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Patient Satisfaction Soars at UMH’s Emergency Department

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Patient Satisfaction Soars at UMH’s Emergency Department

Special to UM News


From left are UMH CEO David Zambrana, COO Kymberlee J. Manni, and Todd Haner, director of the Emergency Department.

MIAMI, Fla. (July 28, 2015)—Following a dramatic four-month rise in patient-satisfaction scores, the Emergency Department at University of Miami Hospital stands as a textbook example of what is possible when top management makes a true commitment to change and the entire staff responds to the personal satisfaction that comes from improved performance.

The satisfaction measures that UMH administrators track closely in the monthly Press Ganey Emergency Department Report are those comparing UMH with approximately 230 peer hospitals across the U.S. The response they value most is “likelihood of recommending.” In April, UMH was ranked in the bottom quarter, with a score in the 24th percentile; the current score is in the 96th percentile.

“Improvement this substantial in such a short time is a remarkable achievement,” said Pascal J. Goldschmidt, M.D., Senior Vice President for Medical Affairs and Dean of the Miller School of Medicine and CEO of UHealth. “It demonstrates what can happen when leadership and staff are given the opportunity to think of new ways to focus on the most important element in medicine — the patient. I am very proud of what they have accomplished.”

Many other measurements, ranging from arrival to release, mirrored that level of improvement. The changes behind the improved numbers, however, took much longer than four months to implement.

“I have worked here for seven years, and throughout all of that time the Emergency Department has struggled,” said Kymberlee J. Manni, Ph.D., UMH’s Chief Operating Officer. “A little more than a year ago, top management committed to a $3.9 million makeover, and for the past 12 months, my team has been on a mission to improve the department. During that time, we have re-engaged the Director, revamped the entire staff, changed our lab test procedures and completed a major renovation of the entire space.”

“The Emergency Department has been one of our areas of focus for some time,” said David Zambrana, D.N.P., M.B.A., CEO of UMH. “It is where, because of its function, we have our least-planned patient encounters. If we can provide superior care in what is often a patient’s greatest time of need, we will build a reputation that produces strong, lasting relationships with the entire community.”

“The commitment at the top empowered me to finally do what needed to be done,” said the department’s Director, Todd Haner, D.N.P., M.B.A., a highly experienced administrator who was brought to Miami in 2012 from a community hospital in Naples, Fla., to turn things around. “We really needed to shake the place up and start again. It begins with the right team; it’s easy to have people with the right skills but not the right fit. The people working here now are here for the right reasons.”

It didn’t take long, in fact, for the department’s 105 staffers to see that management’s commitment to change was real. New physicians with emergency department expertise were contracted from TeamHealth, an outsourcing organization, to work under the direction of David M. Lang, D.O., Medical Director of the department. The 32-bed facility was split into two zones, each run by a team of three nurses and two technicians. A laboratory technician was added to the department to verify orders before they are sent to the lab and track them to make sure they come back as quickly as possible.

“I am grateful to Dr. Lang for his commitment to improving the patient experience,” said Steven Falcone, M.D., M.B.A., Executive Dean for Clinical Affairs and CEO of the UHealth Clinical Practice.

The nurses’ station was torn out and rebuilt. A new clinical area with five new bays was added. Several parking spaces were eliminated, and a new reception area was built in their place. New curtains and paint lightened and brightened the whole department.

One of the biggest morale boosters was new uniforms. Staffers had a say in choosing the color of the new scrubs, which also had the hospital logo embroidered on them.

“The rest of the departments began seeing our uniforms, and they wanted embroidery, too,” said Haner. “Now there’s a spirit of competition within the hospital, and our people are proud of how good they look.”

The last frontier, he said, was the patient experience.

“We renovated not just the look but also the operation of every place that has a patient touch point,” said Haner. “For example, we added a greeter at the front desk. Instead of treating you like a number, they get up and engage you in a conversation. And we don’t call that area the ‘waiting area.’ We don’t want patients to spend much time there. We call it the ‘reception area.’”

Patients don’t leave, either, without an exit interview and a business card.

“We want their last memory to be that they were treated well,” said Haner. “If they have any issues, we try to resolve them on the spot; if that isn’t possible, we will follow up later with a phone call.”

UMH’s Emergency Department is a busy place, treating approximately 120 patients each day. As all of the changes took effect, staffers could feel the improvement and their spirits soared. Haner spurred that morale shift with a tracking board that he updates every day. The staff knows how long it takes a patient to see a physician and how long it takes a patient to be discharged, and it keeps them engaged.

“It means a lot to me when they come to me and say, ‘What’s our score today?’” said Haner. “Our people know that today’s health care consumers are savvy. How we treat them determines if they are going to come back. In today’s market, we have to go the extra mile.”

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Run 4-LIFE on October 11 to Benefit Organ, Eye, and Tissue Donation

Run 4-LifeThe Life Alliance Organ Recovery Agency at the University of Miami Miller School of Medicine will hold Run 4-Life on Sunday, October 11 to benefit organ, eye, and tissue donation education efforts. The 5K run/walk will start at 7:30 a.m. at Charnow Park, 300 Connecticut Street, Hollywood, Florida, following a 3.1-mile course along the Hollywood Beach Broadwalk and back to the park.

To register, view the course, or for more information visit Run 4-Life 2015.


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Sports Medicine Researchers and Athletes Test  Concussion Detection Goggles

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Sports Medicine Researchers and Athletes Test Concussion Detection Goggles

Special to UM News


Andrea Green, assistant professor of otolaryngology, helps Caitlin Fryer, a forward on the women’s soccer team, test the new goggles.

The University of Miami football team and the women’s soccer and volleyball teams helped the Miller School of Medicine Division of Sports Medicine test new goggles that detect mild traumatic brain injury last week at the Hecht Athletic Center. UM researchers are relying on feedback from the student-athletes to fine-tune programming in the I-Portal PAS Goggle.

“This is the first time it’s being used on athletes,” said Mikhaylo Szczupak, a postdoctoral research fellow in the Department of Otolaryngology, “and it’s being done for the first time at the University of Miami.”

Developed by Neuro Kinetics, Inc., the I-Portal PAS goggle is outfitted with software including diagnostic tests that can determine, at the site of injury, whether an athlete can return to the field or needs to seek further medical attention for mild traumatic brain injury. The athletes, who volunteered their time, were excited to be a part of the week’s testing.

“Everything with technology is so much more innovative now,” said Shannon McCarthy, a defender on and one of the captains of the women’s soccer team. “So to have computerized, concrete findings on the spot that seem super accurate can only make us athletes safer and better off in the long run.”

The project is advancing under the guidance of the University of Miami Sports Medicine and Performance Institute and the Athletics Department, with help from Lee Kaplan, chief of the Division of Sports Medicine; Gillian Hotz, director of the Concussion Program; and Vinny Scavo, head athletic trainer. The work is funded by a grant to Michael E. Hoffer, director of the Vestibular and Balance Program in the Department of Otolaryngology, from the NFL, Under Armour, and General Electric.

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Team Identifies Gene Causing Neuorological Disorders

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Team Identifies Gene Causing Neuorological Disorders


This high-resolution microscope image shows the donut-shaped outer mitochondrial membranes. Unlike typical mitochondrial transporters, SLC25A46 localizes to the outer mitochondrial membrane.

CORAL GABLES, Fla. (July 13, 2015)—Researchers at the University of Miami have discovered and characterized a previously unknown disease gene linked to the degeneration of optic and peripheral nerve fibers. Their study, “Mutations in SLC25A46, encoding a UGO1-like protein, cause an optic atrophy spectrum disorder,” is published in the journal Nature Genetics.

Patients with mutations in this gene present symptoms similar to optic atrophy and Charcot-Marie-Tooth Type 2 (CMT2), including vision loss and weakening of the lower leg and foot muscles beginning in the first decade of life.

The novel variants occur in a gene called SLC25A46 that functions in mitochondria, organelles inside animal cells known as the “cellular engines.” They transform food into fuel that allow cells to carry out energy-demanding functions.

“Mitochondria play a large role in human health,” said Alexander Abrams, Ph.D. student in neuroscience at the Miller School of Medicine and first author of the study. “Although we study rare diseases such as CMT2 and optic atrophy, the implications encompass all forms of neurodegeneration, including Lou Gehrig’s and Parkinson’s Diseases.”

Mitochondria constantly undergo fusion and fission to respond to cellular energy demands. By changing their size and connectivity through fusion and fission, mitochondria can travel to regions in cells where they are needed.

“Our study reveals that disrupting SLC25A46 causes mitochondria to become both more highly interconnected and improperly localized in cells,” said Julia E. Dallman, assistant professor of biology in the College of Arts and Sciences and a senior author of the study. “These data support a critical role for SLC25A46 and mitochondrial dynamics in the establishment and maintenance of neuronal processes.”

SLC25A46 encodes an atypical protein in the SLC25 family. SLC25 family members act like a channel, transporting molecules across the bilayer membranes inside mitochondria. But unlike the majority of human SLC25 family members (there are 53) that transport molecules across the inner mitochondrial membrane, SLC25A46 settles on the outer mitochondrial membrane where it regulates mitochondrial dynamics.

Mutations in the genes associated with mitochondria dynamics OPA1 and MFN2 are linked to similar mitochondrial disorders. Homologous genes in baker’s yeast work in combination with a gene called UGO1, which has ancestral similarities to SLC25A46. The new findings suggest that the SLC25A46 and UGO1 proteins may play similar roles.

Given the similarities between the diseases caused by mutations in OPA1, MFN2 and SLC25A46, these genes could be involved in common pathological mechanisms of neurodegeneration, the study says.

“This finding builds on our discovery of MFN2 as a major disease gene in this area over 10 years ago,” said Stephan Züchner, professor and chair of the Dr. John T. Macdonald Foundation Department of Human Genetics, at the Miller School of Medicine, and a senior author of the study. “Only through the new genome sequencing methods and active global data exchange were we able to solve this puzzle.”

The study is a collaborative effort with investigators from nine universities and research institutions in the United States, Italy, and the United Kingdom. Coauthors from UM’s Dr. John T. Macdonald Department of Human Genetics and the John P. Hussman Institute for Human Genomics are post-doctoral fellows Adriana Rebelo and Alleene V. Strickland, graduate Michael A. Gonzalez; Ph. D. candidate Feifei Tao, Fiorella Speziani, former research project manager; Lisa Abreu, clinical research coordinator; and Rebecca Schüle, M.D., Ph.D., visiting Marie-Curie Fellow. Other Miller School co-authors are Antonio Barrientos, professor of neurology, and Flavia Fontanesi, research assistant professor in the Department of Biochemistry and Molecular Biology.

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Miller School Cardiologist and Neurologist Play Key Roles in New Report on Cardiac Arrest


Miller School Cardiologist and Neurologist Play Key Roles in New Report on Cardiac Arrest

Special to UM News

Ralph L. Sacco, M.D., M.S., and Robert J. Myerburg, M.D.

Ralph L. Sacco, M.D., M.S., and Robert J. Myerburg, M.D.

MIAMI, Fla. (July 7, 2015) — An expert committee assembled by the Institute of Medicine (IOM) has produced an important new report proposing methods for increasing survival rates and quality of life following cardiac arrest, and two prominent Miller School of Medicine physicians—cardiologist Robert J. Myerburg, M.D., and neurologist Ralph L. Sacco, M.D., M.S.—played key roles on the committee.

The report recommends seven courses of action, including a national database, new public education and training initiatives, and programs for improving response times in and out of hospitals. Read the full story

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