Archive for the ‘Medical Professionals’ Category

Three Heart Transplants in 34 Hours

When transplant surgeon John Um, MD, walked into Nebraska Medicine – Nebraska Medical Center the morning of April 11, little did he know, it was the start of two very long days. By the evening of April 12, Dr. Um had performed three heart transplants in 34 hours – a personal best for himself and the transplant team at Nebraska Medicine.

“The surgeries were pretty long. About six to eight hours each,” describes Dr. Um.
three heart transplant recipients in 34 hours and their doctor

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From left to right: Harvey Brandy, Lucas Kollars, Curt Spethman and Dr. John Um

It all started with 24-year-old Lucas Kollars of Arlington, Neb., who was found unresponsive at home by his mother. After receiving a left ventricular assist device (LVAD) and a right ventricular assist device (RVAD), Kollars was on the heart transplant waiting list for 58 hours.

“Dr. Um said I had about two more days to live,” says Kollars.

Twelve hours after finishing Kollars’ heart transplant, Dr. Um started on the second one. The patient was 57-year-old Harvey Brandy of Omaha. Brandy’s heart problems began several years ago with a heart attack. After receiving a stent and pacemaker, Brandy’s name was placed on the transplant waiting list. It took three days to find a match.

“At the time, I was feeling really, really bad,” says Brandy. “My heart was only functioning at ten percent.”
heart transplant

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While Dr. Um finished Brandy’s procedure, 60-year-old Curt Spethman of Omaha was being prepped for surgery. Spethman’s heart issues were fairly recent, but progressing quickly. His name was only on the transplant waiting list for five days.

“I was amazed at how fast it happened,” says Spethman. “You’re scared, but then you go – ‘I’m getting a heart. A second chance.'”

At 10:40 a.m. on April 12, Dr. Um began Spethman’s transplant. Even though it was his third in two days, Dr. Um was prepared and ready to go. He couldn’t let Spethman miss out on his second chance at life.

“I have a couch in my office where I can put my feet up, get some sleep and grab a coffee,” explains Dr. Um. “We also have multiple teams that are able to come in. They’re refreshed as well. This allowed everyone to be working at the best possible level. It’s a testament to the med center to invest in those resources and have the personnel to do those things.”

On May 11, all three patients met each other for the first time. They also thanked Dr. Um for his incredible work.

“I feel great. I’m walking around – about a mile or more a day,” says Kollars. “I want to thank Dr. Um and Dr. Aleem Siddique. They saved my life about nine different times.” “If it weren’t for the team at Nebraska Medicine, I wouldn’t be here. . It’s amazing what they do,” adds Spethman. “I’m now walking down the sidewalk and planting flowers again. It’s incredible.”

“One day, I’m going to come back and buy them a box of donuts,” laughs Brandy. “To show my appreciation.”

To learn more about the three heart transplants in 34 hours, watch this video:

 

Nebraska Medicine Again Named To 100 Great Hospitals List

List features biggest names in American health care

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Becker’s Hospital Review has published the 2016 edition of “100 Great Hospitals in America,” a compilation of some of the most prominent, forward-thinking and focused healthcare facilities in the nation. For the third straight year, Becker’s named Nebraska Medicine to the prestigious list.

Hospitals included on the list are home to many medical and scientific breakthroughs, provide best-in-class patient care and are stalwarts of their communities, serving as research hubs or local anchors of wellness. A version of this list has been published each year since 2011.

“It is an incredible honor to once again be included on this list,” said Rosanna Morris, interim CEO at Nebraska Medicine. “Our health care professionals strive every day to provide serious medicine and extraordinary care to each of our patients. It’s gratifying to see that the work we’re doing here is being recognized and is paying off.”

To develop the list, Becker’s Hospital Review‘s editorial team conducted research and evaluated reputable hospital ranking sources, such as U.S. News & World Report, Truven Health Analytics, Healthgrades, the American Nurses Credentialing Center, The Leapfrog Group and several other resources. The final result is a group of 100 hospitals that are leaders in their region, their state and the nation in terms of high-quality patient care.

“This is a testament to the extraordinary patient care we provide at Nebraska Medicine,” said Brad Britigan, MD, interim president at Nebraska Medicine. “It’s also evidence that the cutting-edge treatment we provide is on par with what is being delivered at the most high-profile medical facilities in the country.”

The hospitals included in the 2016 edition of the list are:
•Abbott Northwestern Hospital, part of Allina Health (Minneapolis)
•Ann & Robert H. Lurie Children’s Hospital of Chicago
•Aspen (Colo.) Valley Hospital
•Aspirus Wausau (Wis.) Hospital
•Aurora St. Luke’s Medical Center (Milwaukee)
•Banner – University Medical Center Phoenix
•Baptist Health Lexington (Ky.)
•Barnes-Jewish Hospital (St. Louis)
•Baylor St. Luke’s Medical Center (Houston)
•Beaumont Hospital – Royal Oak (Mich.) Campus
•Billings (Mont.) Clinic
•Bon Secours St. Francis Hospital (Charleston, S.C.)
•Boston Children’s Hospital
•Brigham and Women’s Hospital (Boston)
•Carolinas Medical Center (Charlotte, N.C.)
•Cedars-Sinai Medical Center (Los Angeles)
•CHI St. Vincent Infirmary (Little Rock, Ark.)
•Children’s Hospital Los Angeles
•Children’s Hospital of Philadelphia
•Children’s Hospital of Pittsburgh of UPMC
•Children’s National Medical Center (Washington, D.C.)
•The Christ Hospital (Cincinnati)
•Christiana Hospital (Newark, Del.)
•Cincinnati Children’s Hospital Medical Center
•Cleveland Clinic
•Dana-Farber Cancer Institute (Boston)
•Dartmouth-Hitchcock Medical Center (Lebanon, N.H.)
•Duke University Hospital (Durham, N.C.)
•Emory University Hospital (Atlanta)
•Florida Hospital Orlando
•Froedtert & the Medical College of Wisconsin Froedtert Hospital (Milwaukee)
•Geisinger Medical Center (Danville, Pa.)
•Good Samaritan Hospital (Cincinnati)
•Hackensack (N.J.) University Medical Center
•Hoag Memorial Hospital Presbyterian (Newport Beach, Calif.)
•Hospital for Special Surgery (New York City)
•Hospitals of the University of Pennsylvania-Penn Presbyterian (Philadelphia)
•Houston Methodist Hospital
•Indiana University Health University Hospital (Indianapolis)
•Inova Fairfax Hospital (Falls Church, Va.)
•Intermountain Medical Center (Murray, Utah)
•John Muir Medical Center, Walnut Creek (Calif.)
•Johns Hopkins Hospital (Baltimore)
•Lehigh Valley Hospital–Cedar Crest (Allentown, Pa.)
•Loyola University Medical Center (Maywood, Ill.)
•Massachusetts General Hospital (Boston)
•Mayo Clinic (Rochester, Minn.)
•Medical University of South Carolina (Charleston)
•Memorial Sloan Kettering Cancer Center (New York City)
•Mount Sinai Hospital (New York City)
•National Institutes of Health Clinical Center (Bethesda, Md.)
•Nebraska Medicine – Nebraska Medical Center (Omaha, Neb.)
•NewYork-Presbyterian Hospital (New York City)
•NorthShore University HealthSystem Evanston Hospital (Ill.)
•Northwestern Memorial Hospital (Chicago)
•NYU Langone Medical Center (New York City)
•Ochsner Medical Center (New Orleans)
•The Ohio State University Wexner Medical Center (Columbus)
•Oregon Health and Science University Hospital (Portland)
•Porter Adventist Hospital (Denver)
•Poudre Valley Hospital (Fort Collins, Colo.)
•Rush University Medical Center (Chicago)
•Ronald Reagan UCLA Medical Center (Los Angeles)
•Sanford USD Medical Center (Sioux Falls, S.D.)
•Scripps Memorial Hospital La Jolla (Calif.)
•Sentara Norfolk (Va.) General Hospital
•Spectrum Health Medical Center–Butterworth Hospital (Grand Rapids, Mich.)
•Stanford (Calif.) Health Care-Stanford Hospital
•St. Cloud (Minn.) Hospital
•St. Joseph’s Hospital and Medical Center (Phoenix, Ariz.)
•St. Jude Children’s Research Hospital (Memphis, Tenn.)
•St. Luke’s Boise (Idaho) Medical Center
•Tampa (Fla.) General Hospital
•Texas Children’s Hospital (Houston)
•Thomas Jefferson University Hospitals (Philadelphia)
•UAB Hospital (Birmingham, Ala)
•UC San Diego Medical Center
•UCSF Medical Center (San Francisco)
•UF Health Shands (Gainesville, Fla.)
•University Hospitals Case Medical Center (Cleveland)
•University of California Davis Medical Center (Sacramento)
•University of Chicago Medicine
•University of Colorado Hospital (Aurora)
•University of Iowa Hospitals and Clinics (Iowa City)
•University of Kansas Hospital (Kansas City)
•University of Maryland Medical Center (Baltimore)
•University of Michigan University Hospital (Ann Arbor)
•University of Minnesota Medical Center (Minneapolis)
•University of North Carolina Medical Center (Chapel Hill)
•University of Tennessee Medical Center (Knoxville)
•University of Texas MD Anderson Cancer Center (Houston)
•University of Utah Hospitals and Clinics (Salt Lake City)
•University of Washington Medical Center (Seattle)
•UPMC Presbyterian (Pittsburgh)
•UR Medicine Strong Memorial Hospital (Rochester, N.Y.)
•UW Health–University Hospital (Madison)
•Vanderbilt University Medical Center (Nashville, Tenn.)
•Virginia Commonwealth University Medical Center (Richmond, Va.)
•Wake Forest Baptist Medical Center (Winston-Salem, N.C.)
•Yale-New Haven (Conn.) Hospital

Telestroke Program Off the Ground

Serious Medicine

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Kathleen Harnden, RN, clinical program coordinator in Bellevue, demonstrates how the Telestroke unit functions.

A new technology that’s more convenient for doctors and results in faster treatment for patients has debuted in both Nebraska Medicine emergency departments within the past few weeks.

“We can’t train enough neurologists to support the growing needs of our aging population,” says Marco Gonzalez, MD, neurologist and Telestroke champion. “Telestroke is helping us to fill that gap with the aid of technology. We’re bringing the stroke expert to the bedside.”

3-16-Telestroke-1-690x462Kelley Johnson, nurse in the Emergency Department in Bellevue, receives candy for being the first nurse to use the Telestroke unit in Bellevue.

Stroke treatment is protocol driven. Alteplase is the only FDA-approved drug for the treatment of acute ischemic stroke, but it must be given within four and a half hours of stroke symptom onset. As a result, only about 10 percent of eligible patients receive the treatment, Dr. Gonzales says. Even more advanced treatments like a thrombectomy must be done within six hours, so either way, prompt diagnostics and consultations are essential to quality outcomes.

The Telestroke program has been in the works for more than a year, says Denise Gorski, who began laying the foundation for the program as a clinical program coordinator in Neurosciences before stepping into her current role as director of Diagnostics at Nebraska Medicine – Bellevue.

“Strategic planning for Neurosciences identified Telestroke as a solution to improve access to neurology care at the bedside,” Gorski says. “Emergency physicians welcome it, as it helps them make the best treatment decisions and reduce unnecessary transfers.”

Moving forward, interdisciplinary teams across Nebraska Medicine worked to identify the best technology and processes to make the solution a reality.

In a nutshell, here’s how the Telestroke protocol works:
•A patient presents with recent onset of stroke symptoms (or first responders indicate a likely stroke)
•Someone in the Emergency Department pages the neurologist on call for Telestroke
•The neurologist calls and speaks with the attending emergency physician
•The neurologist uses an app on their phone or tablet to connect to the Telestroke unit

3-16-Telestroke-3-179x190The Telestroke unit functions similarly to the common app FaceTime from a neurologist’s perspective. This is what it looks like to patients.

•The nurse brings the Telestroke unit into the patient’s room, introduces the neurologist and helps with the exam
•The neurologist explains the process, conducts the exam and develops a treatment plan with the patient/family/emergency care provider
•Treatment begins

The Telestroke unit looks like a large, controllable camera screen that acts similarly to the common smartphone application FaceTime. Special adaptations to the Telestroke unit have made it much more clinically useful.

“The Telestroke unit has a number of features to make it useful to clinicians,” says Kyle Hall, Telehealth program coordinator. “It has a wide angle lens to view the patient, family and the care team as if in the same room. It can show the patient’s CT scans to the neurologist and patient. It can zoom on a patient’s eyes and has a stethoscope to help with diagnoses.”

Plans to extend Telestroke to other Nebraska hospitals are under development, Hall says. In the meantime, Nebraska Medicine will focus on optimizing the use of Telestroke to intervene more often and help give stroke patients a higher quality of life as they recover.

“Time is brain, so the sooner we treat, the better the outcome,” says Dr. Gonzalez.

OHSCU’s Journey of Improvement

Extraordinary Service

3-22-OHSCU-Patient-Satisfaction-690x498OHSCU nurses Devon Wilhelm-McMullen (left) and Ben Rawalt are seen discussing a patient in their unit. OHSCU is celebrating a 30-point gain in their patient satisfaction scores and continue to work on other metrics, including overall job satisfaction.

As an organization, we strive to be one of the top places to work in Omaha, attracting and retaining talented people. That’s certainly the goal of leaders in the Oncology Hematology Specialty Care Unit (OHSCU) who desire to make their unit the best in the world. Their focused journey of improvement began about two years ago and it’s one that continues today.

It began during their review of their National Database of Nursing Quality Indicators (NDNQI) survey results in the fall of 2014. The NDNQI survey assesses nurses’ job enjoyment, as well as their perception of their practice environment, which includes leadership, support and staffing resources.

“It provided us a better understanding of how we needed to address our culture challenges,” explains Theresa Woodrum, OHSCU manager. “We analyzed the survey scores and reached out to Employee Engagement for help.”

“This survey was taken during a difficult time,” adds OHSCU associate nurse manager Heidi Tonne. “Many of our nurses are newer nurses. When you have a newer staff treating very sick patients, it can be stressful.”

Linda Gloe, senior analyst, Organizational Development, conducted confidential focus groups to get an understanding of the staff’s concerns last spring. Gloe’s questions included: What behaviors would you like to see more or less of? What is your role in supporting change?

“I really appreciated that Linda also empowered the staff to also consider ‘what could I do to make this a better place to work?’” says Tonne.

From that effort, OHSCU renewed its commitment to creating a culture of clinical excellence, engagement, professionalism, accountability and improved staff satisfaction. With that, changes were made. Tonne says she and Woodrum began coming in around 3 or 4 a.m. alternating weeks to provide greater access to the night staff and an opportunity to talk with them. The two also made an effort to increase communication by sending out their availability for the day through a Voalte’ text.

Around the same time, OHSCU’s Unit Based Council (UBC) rolled out action plans for call lights and bed checks. They implemented the “5-foot rule” which means anyone within five feet of a patient’s room needs to address a call light, even by simply saying “I will get your nurse”, says Tonne.

“We really embraced the concept ‘every patient is our patient’,” Tonne says.

The unit adopted a vision statement of “Safe. Accountable. Caring.”

The unit’s Press Ganey scores improved dramatically this past summer. They achieved the 100 percentile mark for the question “please rate the hospital” and jumped more than 30 percentile points for the question “how quickly were you helped to the toilet.”

The unit also increased its score by nearly 30 points for the question that rates the hospital staff and made a 15-point increase in the call light response time.

“We were working really hard,” says Tonne. “Staff was very engaged. We also focused on holding each other accountable.”

Tonne says their newer nurses now have more than two years of experience, which helped tremendously with their confidence to care for patients.

“They have grown tremendously in their oncology knowledge and their ability to care for pediatric, adult and critical care patients,” says Tonne. “Our entire staff has worked extremely hard to ensure our patients are well cared for and part of a family, not just another patient.”

Unit leadership is celebrating their impressive gains in their patient satisfaction scores, and while this fall’s NDNQI scores didn’t improve the way they hoped, Tonne is not discouraged.

“It can be emotionally difficult to work on OHSCU because of the nature of the patients we treat, but it is also very rewarding,” she says. “This fall, we had several long-term patients pass away. It’s hard. We can look at our staff and know everyone is working very hard. Not only have our Press Ganey scores improved, but we’ve seen great improvements in our quality scores, too.”

Lung Transplant Patient Completes Major Milestone

Serious Medicine

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Lung transplant recipient Donna Jacobsen was introduced to the media April 15. Alongside the Winside, Neb. resident is Heather Strah, MD, medical director of the Lung Transplant Program.

Participated in the Donate Life Nebraska 5K Race & Heroes Walk

Shortly before Thanksgiving, 63-year-old Donna Jacobsen of Winside, Neb. became the first patient to be added to our lung transplant waiting list. Two months later, on Jan. 26, Jacobsen became the second patient to undergo a lung transplant procedure with Nebraska Medicine’s reignited program.

“I was very proud and a bit nervous,” admits Jacobsen. “I got the call the morning of Jan. 25 and just said, ‘okay – here we go!’ I was ready to start feeling healthy again.”

In 2012, Jacobsen had a cough that wouldn’t go away. As a registered nurse with more than 40 years experience, Jacobsen knew she needed to see a physician. A lung biopsy revealed a diagnosis of idiopathic pulmonary fibrosis (IPF), a disease that causes scarring of the lungs, often resulting in respiratory failure. There is currently no cure.

“I felt fine until August 2014 – that’s when I started going downhill,” remembers Jacobsen. “It got so bad that I had no choice but to retire from the job I loved.”

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Heather Strah, MD, Medical director of Lung Transplantation Program

“When I first met Donna last spring, she was very sick and getting worse quickly,” explains Heather Strah, MD, medical director of the Lung Transplantation Program. “Her oxygen needs were going up and she wasn’t able to walk very far. We were worried that she wouldn’t be able to wait for our lung transplant program to start, but Donna was determined to be transplanted close to home even though there were other programs that could have transplanted her sooner.”

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Aleem Siddique, MD, surgical director of Lung Transplantation Program

Jacobsen’s single lung transplant started around 1:30 a.m. on Jan. 26 and lasted between four and five hours. Aleem Siddique, MD, surgical director of lung transplantation, performed the operation, assisted by transplant surgeon Michael Moulton, MD. A team of anesthesiologists, surgeons, physician assistants, perfusionists, pharmacists, nursing personnel and other staff members were also in the room.

“The surgery went very well without any particular complications,” says Dr. Siddique. “We’re very excited and hope that Donna can lead a fulfilling life. For me, the improvement in quality of life is just as important as the longevity gained with a transplant.”

Jacobsen spent three weeks at Nebraska Medical Center before being discharged. Because her hometown is more than two hours away, she’s been staying at an Omaha hotel while attending daily pulmonary rehabilitation sessions at the med center.

“Donna has done wonderfully during her recovery and is on track to move back home by the end of the month,” says Dr. Strah. “But, in order to complete pulmonary rehab, we’ve asked her to do something very special – walk one mile in the Donate Life Nebraska 5K Race & Heroes’ Walk.”

4-18-Lung-Transplant-Family-690x341Donna Jacobsen found strength in numbers over the weekend. The Jacobsen family took part in the Donate Life Nebraska 5K Race & Heroes Walk.

On April 16, Jacobsen, her husband Randy, their three children and eight grandkids, took part in the walk with other members of Nebraska Medicine’s transplant program.

Donna Jacobsen’s Journey

Watch lung transplant patient Donna Jacobsen’s video to learn more about her journey.

“It’s very emotional for me,” says Jacobsen. “Especially when I start to think about my donor and their family. I can’t thank them enough for what they’ve done.”

“Nationally, it’s estimated that 18 people die every day while waiting for organ transplants. A single donor may save up to eight lives,” adds Dr. Siddique. “To see Donna and other transplant patients doing so well is exactly the positive reinforcement and gratification that keeps patients and providers going during difficult times.”

Jacobsen will continue to receive checkups every few months for the rest of her life. Patients who survive their first year after transplant are typically expected to live seven or eight years, but Dr. Strah has seen many patients who were transplanted 10, 15, 20 years ago who are still enjoying relatively good health.

Jacobsen says she’s excited to get home, spend time with her family and start doing all the work around her house that she didn’t have the energy to do before. But, she will miss seeing members of her transplant team every day.

“Everyone at Nebraska Medicine is simply phenomenal. From the doctors, to the nurses and therapists, I couldn’t ask for better care – and that’s saying a lot coming from a nurse!” says Jacobsen. “I am so grateful this hospital is here in Nebraska. I was able to stay close to home and receive my transplant. I don’t know why you’d go anywhere else.”

Nebraska Medicine’s Lung Transplant Program offers single lung, double lung and heart-lung transplants. Clinicians hope to evaluate 20-30 patients and transplant 10 patients in the first year. Along with extraordinary patient care, the program will provide lung education, research and innovation.

To register as an organ donor, visit www.donatelife.net or www.nedonation.org. For more information about our Lung Transplant Program, visit www.nebraskamed.com/transplant.

Bariatrics Center Achieves National Re-accreditation

Serious Medicine

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The Bariatrics Center recently received national re-accreditation by the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP). The MBSAQIP is a combined program of the American College of Surgeons (ACS) and American Society for Metabolic and Bariatric Surgery (ASMBS), which recognizes commitment to providing multidisciplinary, high-quality, patient-centered care.

To achieve accreditation, bariatrics centers must undergo an independent, voluntary, and rigorous peer evaluation in accordance with nationally recognized bariatric surgical standards. Bariatric surgery accreditation not only promotes uniform standard benchmarks, but also supports continuous quality improvement. All accredited centers report their outcomes to the MBSAQIP database.

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Corrigan McBride, MD, medical director of the Bariatrics Center

Currently, the Bariatrics Center has three surgeons, an endocrinologist and a psychologist, in addition to other providers.

“We set and achieve high standards for patient outcomes (surgical patients),” says Molly Wickert, clinic manager of the Bariatrics Center. “We are evaluated by our peers and have been recognized as having an outstanding program with no deficiencies.”

Bariatric surgical procedures have been shown to reduce obesity, improve mortality, and decrease the health risks from chronic diseases such as cardiomyopathy and diabetes. For these reasons, the MBSAQIP recognizes those facilities that implement defined standards of care, document their outcomes, and participate in regular reviews to evaluate their bariatric surgical programs.

“We are proud to have once again received this designation,” says Wickert. “It is not only a testament to how hard our team works to provide excellent patient care; but also serves as a solid benchmark for patients to utilize when choosing a facility they can trust to provide high-quality bariatric surgical care.”

 

Signs placed on Fred & Pamela Buffett Cancer Center

by Tom O’Connor, UNMC public relations

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Workers put one of the signs in place atop the Fred & Pamela Buffett Cancer Center.

Two large exterior signs identifying the Fred & Pamela Buffett Cancer Center were placed on the building Monday by Kiewit Building Group. The 615,000-square-foot cancer center is located on Dewey Avenue between 44th Street and Durham Research Plaza (formerly 45th Street).

The two signs are identical. One was placed on the north side of the building, the other on the south side of the building.

The cancer center is scheduled for completion in the spring of 2017. Since the project is near completing use of the existing tower cranes, the sign installation had to be scheduled before the cranes were removed, said Kathy Bauer of Tetrad Property Group, the company which is providing owner’s representation services for the new facility.

Unlike other signs that are installed in sections on a building, these signs featured a unique unit assembly system that allowed the signs to be completely assembled at ground level. They were then hoisted onto the building in one piece.

Kiewit monitored weather conditions to determine the install date. “Because of the size of the signs and the fact that we needed to use a crane for placement, it was important that we have minimal wind during installation,” Bauer said.

Several Omaha firms were involved in the signage project. They included:
•HDR, which completed the design for the signage;
•Architectural Wall Systems, which locally manufactured and assembled the sign frame;
•ASI Signs, which fabricated the lettering; and
•Christensen House Moving, which transported the signs to the UNMC/Nebraska Medicine campus.

Here are some other quick facts about the signs:
• The signs weigh 8,000 lbs. each. In addition, there is another 1,400 pounds of weight in the associated rigging needed to put the signs in place.
•They are 36 feet long, 16 feet tall, and 13 feet deep.
•Lettering on the “BUFFETT” name on the signs is five feet tall and is visible from nearly a half-mile away.
•The signs are comprised of zinc panel cladding with aluminum frame and utilize energy efficient LED lighting.
•The signs were moved at midnight on Monday morning when traffic was minimal. They were transported from the Architectural Wall Systems facility.
•The signs are the largest fabricated by Architectural Wall Systems. They took approximately six weeks to assemble.

New U.S. News rankings released

by John Keenan, UNMC public relations

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UNMC’s primary care program is the fifth best in the country, placing in the top five for the second consecutive year, according to the 2017 ranking of the nation’s top graduate schools by U.S. News & World Report.

In other new rankings, the UNMC College of Pharmacy was ranked 25th in the nation, and the College of Allied Health Professions’ physical therapy program was ranked 28th. The last time U.S. News ranked the College of Pharmacy, in 2012, it was 32nd in the country. The physical therapy program also improved in the new rankings, moving from 34th in 2012 to 28th this year.

College of Nursing had three programs ranked: the Master’s of Nursing program was ranked 46th in the country, while the Doctor of Nurse Practitioner program was ranked 54th. UNMC was ranked 73rd in Online Graduate Nursing Programs. U.S. News also ranked UNMC 63rd in research.

U.S. News sent surveys to 170 medical schools to compile its primary care and research lists. It ranked 259 schools for master of nursing, 149 for DNP, 125 for pharmacy and 217 for physical therapy.

“I’m pleased to see in the latest U.S. News rankings that UNMC retains a position among the top primary care programs in the country,” said UNMC Chancellor Jeffrey P. Gold, M.D. “In addition, the new national rankings for the College of Pharmacy and the physical therapy program, as well as our nursing programs, reflect the dedication and hard work of their faculty and students. These rankings should provide us a point of pride, but we also will continue in our efforts to ensure that UNMC delivers world-class education in every aspect of its medical, health care and nursing programs.”

U.S. News does not re-rank every program every year. In rankings compiled in 2015 and 2014, UNMC’s physician assistant program was ranked 9th, public health was ranked 39th and the university was ranked 93rd in biological sciences.

“The continued ranking of our primary care and physician assistant programs among the best in the country, as well as the improved rankings of our pharmacy and physical therapy programs, is a strong indication of the ongoing commitment and dedication of our faculty and staff to providing the best training opportunities to our students,” said Dele Davies, M.D., vice chancellor for academic affairs. “We are constantly striving to innovate in educational and clinical opportunities that enable us to help meet the health needs of all segments of the population.”

For information on the ranking methodology, click here.

Diabetes drug may prevent stroke/heart attacks in people with insulin resistance

Fayad07121Pierre Fayad, M.D.

Pioglitazone, a drug used for type 2 diabetes, may prevent recurrent stroke and heart attacks in people with insulin resistance but without diabetes.

The results of the Insulin Resistance Intervention after Stroke (IRIS) trial, presented at the International Stroke Conference last month in Los Angeles and published in the New England Journal of Medicine, suggest a potential new method to prevent stroke and heart attack in high-risk patients who have already had one stroke or transient ischemic attack.

Pierre Fayad, M.D., professor in the University of Nebraska Medical Center Department of Neurological Sciences, and medical director, Nebraska Stroke Center, was the local principal investigator at UNMC in this large, international study, which was funded by the National Institutes of Health’s National Institute of Neurological Disorders and Stroke (NINDS).

“This is really exciting news,” Dr. Fayad said. “This is the first medication that has been shown to decrease the risk of stroke and heart disease in individuals at high risk for diabetes.”

The study was supported by the National Institutes of Health’s National Institute of Neurological Disorders and Stroke (NINDS).

The IRIS trial is the first study to provide evidence that a drug targeting cell metabolism may prevent secondary strokes and heart attacks even before diabetes develops. Insulin regulates metabolism and keeps blood sugar levels from getting too high, along with many other processes, in the body. Insulin resistance is a condition in which the body produces insulin but does not use it effectively.

“This study represents a novel approach to prevent recurrent vascular events by reversing a specific metabolic abnormality thought to increase the risk for future heart attack or stroke,” said Walter Koroshetz, M.D., director of the NINDS.

“The IRIS trial supports the value of more research to test the vascular benefits of other interventions such as exercise, diet and medications that have similar effects on metabolism as pioglitazone,” said Walter Kernan, M.D. professor of general medicine at Yale University School of Medicine, New Haven, Conn., and lead author of the study. Dr. Kernan was featured in a UNMC Today story when he visited UNMC in 2009.

Close to 4,000 patients from seven countries who had experienced an ischemic stroke or transient ischemic attack within the previous six months were randomized to receive pioglitazone or placebo for up to five years in addition to standard care. The UNMC/Nebraska Medicine study site enrolled a total of 49 patients from Nebraska and Iowa, ranking as the 11th highest enrolling site in the United States.

Ischemic stroke and transient ischemic attacks can occur when a cerebral blood vessel becomes blocked, cutting off the delivery of oxygen and nutrients to brain tissue.

In this study, stroke or heart attack occurred in 9 percent of participants taking pioglitazone and 11.8 percent of patients on placebo, which was a relative decrease of 24 percent. The results suggest that 28 strokes or heart attacks may be prevented for every 1,000 patients who take pioglitazone for up to five years.

Insulin resistance is a hallmark of type 2 diabetes but also occurs in more than 50 percent of people with ischemic stroke who do not have diabetes. People with diabetes are known to have increased risk of stroke.

Previous research suggested that insulin resistance increases risk for stroke, but the IRIS trial was the first to treat it and suggested that the therapy reduced the risk of recurrent stroke and heart attacks. However, pioglitazone is not FDA-approved for the uses studied in the IRIS trial.

In this study, pioglitazone also reduced the risk of diabetes by 52 percent in the study participants.

The study evidenced an additional known side effect of the drug, which is an increased risk of bone fractures. To help doctors and patients choose the best strategy for preventing recurring strokes, future studies will attempt to identify a person’s risk of bone fractures due to pioglitazone. As approved for use in medical practice, the drug also carries additional side effects.

“More research is needed to determine the mechanisms by which pioglitazone decreases risk for stroke and heart attack and increases bone fracture risk, with the hope of developing strategies that maximize benefit and minimize serious side effects in our patients,” said Dr. Kernan.

This work was supported by the NINDS (NS04486).

The NINDS is the nation’s leading funder of research on the brain and nervous system. The mission of NINDS is to seek fundamental knowledge about the brain and nervous system and to use that knowledge to reduce the burden of neurological disease.

About the National Institutes of Health (NIH): NIH, the nation’s medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.

Multidisciplinary Breast Cancer Clinic Provides Team Approach

Today, there are numerous choices available for breast cancer treatment and women want to be a part of that decision-making process. The Nebraska Medicine’s Multidisciplinary Breast Cancer Clinic at Village Pointe Cancer Center provides a very personalized and comprehensive approach to breast cancer care based on a patient’s individual needs and wishes as well as the expertise and careful assessment of a team of breast cancer specialists.

Sarah-Thayer

Sarah Thayer, MD, PhD

“We believe that the best care plan is one that has been developed with the input and expertise of a multidisciplinary team of cancer experts,” says Sarah Thayer, MD, PhD, surgical oncologist at Nebraska Medicine and physician-in-chief at the Fred and Pamela Buffett Cancer Center. “Our multidisciplinary team of experts will help each patient navigate through the many decisions available in breast cancer treatment including lumpectomy, mastectomy, chemotherapy, radiation therapy, targeted therapies and breast reconstructive surgery in a collaborative approach.

The multidisciplinary team includes medical oncologists, surgical oncologists, radiation oncologists, plastic and reconstructive surgeons, oncology nurses, geneticists and social workers who will work closely with each patient to provide a very personalized and patient-directed care experience.

The Seventh: Extraordinary Innovations and Emerging Trends in Transplantation and Oncology

July 12 – 13, 2016

Nebraska Medicine is co-sponsoring a two day conference with OPTUM Health that highlights advances in complex cancer treatment and transplants’ organ failure management. The structure of the Nebraska Medicine’s Multidisciplinary Breast Cancer Clinic will be reviewed, in addition to, key components in managing organ failure.

For more information about this continuing education series, visit optumhealtheducation.com.

As part of the evaluation, all outside films and mammograms are re-reviewed by a specialized breast radiologist. The clinic also offers the newest, most advanced form of mammograms, called 3-D mammography. “This new technology increases detection rates by 40 percent and is able to find the cancers at a smaller size — in all levels of density of the breast,” says Cheryl Williams, MD, radiologist at the Multidisciplinary Breast Cancer Clinic. “This is very important. The smaller a tumor is when we find it, the more likely it is that we’ll be able to cure it.”

“Patients benefit from getting not just one opinion, but a comprehensive plan developed by a multitude of breast cancer experts using the most recent studies,” says Dr. Thayer. “This model allows for enhanced communication between providers and the patient to ensure her goals and individual needs are met.”

When a patient arrives for her appointment, she sees all of the specialists required for that visit in one setting and one appointment. Not only does this save the patient time, but helps eliminate duplication of tests and services. “This streamlined approach to care provides a more comfortable and pleasant experience for the patient,” says Dr. Thayer.

Cheryl-WilliamsCheryl Williams, MD

The Village Pointe Cancer Center is located at 175th and Burke St. just west of the Village Pointe shopping center. The Multidisciplinary Breast Cancer Clinic offers easy access with care provided in an intimate and comfortable environment. Patients can receive an array of cancer services in one convenient location:
•Comprehensive care plan developed by a multidisciplinary team of experts
•Consultative services or second options from cancer experts in medical oncology, surgical oncology, radiation oncology and plastic and reconstructive surgery
•Infusion services within private infusion rooms
•Radiation treatment center
•Women’s Imaging Center with state of the art 3D-mammography and MRI capabilities
•Amenities and supportive services including wig fittings, a free wig bank, prosthetic and bra fittings, yoga, massage therapy, skin care and make-up lessons specifically geared for people with or recovering from cancer

“Addressing a patient’s physical, educational, emotional and spiritual needs are important aspects of providing a more complete and holistic approach to care,” notes Dr. Thayer.

Patients will also be given the opportunity to participate in breast cancer clinical trials offered through the University of Nebraska Medical Center as part of their treatment program.

“The Multidisciplinary Breast Cancer Clinic is designed to provide patients the most oncologically-sound plan in an environment that is more personal, private and positive,” says Dr. Thayer.

To speak to a member of our multidisciplinary breast cancer team or to make a referral, please call 402-559-1600.

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