when administered at the onset of the disease.

However, Crow said, development of totally new, experimental drugs requires lengthy and costly safety testing prior to use in ALS patients. By utilizing drugs and compounds that have already been tested for safety in humans, Crow and his colleagues hope to greatly accelerate the process of getting new treatments to patients.

Trauma System "Dashboard" Goes Live

LITTLE ROCK — The first major component of a potential trauma system for Arkansas was made operational Nov. 3, according to officials at the Arkansas Department of Health (ADH). A new computer database, called a "dashboard," provides an electronic communications link so hospital personnel can guide the timely transfer of a severely injured person to the hospital with the most appropriate medical staff, equipment and facilities to fit the patient's particular needs.

The dashboard has been made possible through a $200,000 grant from Governor Mike Beebe's Emergency Fund earlier this year. The grant paid for the software development and 24/7 system operation of the dashboard.

The dashboard is only one part of a trauma system-a lifesaving network when minutes count as a result of traumatic injury. This system consists of a network of hospitals and the complete, up-to-the-minute information about them that allows hospital and emergency department personnel to make the best decisions for appropriate patient care.

Most Arkansans believe that when they or a loved one is severely injured, they will receive specialized care in a hospital with doctors and equipment available to treat their particular needs. Arkansas is one of only three states in the nation without a trauma system, and the only state without a designated trauma center.

A necessary element for a trauma system in Arkansas is a database, or "dashboard", that provides up-to-date status information to the 83 participating acute care hospitals in Arkansas. This information is necessary for rapid transfer of patients to the most appropriate care facility. By using the electronic dashboard database, hospital and emergency medical personnel will know which hospitals have available the most appropriate care for their patients. The database tells them whether or not hospitals in the system have specialists like neurosurgeons, orthopedic surgeons and general surgeons available for duty.

The Department of Health has partnered with the Arkansas Hospital Association and contracted with Metropolitan Emergency Medical Services (MEMS) to design and manage the dashboard.

St. Edward Mercy Medical Center Named as Consumer Choice Award Winner Fifth Consecutive Year

FORT SMITH — St. Edward Mercy Medical Center was named as a 2008-2009 Consumer Choice Award Winner by the National Research Corporation (NRC). The award identifies hospitals which healthcare consumers have chosen as having the highest quality and image in over 250 markets throughout the United States. This is the fifth year in a row that St. Edward Mercy has won the Consumer Choice Award.

"We are happy to have earned the trust and confidence of our community," said Dr. Larry Pearce, vice president of medical affairs for St. Edward Mercy. "It is an honor for St. Edward Mercy to have earned this award five straight times."

Winners are determined by consumer perceptions on multiple quality and image ratings collected in the company's Healthcare Market Guide Ticker® study. The Healthcare Market Guide Ticker study surveyed over 200,000 households representing over 400,000 consumers in the contiguous 48 states and the District of Columbia.