Progressnotes: Year-in-Review: 2015
The 2015 Year in Review chronicles how MUSC Health has redefined care this year and is working toward “revealing tomorrow” by supporting research, quality initiatives, and new care delivery models that will change the face of health care in the future. Read the Digital Version of the full issue.
Strong Solutions (Quality)
Discovering new ways to strengthen patient safety and quality is an expectation of every member of the MUSC Health team. In 2015, infection control experts succeeded in reducing infection rates, clinicians built more evidence-based practices into Epic electronic medical records, and managers adopted a business-world methodology that leads to controlling costs. For many years, MUSC Health has been building a nursing culture that engages nurses and involves them in organizational decision-making.
In 2015, the American Nurses Credentialing Center recognized that culture with Magnet® designation. A Gallup survey estimates that Magnet® hospitals experience 7.1% fewer safety-related incidents than the industry norm. Culture and commitment come together at MUSC Health for strong solutions, strong lives.
In September, MUSC Health received the ultimate credential for high-quality nursing care.
MUSC Health nurtures a diverse and diversity-aware workforce.
MUSC Health operates on the principles of a High Reliability Organization: leadership engagement, robust process improvement, and a culture of safety.
Throughout the health care industry, there is increased demand for providing value, which is determined by quality of care and cost control. MUSC Health is responding to this demand.
Innovation in the Clinic
Innovation reaching the clinic in 2015 thanks to MUSC Health clinician/researchers includes new drugs for heart failure and cystic fibrosis; new medical devices such as the first MRI-safe implantable cardioverter-defibrillator and a novel spinal surgery rod; and a diagnostic tool that will remove the ambiguity from lung cancer diagnosis. Clinical trials at MUSC Health are setting the standards for care nationwide and offering patients in the region access to revolutionary cancer treatments, including precision therapy and immunotherapy, as well as novel treatments for many other diseases, such as a thermosensitive gel for Menière’s disease and a gene therapy for sickle cell disease. New centers are fostering a culture of innovation and helping translate that innovation into improved patient care.
MUSC Health cardiologist Dr. Michael Zile was on the international executive committee of the PARADIGM-HF trial, which led to approval in the summer of 2015 of the first drug for heart failure in 20 years.
The first MRI-safe implantable cardioverter-defibrillator and a novel spinal rod with a sine wave (oscillating) shape are among the devices MUSC Health clinicians helped shepherd into/toward the clinic in 2015.
.MUSC Health’s Comprehensive Stroke & Cerebrovascular Center played a role in the revision of the American Heart Association (AHA) guidelines for treating certain stroke patients. The guidelines included the recommendation that stent retrieval devices be used to remove blood clots in large arteries for patients with acute ischemic stroke
Clinical trials conducted at MUSC Health and other sites that studied the efficacy of therapies for cystic fibrosis (CF) have revealed a winning two-drug combination that is a significant step toward a cure for CF. MUSC Hollings Cancer Center researchers also participated in the National Lung Screening Trial, which provided evidence that is the basis for new best practices in screening for lung cancer.
In August, MUSC was awarded $13.5 million by the Patient-Centered Outcomes Research Institute (PCORI) to conduct a 25-site trial enrolling 25,000 patients that will answer a long-standing clinical question: what is the best approach to anticoagulation after hip or knee replacement to prevent pulmonary embolism?
Encouraging a culture of innovation and helping translate creative ideas into actual innovation in the clinic is the mission of the MUSC Health Innovation Center, one of only a handful of such centers nationwide.
In 2015, MUSC Hollings Cancer Center offered opportunities for cancer patients to enter trials of two of the most revolutionary approaches to cancer care: precision therapy and immunotherapy.
Learn more about trials at MUSC Health of a thermosensitive gel for Meniere's disease, a gene therapy for severe sickle cell disease, surgical management vs. intensive medical management in patients with asymptomatic narrowing of the carotid artery, and a liver-directed therapy for intrahepatic cholangiocarcinoma.
New Care Delivery Models
Health care resources in South Carolina are concentrated in its metropolitan areas, limiting access for many of its rural residents and threatening to divide its population into health care “haves and have nots.” The state’s burden of chronic diseases, such as stroke, diabetes, and heart disease, is high, with increased complication and mortality rates among rural minority populations. Too often, patients with limited access to care have relied on emergency departments as a last resort, receiving care too late and at a high price tag for the state. South Carolina is responding with an ambitious telehealth initiative that will begin to erase health care inequities by delivering high-quality, affordable care, including preventive care, to all its residents.
The South Carolina Telehealth Alliance is committed to improving access to affordable, quality care via telehealth for all South Carolina residents.
A collaborative spirit and an enhanced telehealth infrastructure are enabling hospitals throughout South Carolina to cooperate in unprecedented ways to provide coordinated, convenient, and cost-effective patient care to all of South Carolina’s residents.
Nutritional counseling was the first service provided by Virtual TeleConsultation at MUSC Health and remains one of the most popular, with almost 600 teleconsultations in 2015.
All schools in rural Williamsburg County now have easy access to pediatric care thanks to MUSC Health's school-based telehealth program.
The Technology Applications Center for Healthful Lifestyles (TACHL) in the MUSC Health College of Nursing is committed to developing patient-friendly mobile health (mHealth) technology that seamlessly connects patients and health care providers using apps, body sensors, remote monitoring devices, and the electronic health record.
Tomorrow’s clinical innovations will spring from today’s research only if models of discovery evolve to promote translation. The South Carolina Clinical & Translational Research Institute, which received a $23.7 million follow-on grant in 2015 from the NIH’s Clinical and Translational Science Award program, provides research teams with the infrastructure to move innovation into the clinic. Better collaboration between basic scientists and clinicians will also be needed if research is to yield clinically meaningful answers, and multi-institutional collaborations will provide the required diversity of expertise and scope of resources.
New models of funding, including industry/academia partnerships and entrepreneurial ventures, are also necessary. This strategy has worked well for MUSC, which garnered $247 million in research funding in fiscal year 2015, representing a 12% increase in overall funding and a 32% increase in corporate funding since last year.
In May 2015, MUSC Health entered into a collaboration with Bristol-Myers Squibb (BMS), the goal of which is to identify biomarkers and possible drug targets for fibrotic disease.
In 2015, productive clinician/researcher collaborations led to a new approach to preventing organ rejection after transplant using nanotechnology and a smart wound dressing.
In 2015, MUSC researchers participated in a trans-Atlantic partnership that identified the gene causing mitral valve prolapse and were funded to lead a world-class team in developing a new line of cancer therapeutics.
In 2015, Ford received new support from the National Cancer Institute to fund an educational approach to the crisis: a $1.2 million, five-year grant that connects youth in the most affected communities with leading MUSC cancer researchers.
Read about five start-up companies that are working to translate discovery into the clinic.