MAY / JUNE 2006

BULLETIN

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Vishal Bali, at left, with members of the Wochhardt team: “Stability is an area of great concern as we take a look at how Wockhardt nursing services will emerge as the front-line, leading nursing program in India.”

Nursing professional development tops Wockhardt agenda
During a weeklong strategic planning session in Boston, leadership from Wockhardt Hospitals teamed with HMI to formulate plans for the coming year. Wockhardt, which earned accreditation by Joint Commission International last year, is looking to enhance health care quality throughout its network, including facilities in Bangalore and Hyderabad.

Wockhardt and HMI have prioritized the implementation of clinical training and leadership development for the network’s nursing staff, as well as the development of specialty programs through clinical collaborations with Harvard Medical School-affiliated hospitals. The Wockhardt contingent included Vishal Bali, vice president; Lloyd Nazareth, MD, general manager; Vikram Raghuvanshi, MD, general manager of business development; and Zahabiya Khorakiwala, director of business development.

“Stability is an area of great concern as we take a look at how Wockhardt nursing services will emerge as the front-line, leading nursing program in India,” said Bali. “As nurses climb the clinical ladder, we are asking ourselves: what reinforcements can we give them?”

Wockhardt will address this issue through a network-wide initiative focused on developing nursing leadership. The program will be led by Elizabeth Kuriakose, chief of nursing at Wockhardt Hospital & Heart Institute in Bangalore, and Elizabeth Brown, RN, MSN, MBA, HMI director of clinical services. The challenges facing Wockhardt, including high turnover rates and a young managerial staff, exist on a global level. Brown emphasized the wide-ranging need for building an infrastructure that encourages professional development for nursing staff. “It’s extremely important to provide nurses with a clear pathway for clinical competence growth with milestones of reward and recognition,” said Brown, who headed a similar nursing leadership program as part of HMI’s partnership with Acibadem Healthcare Group in Turkey.

Kuriakose and Brown met with nursing leadership at Children’s Hospital and Beth Israel Deaconess Medical Center (BIDMC) to discuss how to address nursing administrative and clinical issues. They also focused on developing nursing leadership and education in the areas of labor and delivery, neonatal intensive care, and pediatrics. Kuriakose and Brown will lead a nursing work group at Wockhardt that will continue these discussions via videoconference in the coming months.

During the visit, Wockhardt also focused on its goal of developing clinical collaborations with Harvard Medical School-affiliated hospitals in the specialty areas of emergency medicine, pediatric intensive care, and minimal access surgery. The group made visits to the medical/surgical and cardiac intensive care units at Children’s Hospital, as well as the emergency room and minimal access surgery laboratory at BIDMC, among other facilities. Wockhardt also plans to work with HMI to enhance its programs in neonatology critical care, obstetrics, oncology, and cosmetic surgery.

HMS faculty member joins TMDU medical education initiative during visiting professorship

Dr. Clifford Lo

Clifford Lo, MD, MPH, ScD has completed a visiting professorship on behalf of HMI at Tokyo Medical and Dental University (TMDU). The program, which ran from February to April, was designed to help further medical education reform efforts at TMDU, particularly in the areas of clinical teaching and faculty development.

Lo, who specializes in pediatrics and nutrition at Children’s Hospital, is Assistant Professor of Pediatrics and Nutrition at Harvard Medical School (HMS) and Harvard School of Public Health (HSPH). During his two-month stay in Tokyo, Lo worked extensively with a group of seven fifth-year students in preparation for their arrival at HMS, where they are currently taking clerkship electives in HMS-affiliated hospitals. The goal was to introduce the students to the U.S. style of clinical education, and prepare them to see patients on their own—an opportunity not available to medical students in Japan.

“In Japan, students are observers, even during the fifth and sixth years, which are spent in the hospital wards,” said Lo. “TMDU’s students were very eager to have the opportunity not only for more active participation in patient care, but also for discussion with faculty.”

Lo met with several groups of seven to eight students for six sessions each week. During these meetings, the students presented patients they had seen, discussed the pathophysiology of each case, and worked to improve their ability to perform differential diagnosis.

Since partnering with HMI in 2002, TMDU has been working to introduce more active learning into its curriculum, and has used a series of HMI-led faculty development programs to help institute reforms focused on problem-based learning, case teaching, and communication. During the same period, HMI and TMDU have annually facilitated HMS-based clerkship experiences for a contingent of top students. According to Lo, the student exchange programs are closely connected to the TMDU’s long-term vision of improving medical education not only at that institution but throughout Japan.

“The hope is that upon returning to TMDU, these students will become part of the reform of the Japanese medical education system. TMDU is investing in them as the next wave of residents and teachers,” said Lo.

Of course, to accomplish its goals, TMDU must look to its current crop of educators to adopt innovative teaching strategies and help drive systematic change in the institution. Each week during his visit, Lo led faculty development sessions with groups of junior faculty and chief residents. “We would have these faculty sit in on a case presentation and discussion, and then select one of them to lead the next discussion. The objective was twofold: first, to help the faculty become comfortable in this teaching format, and second, to emphasize the importance of medical reasoning in providing patient care. We encouraged the faculty and students to discuss all the possibilities pertaining to the diagnosis of a given patient, to enable the development of important medical reasoning skills.” 

Lo’s other activities included weekly participation in clinical skills discussions and pediatric case discussion rounds. He also presented lectures on child health and obesity, and consulted with TMDU’s leadership on strategies for enhancing faculty development.

“The top leadership of TMDU, including President Suzuki, Dean Koike, and Professor Tanaka, have made a significant commitment to medical education reform, devoting considerable resources to establishment of chief residents and student exchange programs,” said Lo. “It was quite a gratifying experience for me and the Japanese students to bridge the gaps in culture and medical education between Harvard and Japan."

Arthur Lin and Joe Yeh talk about their clerkship experiences with HMI’s Tom Aretz.

Students from Taiwan see differences in practice, lifestyle through exchange program
Three students from National Taiwan University College of Medicine (NTUCM) are completing clerkships in HMS-affiliated hospitals. NTUCM has sponsored highly valued medical student exchanges with Harvard Medical School since 1985.

Two of the students, Arthur Lin and Joe Yeh, visited HMI in April, as they prepared to finish the first of two monthlong clerkships. Lin, who is studying clinical transplantation and radiation oncology during his stay in Boston, said that the relatively small number of students present in the hospitals allows HMS students have more opportunities to participate and observe. Yeh is studying first diagnostic radiology and then general surgery—a chance to see not only two very different specialties, but different physician lifestyles as well. His time at Massachusetts General Hospital has caused him to become much more interested in radiology. “In radiology you get to see interesting cases from every department. It gives me a great feeling to be able to tell other doctors a patient’s diagnosis,” he said.

Robot technology helps physicians in new Acibadem hospital get around
A breakthrough in remote presence technology is allowing physicians in Acibadem's new hospital in Bursa to increase their access to patients, colleagues, and patient data. Dr. Robot, as the technology is known, was unveiled at the February opening of Acibadem's fourth hospital, and was the first member of the Bursa staff to greet Turkish Prime Minister Recep Tayyip Erdogan when as he arrived for the festivities. The Prime Minister was surprised to discover his personal physician, a member of Acibadem's staff, on the robot's screen, and the two had a brief conversation about the new facility's other high-tech features.

Dr. Robot is manufactured by InTouch Health, Inc., a California-based robotic technology company that focuses on developing medical tools that utilize remote presence technology. This enables physicians to easily and more frequently visit with hospital-based patients, consult with staff, and access patient data through the hospital’s information technology system—all via a live audio-video broadcast. Remote Presence Robot RP-7 enables Acibadem physicians at Bursa and other hospitals in the network to be available on-demand across multiple areas of high acuity, including the intensive care unit, emergency room, and patient wards.

Semih Sen, a consultant who works with Acibadem and HMI, said, “Increased physician presence can help ensure patient safety and satisfaction, and lead to greater efficiency and throughput gains—all significant factors in hospital economics and quality of care.”

Elizabeth Brown of HMI and Semih Sen got to know Dr. Robot at the opening of the Bursa hospital.

Education calendar: A roundup of upcoming courses and events
Together with HMI, Asan Medical Center (AMC) and the University of Ulsan College of Medicine will host New Frontiers of Oncology in Seoul, Korea June 23-24. The fifth joint symposium held by the partners, this year’s meeting will bring together leading researchers and clinicians to provide state-of-the-art information on cancer to an international audience of academic and private physicians and researchers. Each day of the symposium will be dedicated to examining different types of cancer and discussing the current use of molecular markers and diagnostic strategies for the prevention, screening, and diagnosis of cancers. “New Frontiers of Oncology” is designed for individuals with clinical and research interests in the prevention, screening, evaluation, and management of cancers, including radiologists; medical, surgical and radiation oncologists; pathologists; translational-oriented laboratory scientists; nurses; pharmacists; physicians; and all other health care professionals involved in clinical care and research in the area of cancers. For more information about the symposium, please contact Annie Seo at annie_seo@amc.seoul.kr.

On May 10-11, the Harvard Medical School Dubai Center Institute for Postgraduate Education and Research (HMSDC) will present Specialty Practi-Med: Oncology Update, a two-day continuing medical education (CME) programs covering a wide range of issues related to cancer. Oncologists, surgeons, nurses, and primary care practitioners are encouraged to attend. To learn more about this and other programs offered by HMSDC, visit the HMSDC website at www.hmsdc.hms.harvard.edu.

HMI, partnership with Novartis Pharma Schweiz AG, will deliver two CME programs for health care professionals in Switzerland. On May 4, Cardiology 2006: Progress in Cardiovascular Medicine will be held in Montreaux. The course will feature a series of interactive case discussions on topics such as hypertension, primary and secondary prevention of coronary artery disease, congestive heart failure, and atrial fibrillation. HMI will also present Advances in Neurology, a one-day CME program for neurologists, which will take place on June 29 in Lucerne. The topics to be discussed include epilepsy, schizophrenia, cognition and neurobiological diseases, and Alzheimer’s disease, as well as updates on Parkinson’s-related dementia and vascular dementia.

In partnership with HMI, the Institute of Health Economics and Management at the University of Lausanne in Switzerland will offer Mastering the New Challenges of Health Care, an executive education program designed to provide leaders with the essential knowledge and skills to better understand the evolving health care industry, drive innovation, and guide change in health care policy. This five-day program is aimed at European health care leaders in both the public and private sectors and will involve highly interactive exercises encouraging discussion and collaboration among participants. The program will cover topics such as health care quality, organization-wide strategic planning, and the role of technological innovation in reducing costs, preventing medical error, and advancing clinical excellence. The program will take place May 15-19, 2006 at the University of Lausanne. For further information, visit the program website or contact Isabelle Chappuis.

For more information about educational programs offered by HMI, visit the Clinical CME/Practi-Med section of the HMI website.

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Copyright 2006 Harvard Medical International