May 2016 Newsletter

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Department of Medicine eNewsletter
May 2016
:: Interview
:: Department News
:: Department Events
:: Development & Diversity
Research Day Awards

Asrar Alahmadi, MD
Nissreen Elfadawy, MD
Will Garner, MD
Won Ho, MD
Ellen Kim, MD
JaMia Washington, MD

Sejal Danawala, MD
Megan Moini, MD
Paul Shaniuk, MD

Nadim El Chakhtoura, MD
Folashade Otegbeye, MD
Mo Sabeh, MD

Graduate Student/
Postdoctoral Researcher
Paola Menghini
Jonathan Ray
Nivetha Subramanian
Department of Medicine Awards

Master Clinician Educator
Joseph Krall, MD
Lavinia Negrea, MD
Thomas Knauss, MD

Faculty Teacher of the Year - Inpatient
Christina Hirsch, MD

Faculty Teacher of the Year - Outpatient
David Blumenthal, MD

Faculty Clerkship Teaching Award
Aaron Kistemaker, MD

Agre Award
Gregory Cooper, MD

Ambulatory Excellence
Leland Hull, MD
Neetika Srivastava, MD

Resident Clerkship Award
Aniket Rali, MD
Rachel Romero, MD
Rishi Shah, MD

Norman Gordon Award
Yosra Moria, MD

Peter Morgan Award
Ahmed Alsalem, MD

Willard Bernbaum Award
Chante Karimkhani, MD

Harold Klein Award
Aditya Khetan, MD

Charles Carpenter Award
Nate Summers, MD
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department interview
Christine Koniaris, MD, Medical Director of Palliative Care at University Hospitals Case Medical Center, discusses the common misconceptions about palliative care, shares the impact it has on quality and the role it plays for patients and their families.
What is the most common misconception about palliative care?

Palliative care is specialized medical care for people living with a serious illness. Our palliative care team includes palliative care doctors, nurse practitioners, social workers and a chaplain, all of whom work with a patient's other physicians to provide an extra layer of support. Palliative care is appropriate at any age and at any stage in a serious illness; it can be provided along with curative treatment.

Our team focuses on providing relief to patients from the symptoms and stress of serious illnesses. The goal is to improve the quality of life for both the patients and their families. We do this by controlling symptoms that negatively affect their lives and helping to initiate important conversations regarding their goals of care and what makes sense for them based on their preferences. We also help maintain communication between the patient/family and their medical providers so that they do not feel lost in the medical lingo.
People often confuse palliative care with hospice care. Hospice care is for patients with a prognosis of less than six months who are no longer receiving curative treatment for their underlying disease. Like palliative care, hospice care focuses on controlling symptoms and maximizing quality of life but the focus shifts to providing comfort. Palliative care can help patients and families transition to hospice care. This occurs when it makes sense based on the previously verbalized goals and/or when there are no longer any curative options available.

What is currently being done at University Hospitals Case Medical Center to establish and promote the Palliative Care Program?

We have three core teams here at UH Case Medical Center. At UH Rainbow Babies & Children's Hospital we have Dianna Yip, DO, leading the pediatric team; at UH Seidman Cancer Center we have Elizabeth Weinstein, MD, leading the outpatient supportive oncology clinic; I lead the inpatient services for UH Case Medical Center. Jennie Savoca, MD, who trained at Brown University, recently joined the inpatient team.
Thanks to the ongoing support from the Department of Medicine, as well as University Hospitals administrators systemwide, we have begun envisioning a palliative care program for the whole system. This includes assessments of the palliative care needs at our community hospitals, seeing how we can fill those needs, provide educational opportunities for staff, and regular meetings to touch base and ensure continued growth. We expect requests for our services to continue to grow and plan to expand eventually to offer a full range of services across all care settings.

How is the shortage of palliative care providers being addressed?

Traditional medicine has afforded patients the opportunity to live longer lives. While this is an ultimate benefit, the result is that many more people are living with chronic diseases. Health systems across the country have signed up to build palliative care programs resulting in a burgeoning demand for palliative care providers. Nationally palliative care fellowships produce too few physicians yearly to gain ground on this increasing demand. There are a number of national efforts currently under way to facilitate training of physicians to rectify the imbalance of demand with supply of physicians. This includes the use of advanced practice providers such as nurse practitioners with advanced training in palliative care. Nurse practitioners are invaluable to our team approach. At UH Case Medical Center we plan to open a palliative care fellowship program for both nurse practitioners and physicians; we hope to help fill the needs of our system and meet the needs of our patient population going forward.

What role does palliative care services play in improving quality? How has the field of palliative care been changing lately?

As hospitals and health care systems work more on lean operations, palliative care research has repeatedly shown to improve goals of care conversations and advanced directives, increase patient satisfaction, as well as decrease readmissions and length of stay. As treatment options are advancing, the benefits of involving us sooner in patients' care have also been proven.
At the same time, we look forward to focusing our time and energy toward research. We have projects under way with both the heart failure and trauma teams. Many yet to be answered questions about how best to alleviate the pain and suffering of those with a serious illness exist. We are eager to contribute to this exciting frontier of medical research.

Your patients are often going through tough times and experience turbulent emotions. How do you go about establishing trust with them at those difficult times and prevent them from closing off emotionally?

It is important to remember that everyone has a story, so the goal is to meet our patients "where they are" and provide ongoing support. I always tell patients that no matter where they go within the hospital, we will continue to see them, serving as their constant care team members. Patients find this continuity to be very supportive and reassuring during the time in their lives that is wrought with complexities. This is why our interdisciplinary team approach works so well. By using various team members as well as working closely with art and music therapy, we can help support our patients and their families. Palliative care is that symbolic blanket that comforts patients and their families, making them feel protected and secure throughout their medical journey.

department news report

Division of Cardiovascular Medicine
Mahazarin Ginwalla, MD, has been nominated by the International Society for Heart and Lung Transplantation to serve as a representative on the multisocietal writing committee led by the American College of Cardiology (ACC) Competency Management Committee. The writing committee will focus on advanced training in heart failure and cardiac transplantation.

Division of General Internal Medicine
Jill Huded, MD, published her research in an article entitled "Frailty Status and Outcomes after Transcatheter Aortic Valve Implantation" in the American Journal of Cardiology. Dr. Huded found that the safety of TAVI is not affected by frailty status, but patients with frailty are less likely to be discharged directly home after TAVI. Dr. Huded also wrote a book chapter entitled "Skilled Nursing Facilities and Post-Hospitalization Options for Older Adults" in the New Directions in Geriatric Medicine. The chapter provides information on the post-acute setting available to older adults following a hospitalization and key features of each. Also included are resources to make the decisions for post-acute care that can also be provided to family members and patients.

Goutham Narla, MD, PhD, was elected to the American Society of Clinical Investigation. The election recognizes and celebrates Dr. Narla's significant research accomplishments.

Atilla Nemeth, MD, was selected to serve on two committees for the Society of General Internal Medicine (SGIM). Dr. Nemeth will work with the Education Committee and the VA Task Force Committee.

Ganesh Pantham, MD, published an article entitled "Assessment of the Incidence of Squamous Cell Papilloma of the Esophagus and the Presence of High-Risk Human Papilloma Virus" in the Journal of Disease of the Esophagus. Dr. Pantham argues that the incidence of esophageal papilloma has increased by fourfold over the past 14 years and about half of the tested patients demonstrated high risk HPV. Dr. Pantham believes that this may suggest a potential growing risk for esophageal squamous cell cancer in the future.

Division of Hematology & Oncology
Evi Stavrou, MD, was appointed to the Board of Trustees of Case Western Reserve University as the inaugural occupant of the Oscar Ratnoff Professorship in Medicine and Hematology. This endowed chair represents a high academic honor and celebrates Dr. Stavrou's scientific contributions.

Division of Infectious Diseases & HIV Medicine
Curtis Donskey, MD, received the 2016 Award for Publication Excellence from the Association for Professionals in Infection Control and Epidemiology (APIC) and the American Journal of Infection Control (AJIC) Editorial Board of Directors.

Robin Jump, MD, PhD, was selected for the Member Spotlight of the Society for Healthcare Epidemiology of America (SHEA). Dr. Jump was recognized for the work she did in the consultation service for the Louis Stokes Cleveland VA Medical Center's long-term care facility. Dr. Jump's program reduced overall antimicrobial use by 30 percent over the past 18 months. Building upon the success of the program, Dr. Jump is also recognized as the principal investigator of a multisite VA study designated to help providers at long-term care facilities improve their use of antimicrobials.

Michael Lederman, MD,
received the Faculty Distinguished Research award. This honor recognizes Dr. Lederman's outstanding contributions to research that made a lasting impact in the field of infectious diseases. The award is given to faculty who uphold and build upon Case Western Reserve University's history as an innovative and research-driven institution.

Usha Stiefel, MD, received the 2016 Helen Evans Mid-Career Faculty Development award from the Women Faculty of the School of Medicine. The prestigious award is given to faculty members demonstrating outstanding potential for a promising career in academic medicine.
department conferences & events
Chairman's Intern Welcome Dinner
Date: Thursday, June 16
Time: 6:00 - 9:00 p.m.
Location: Shoreby Club, 40 Shoreby Drive, Bratenahl, OH 44108
development & diversity events
Interrupting Bias in Faculty Searches
Date: Friday, June 17
Time: 9:00 - 10:30 a.m.
Location: Adelbert Hall, Room M1
Sponsor: Case Western Reserve University Office for Inclusion, Diversity, and Equal Opportunity
Audience: All faculty interested in improving their faculty searches; the session explores barriers within the faculty search process that prevent the fair evaluation of underrepresented candidates

Improving Presentation and Teaching Skills
Date: Tuesday, June 21
Time: 12:00 - 1:00 p.m.
Location: Frohring Auditorium, BRB Room 105
Sponsor: School of Medicine Office of Faculty Affairs, Office of Faculty Development and Diversity
Audience: All faculty interested in optimizing their professional presentation skills and executive presence

Case Forum to Discuss the Interdiversity and Inclusion: External Review Report
Date: Tuesday, June 28
Time: 12:00 - 1:30 p.m.
Location: Tinkham Veale University Center, Ballroom C
Sponsor: Case Western Reserve University Office for Inclusion, Diversity, and Equal Opportunity
Audience: All faculty interested in learning more about diversity initiatives on Case campus and making suggestions for the University's Diversity Strategic Action Plan. For more information click here.

Among the nation's leading academic medical centers, University Hospitals Case Medical Center is the primary affiliate of Case Western Reserve University School of Medicine, a nationally recognized leader in medical research and education.