Collaboration advances excellence in clinical care and clinical research

As an integrated health system, University of Iowa Health Care unifies the Carver College of Medicine, UI Hospitals and Clinics, community clinics, and the University of Iowa Physicians (UIP) to ensure that our missions as an Academic Medical Center (AMC) combine to provide high-quality health services to the region, while advancing missions of education and research. Although many of you may take this for granted, you might not be aware that integrated health systems and academic partnerships that support our missions are not the usual model across most AMCs. Other structures at times may impose challenges in implementing new initiatives because of competing interests or priorities. Thus, our unified structure should make us stronger, nimbler, and more adaptable. Change remains a challenge, but our culture of collaboration at Iowa has allowed us to innovate in interdisciplinary initiatives that support our diverse missions.

A recent example of interdisciplinary collaboration that leads to extraordinary results can be found as an offshoot of institutional efforts to reduce surgical site infections in patients undergoing colon and cardiothoracic surgery. Eight different departments, including members of the Quality Improvement Program, provided representatives to this working group. Members included Dr. Jorge Salinas, clinical assistant professor in GlucoseMonitoringInfectious Diseases and Hospital Epidemiologist, and physician assistant Sarah Nolan and nurse practitioner Melissa Collier, both of whom are members of the Division of Endocrinology and Metabolism. Nolan’s and Collier’s expertise in inpatient blood glucose management provided an essential perspective to the larger team. By monitoring and maintaining acceptable glucose levels in these surgical candidates, the team has successfully prevented episodes of hyperglycemia in these patients. An impressive 40 percent drop in infections and elimination of all instances of hyperglycemia are a strong testament to the effectiveness of the working group’s collaboration. Although I understand that their story may not be part of the upcoming Quality and Safety Symposium later this month, this stands as an impressive model for other groups contemplating their own QI projects.

Other members of our department are also piloting their own patient care improvements, on large and small scales. Dr. Arwa Aburizik holds dual appointments in our department and in Psychiatry. As Oncology Section Chief Dr. Mo Milhem pointed out last month, she has developed a group therapy service that also incorporates access to social support for people with cancer and their families. Another oncologist, Dr. Sneha Phadke, is tackling a different aspect of the neuropsychological challenges of patients undergoing treatment of cancer, as she searches for a better understanding of the adverse cognitive impact of chemotherapy treatment, termed “chemo brain.” Dr. Phadke and Dr. Kanchna Ramchandran recently received an American Cancer Society pilot grant to identify biomarkers of “chemo brain” that could be leveraged to generate novel therapeutics for this syndrome in clinical trials.

clinical-trial-iconOur clinical trials portfolio remain another distinguishing strength of UI Health Care. A major component of our success in this area is the administrative support required to manage their design, recruitment, and budgets. Without experienced people like Kimberly Sprenger in the Institute for Clinical and Translational Science, our ability to find breakthrough treatments for diseases such as cystic fibrosis would be diminished. Her receipt of the David J. Skorton Award for Staff Excellence in Service to the University of Iowa is a worthy recognition of the difference her work has made in the lives of countless people.

And speaking of awards, I would like to add my congratulations to the chorus praising Dr. Alicia Gerke (Pulmonary) and Dr. Poorani Sekar (Infectious Diseases) for their receipt of UIP Clinical Awards this year. Each of them has distinguished themselves with consistent creativity and compassion in their care. You can read some of what their nominators had to say here. In the case of Dr. Sekar, you can also read some comments from patients who have nominated her for You Make a Difference awards. Congratulations to both Dr. Gerke and Dr. Sekar!

One division that has provided world-class care for decades are the faculty and providers in the Division of Cardiovascular Medicine. Cardiologists, in fact, were some of the early pioneers at Iowa that laid the groundwork of our institution’s reputation for discovery and healing. Under the leadership of Dr. Barry London, the division continues to find new treatments and new understanding of some of the most vexing and pressing threats to human health. I am grateful for his comprehensive overview of the division’s activity. It is truly impressive the number of research grants, clinical breakthroughs, and educational achievements its members deliver every day.

 

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