A Publication of SPRING 2019 ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL NEW BRUNSWICK healthytogether
MIRACLE BABY THREE-TIME CANCER SURVIVOR FASTER, BETTER EMERGENCY CARE
WHERE TO GET THE BEST CANCER CARE
NB_Cover_Spring19_final.indd 1 4/5/19 8:42 AM A MESSAGE FROM LEADERSHIP HEALTH NEWS
Transplant Patient Honored Robert Wood Johnson University Hospital (RWJUH) New Brunswick heart transplant patient Michal Duchnowski was honored in February as the New Jersey Devils Hero of the Game during the team’s “Go Red Day” SAFETY: at the Prudential Center in Newark. “Go Red Day” was established to raise awareness of women’s heart health and cardiovascular disease. Throughout the day, It Takes a Team members of RWJUH New Brunswick’s Heart Transplant Team were on hand to educate fans about cardiac hen it comes to safety, our philosophy is simple. RWJBarnabas conditions and procedures. Health is committed to zero incidents of preventable harm for W our patients, families, visitors and each other. This quest, which we call Safety Together, is designed to help create the best possible outcomes New Cardiovascular for our patients and an exceptional work environment for our team. Intensive Care Unit We’re applying the same tools used by High Reliability Organizations Robert Wood Johnson University Hospital (RWJUH) New (HROs) in the manufacturing and nuclear industries. These companies have Brunswick’s state-of-the-art Critical Cardiovascular Care greatly reduced accidents by using standardized error-prevention processes. Unit opened earlier this year. Located on the hospital’s 3 Core Unit, the new 21,000-square-foot unit features Similar safety systems are being embraced by our staff in both clinical and 24 critical cardiac intensive care unit rooms and a non-clinical roles as they go about their day-to-day tasks. comfortable waiting area. As a Cardiovascular Center of It has been a remarkable journey at Robert Wood Johnson University Excellence, the newly expanded unit enhances RWJUH Hospital (RWJUH) New Brunswick as we continue to foster a culture New Brunswick’s ability to provide exceptional cardiac of safety and high reliability. Our tireless commitment to this effort has care in a warm, family-centered setting. helped us make many improvements in a range of clinical and operational areas, such as the addition of motion-sensing capability to security
cameras and modification of the medications included in oncology order Pediatric ED Open Robert Wood Johnson University Hospital (RWJUH) sets to reduce the risk of patient falls. These improvements and many New Brunswick completed its new Pediatric Emergency other similar changes increase the quality and safety of the RWJUH New Department (ED) in late 2018. It features an isolation Brunswick patient experience. room and a sensory room to accommodate children with Becoming an HRO means everyone who works for RWJBarnabas Health autism or special needs. The Pediatric ED is New Jersey’s first American College of Surgeons-designated Pediatric knows that they can make a difference for our patients, for their teammates Trauma Center. The department is staffed by board- at work, and for our communities as a whole. We’re excited to empower certified emergency medicine physicians and nurses our family of employees to do everything possible to support our mission of who specialize in advanced pediatric care. It also offers excellence as we care for you and your family. pediatric telemedicine capability. Yours in good health,
BARRY H. OSTROWSKY JOHN J. GANTNER 1 Robert Wood Johnson Pl., New Brunswick, NJ 08901 PRESIDENT AND CHIEF EXECUTIVE OFFICER PRESIDENT AND CHIEF EXECUTIVE OFFICER 888.MD.RWJUH (888.637.9584) RWJBARNABAS HEALTH ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL NEW BRUNSWICK READ OUR INTERACTIVE DIGEST ONLINE! www.rwjbh.org/newbrunswickmag
CONNECT WITH US ON @RWJUH @RWJUH RWJBarnabas Health
Robert Wood Johnson University Hospital New Brunswick complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. For more information, see link on our home page at www.rwjbh.org/newbrunswick. RWJUH New Brunswick cumple con las leyes federales de derechos civiles aplicables y no discrimina por motivos de raza, color, nacionalidad, edad, discapacidad o sexo. ATENCIÓN: Si usted habla español, servicios de asistencia lingüística, de forma gratuita, están disponibles para usted. Llame al 888.637.9584. RWJUH New Brunswick konfòm ak lwa sou dwa sivil Federal ki aplikab yo e li pa fè diskriminasyon sou baz ras, koulè, peyi orijin, laj, enfimite oswa sèks. ATANSYON: Si w pale Kreyòl Ayisyen, gen sèvis èd pou lang ki disponib gratis pou ou. Rele 888.637.9584.
Healthy Together | 2 | Spring 2019
RWJUHNB_Memo_Spring19_final.indd 2 4/5/19 8:44 AM healthytogether contents SPRING 2019 4
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6 17 12 2. WELCOME LETTER. 12. WHERE TO GET THE 18. THE POWER OF A community update BEST CANCER CARE. PRECISION. How an from our CEOs. For patients, what does advanced radiation it mean to have access therapy helped one 4. A THIRD CHANCE AT to a “comprehensive” woman beat brain cancer. LIFE. How cutting- cancer center? edge medical care 20. HELPING YOUNG PATIENTS helped one woman 14. THE GOAL: HEAL. A couple who survive three different ZERO ERRORS. lost their teen daughter cancers. Our health system is provides generous on a mission to achieve support to help other ill 6. BEATING THE ODDS. the highest safety adolescents. A young woman with standards. two serious medical 9. MAKING A REAL IMPACT. 22. FASTER, BETTER conditions has the RWJBarnabas Health is 16. A BABY’S BEST FRIEND. EMERGENCY CARE. Our baby she always committed to promoting How a therapy dog newly expanded ED is dreamed of. community health. helped one little girl enabling patients to go recover her strength. home sooner. 8. 9 TIPS TO PREVENT 10. BETTER CARE FOR BIKE ACCIDENTS.Where These to OLDERGet ADULTS. the 17. SAVING MORE LIVES. 23. A MOST GENEROUS GIFT. simple habits will help Healthcare providers are A new state-of-the-art Donating blood saves kids stay BESTsafe on two CANCERtaking a fresh look atCARE neurocritical care unit lives, as one new mother wheels. FOR PATIENTS, WHAT DOES IT MEAN TO HAVE ACCESShow TO to A “COMPREHENSIVE”treat the elderly. will open in May. knows only too well. CANCER CENTER THAT IS DESIGNATED BY THE NATIONAL CANCER INSTITUTE?
RWJBarnabas Health, in partnership with Rutgers Cancer Institute of New Jersey—the state’s To learn more about programs and services at only NCI-designated Comprehensive PB | Healthy Together | Fall 2018 RobertCancer Center—providesWood Johnson close-to- University Hospital New Brunswick | RWJBH.ORG/NEWBRUNSWICK | 3 the Rutgers Cancer Institute of New Jersey, home access to the latest treatment visit www.cinj.org. and clinical trials. To learn more, visit www.rwjbh.org/beatcancer.
Healthy Together | 12 | Spring 2019
RWJUHNB_TOC_Spring19_final.indd 3 4/5/19 8:44 AM Ferum in consequ iamendi cipsam fugia non nonserum repelAnnette ero ommodipsam Pugliese didn’t quia num lautthink quibus she’d eabe veremalive for que the birthviducid of her grandson esti cum last year, but she was able to hold him, thanks to lifesaving treatment.
hey say bad things come in threes. That was the case for Annette T Pugliese, a 73-year-old, three-time cancer survivor who recently triumphed A THIRD over multiple myeloma, thanks to expert care at Rutgers Cancer Institute of New Jersey and Robert Wood Johnson University Hospital (RWJUH) New Brunswick. CHANCE Annette’s long and arduous fight for her life began in 2006, when she was diagnosed with Stage IV non-Hodgkin lymphoma, a RWJBarnabas Health and cancer that affects white blood cells, which Robert Wood Johnson University are part of the immune system. “I began Hospital New Brunswick, in AT LIFE researching the best New Jersey physicians partnership with Rutgers Cancer for blood cancers, and Roger Strair, MD, Institute of New Jersey—the HOW A STEM CELL TRANSPLANT PhD, at the Rutgers Cancer Institute of state’s only NCI-Designated AND CUTTING-EDGE MEDICAL CARE New Jersey came up,” recalls Annette, who Comprehensive Cancer Center— HELPED ONE WOMAN SURVIVE THREE lives in Freehold. She met with Dr. Strair, provide close-to-home access to a medical oncologist and Chief of Blood the latest treatment and DIFFERENT CANCERS. Disorders at the Institute, and he reassured clinical trials. Visit her that she was in good hands with her www.rwjbh.org/beatcancer. local oncologist. After two years of chemotherapy,
READ OUR INTERACTIVE DIGEST TO LEARN MORE ABOUT CAR T-CELL THERAPY. www.rwjbh.org/newbrunswickmag
Healthy Together | 4 | Spring 2019 Robert Wood Johnson University Hospital New Brunswick | RWJBH.ORG/NEWBRUNSWICK | 5
NB_BoneNarrow_Spring19_final.indd 4 4/5/19 8:46 AM Annette went into remission. But in 2009, Annette Pugliese with her a routine PET scan revealed a mass in her medical oncologist, Roger right kidney. Annette was diagnosed with Strair, MD, PhD, on right, and early-stage renal cancer and the kidney Jacqueline Manago, RN, BSN, BMTCN, nurse clinician. was removed. She recovered, but seven years later another alarm went off when routine bloodwork came back abnormal. After several tests, her oncologist had grim news: Annette had another blood cancer—this time, multiple myeloma. Unlike non-Hodgkin lymphoma, the disease is less curable, with a five-year survival rate of only about 50 percent. Annette was stunned, but once again she threw herself into researching the best local oncologists for the disease. “I have grandchildren, and I was determined to stay alive for them,” she says. Her research led her back to Dr. Strair. His recommendation: a stem cell transplant, in which a patient’s own stem cells— “ANNETTE HAS A TYPE OF MULTIPLE MYELOMA THAT’S immature cells found in bone marrow ESSENTIALLY INCURABLE, BUT THERE ARE MORE TREATMENTS and blood—are removed, then returned AVAILABLE NOW THAN EVER BEFORE. WE’RE CONTINUALLY after a course of high-dose chemotherapy. The stem cells replace the ones that are DEVELOPING NEW CLASSES OF MEDICATIONS.” destroyed by chemotherapy. “I looked at Roger Strair, MD, PhD him and said, ‘I’m 70. Aren’t I too old for this?’ and his response was so reassuring,” she recalls. “He said, ‘Annette, we do these RELISHING EVERY DAY range in age from 11 months to 12 years. in people your age all the time.’” After the transplant, Annette required “The most amazing moment for me was weekly doses of the chemotherapy drug holding my 2-day-old grandson last year,” A LIFESAVING TREATMENT bortezomib (Velcade) for six months, she says. “When I was diagnosed three On November 2, 2016, Annette was which helps prevent multiple myeloma years ago, I never thought I’d be alive admitted to RWJUH New Brunswick from returning. Last year, she was for his birth. But here I am, driving my for a stem cell transplant. Her recovery switched to a newer drug, daratumumab grandkids to soccer games and chasing was grueling. “I had a lot of side effects— (Darzalex). them around the house.” everything from GI issues to simply “The hope is that it will get rid of any Annette credits her survival to feeling very weak,” she says. The nurses new multiple myeloma cells as soon as Rutgers Cancer Institute and RWJUH made sure she got up and moved every they crop up,” says Dr. Strair. “Annette New Brunswick. “I tell everyone I know day, and her son and daughter-in-law has a type of multiple myeloma that’s that if they or a loved one is diagnosed visited daily. “That support was so essentially incurable, but there are more with multiple myeloma, they must see Dr. important because I was so lonely and treatments available now than ever before. Strair,” she says. “I had a phone number scared,” she says. “I knew I needed to We’re continually developing new classes I could call any time of the day or night. maintain a positive attitude if I was going of medications.” For example, Rutgers I don’t know of any other hospital that to get through this.” Cancer Institute and RWJUH New would provide that sort of attentive care.” After about a month, Annette was well Brunswick are currently offering CAR T- Dr. Strair says taking care of patients enough to go home, but Dr. Strair would cell therapy, in which a patient’s immune like Annette is what makes his work so not release her until she had a caretaker system is harnessed to fight the disease. rewarding. “Annette is a wonderful, caring lined up for the next three weeks (her In the meantime, Annette is relishing person. I don’t know if anyone else could siblings and cousins took turns staying her new lease on life. The former teacher have gone through three cancer diagnoses with her). “It warmed my heart how much enjoys long walks, cooking and spending with her grace and perseverance,” he says. he looked out for me,” says Annette. time with her four grandchildren, who “She’s a true inspiration.”
To make an appointment at Rutgers Cancer Institute, call 732.235.8515. To learn more about cancer care at Robert Wood Johnson University Hospital New Brunswick, visit www.rwjbh.org/rwjuhcancer.
Healthy Together | 4 | Spring 2019 Robert Wood Johnson University Hospital New Brunswick | RWJBH.ORG/NEWBRUNSWICK | 5
NB_BoneNarrow_Spring19_final.indd 5 4/5/19 8:46 AM Danicca and Joseph Bolante are grateful to RWJUH New Brunswick and Rutgers Robert Wood Johnson Medical School cardiologist Deepa Iyer, MD, for helping to save the lives of Danicca and baby Jonica.
or most expectant mothers, giving birth is a joyous occasion. But as FDanicca Bolante lay on the operating room table during her C-section in August 2018, her body clenched with fear. “I kept BEATING feeling like I was fading away,” recalls the 35-year-old nurse. “I didn’t know if I’d make it through the procedure alive.” Danicca wasn’t the only one who was worried. A team of more than 40 healthcare THE ODDS professionals was in the room with her at Robert Wood Johnson University Hospital A YOUNG WOMAN WITH TWO SERIOUS MEDICAL (RWJUH) New Brunswick to make sure CONDITIONS RISKED HER LIFE TO HAVE THE both she and her baby survived. Danicca had two potentially life-threatening FAMILY SHE ALWAYS DREAMED OF. conditions: severe mitral valve stenosis and severe pulmonary hypertension (PH). With mitral valve stenosis, the heart’s mitral valve doesn’t open properly, preventing
Healthy Together | 6 | Spring 2019 Robert Wood Johnson University Hospital New Brunswick | RWJBH.ORG/NEWBRUNSWICK | 7
NB_Cardiac_Spring19_final.indd 6 4/5/19 8:47 AM Danicca brushed him off. “I felt fine,” she anesthesiologists, pediatricians and nurses says. “I was young and healthy and assumed I at RWJUH New Brunswick and Rutgers had nothing to worry about.” RWJMS. The team concluded Danicca, When Danicca learned she was pregnant who was only 31 weeks pregnant, should in February 2018, she was so overjoyed have a C-section. They counseled Danicca she didn’t think of mentioning her heart and her husband, Joseph, that there was a condition to her obstetrician. Her first chance mom and baby wouldn’t make it. trimester was uneventful, but in her fourth “We had a priest come to administer last month, Danicca began experiencing trouble rites, and after he left, I said to Danicca, breathing after flying home to visit relatives ‘If something happens to you, what do in her native Philippines. you want me to tell our daughter?’” recalls As soon as she returned home, she Joseph. Danicca’s reply was swift: “It was saw her obstetrician, who immediately worth it to die to give you life,” she says. referred her to Justin Brandt, MD, a Two days later, RWJUH New high-risk obstetrician at RWJUH New Brunswick and Rutgers RWJMS Brunswick and Rutgers Robert Wood obstetrician William MacMillan, MD, Johnson Medical School (RWJMS). Her delivered Jonica (a combination of condition deteriorated rapidly, and she was Danicca’s and Joseph’s names). After the unable to work. At that point, Dr. Brandt C-section, Danicca was whisked to the called Deepa Iyer, MD, cardiologist and intensive care unit, while Jonica was sent advanced heart failure specialist at RWJUH to the neonatal intensive care unit. As soon New Brunswick and Rutgers RWJMS. as Danicca was medically stable, she was After hearing that Danicca couldn’t walk brought to see her baby. “I couldn’t contain across the room, Dr. Iyer advised that she my happiness,” she recalls. be admitted to the hospital immediately. But Danicca wasn’t out of the woods just Since Danicca’s mitral stenosis was never yet. It would take a few weeks to continue to “FROM THE MOST SENIOR treated, she had developed pulmonary monitor her closely as the amount of blood hypertension. “During pregnancy, a in her body returned to pre-pregnancy PHYSICIAN TO THE woman’s blood volume increases,” says Dr. levels. Two weeks after her C-section, she HOUSEKEEPING STAFF, THEY Iyer. “Danicca’s heart could not handle underwent a mini mitral valve replacement WERE ALL AMAZING AND the extra volume due to her severe mitral surgery, in which smaller incisions are made stenosis, so the pressures in her lungs got without cutting the breastbone, causing less MADE US FEEL AT HOME.” higher as the pregnancy progressed. The pain, better healing and quicker recovery. Joseph Bolante right side of her heart was starting to fail. I knew we’d need a multidisciplinary team THE ROAD TO RECOVERY right away.” But survive she did, and she and Jonica were discharged at the end of August. SAVING TWO LIVES Both parents say they’re beyond thankful blood from flowing forward into the left Danicca was given IV diuretics and beta to the team at RWJUH New Brunswick. ventricle, the main chamber of the heart. blockers to slow her heart rate and improve “From the most senior physician to the This causes blood to back up into the lungs, forward blood flow. Although she felt housekeeping staff to the patient reps, raising pressure inside the arteries, which better and was able to walk around a week they were all amazing and made us feel at eventually leads to failure of the right side later, Dr. Iyer was still concerned. Repeat home,” says Joseph. of the heart. echocardiograms showed that the right side Danicca is especially grateful to Dr. of her heart was enlarging, putting her at Iyer. “She was very motherly to us, and I A RISKY PREGNANCY high risk for heart failure. A meeting was needed that at the time because my mother In 2014, Danicca was diagnosed with called with Danicca’s new multidisciplinary is in the Philippines,” she says. As for Dr. mitral valve stenosis. The condition is healthcare team. In addition to Dr. Iyer, it Iyer, she says, “I have a picture of Danicca, often a complication of rheumatic fever, included Dr. Brandt, high-risk obstetrician Joseph, Jonica and their bulldog, and which Danicca had suffered as a child. Her Todd J. Rosen, MD, Aziz Ghaly, MD, it lights up my heart,” she says. “I never cardiologist had recommended surgery, but a cardiothoracic surgeon, cardiac imagined such a beautiful outcome.”
Your heart doesn’t beat just for you. Get it checked. To learn more about the full range of cardiac services at Robert Wood Johnson University Hospital (RWJUH) New Brunswick or to schedule an appointment with one of New Jersey’s top cardiac specialists, visit www.rwjbh.org/heart.
Healthy Together | 6 | Spring 2019 Robert Wood Johnson University Hospital New Brunswick | RWJBH.ORG/NEWBRUNSWICK | 7
NB_Cardiac_Spring19_final.indd 7 4/5/19 8:47 AM MODEL SAFE BEHAVIORS. “A lot of 1 parents will ask me to talk to their child about wearing a helmet, but they’re not wearing one themselves,” says Starace. “It’s important for parents to be role models. They should wear helmets, too.”
BE SURE THE BIKE FITS YOUR 2 CHILD’S HEIGHT. When seated on a bike, your child should be able to touch the ground with his or her toes. Handlebars should be easy to grip.
CHILDREN SHOULD ALWAYS WEAR A 3 HELMET—EVEN IF THEY’RE RIDING A SCOOTER OR SKATEBOARD. Helmets can reduce the risk of severe brain injury by 88 percent, yet only 45 percent of children ages 14 and under usually wear one, according to Safe Kids. New Jersey’s mantra: “Wheels Under Your Feet? Helmet on Your Head!”
MAKE SURE THE BIKE HELMET FITS 4 PROPERLY. It should sit on top of the head in a level position and should not rock forward, backward or side to side. The helmet should cover your child’s forehead; there should be no more than two finger-widths between the eyebrows and the rim of the helmet. The straps should form a “V” under the ears when buckled. Kids should avoid wearing ponytails under helmets because they interfere with proper fit. The chin strap should 9 be snug—no more than two fingers should be able to fit between the chin and the strap. TIPS TO RIDERS SHOULD WEAR PROTECTIVE iding a bike is one of the many 5 GEAR, such as knee and elbow pads. joys of childhood, but it’s not PREVENT R without risk. For kids ages 14 IF A BIKE LANE IS AVAILABLE, KIDS and under, pedestrian and bike accidents 6 SHOULD USE IT. The same goes for accounted for nearly 20 percent of pediatric those riding scooters or skateboards or trauma patients at Robert Wood Johnson wearing Rollerblades. BIKE University Hospital (RWJUH) New Brunswick between March KIDS UNDER AGE 10 SHOULD RIDE ON 2017 and February 2018. Diana 7 A SIDEWALK, NOT THE ROAD. Younger J. Starace, Injury Prevention kids don’t have the developmental ability to ACCIDENTS Coordinator for RWJUH New judge a vehicle’s speed or distance. Brunswick’s Level I Trauma THESE SIMPLE HABITS WILL HELP Center and coordinator for Safe Kids OLDER KIDS SHOULD FOLLOW THE Middlesex County, partners with schools 8 RULES OF THE ROAD. If there’s a red KIDS STAY SAFE ON TWO WHEELS. and community groups to teach kids and light, they should stop. Also, they should parents about bike safety. Her best tips: ride with the traffic, not against it. Bikes are considered vehicles, so riders should follow the same rules that cars do. To learn more about injury prevention, visit www.rwjbh.org/rwjuhinjuryprevention. YOUR CHILD SHOULD WALK, NOT RIDE, 9 HIS OR HER BIKE ACROSS THE STREET.
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NB_BikeSafety_Spring19_Rev2.indd 8 4/8/19 11:12 AM purchase socks for its patients, which has strengthened the vendor’s capacity to grow and expand. • HIRE LOCAL: RWJBH has pledged to hire 350 Newark residents by 2020 as part of the Newark 2020 partnership of local institutions and employers. Jersey City Medical Center’s Career Ladders program, which will soon be adopted system-wide, helps develop a path to promotion for entry-level employees. • INVEST LOCAL: To spur innovation and future investment, RWJBH has invested in Audible.com’s Newark Venture Partners Labs IT innovation center to stimulate the establishment of new businesses. Through partnerships, the RWJBH system helps improve community health, reduce disparities and enhance equity, including: • SAFE AND HEALTHY HOUSING: MAKING A Robert Wood Johnson University Hospital New Brunswick participated in the New Brunswick Healthy Housing Collaborative, designed to work with families to create REAL IMPACT high-health environments in homes RWJBARNABAS HEALTH IS COMMITTED TO PROMOTING COMMUNITY throughout the region. RWJBH is currently in discussions with national, state and HEALTH, BOTH INSIDE AND OUTSIDE A MEDICAL CENTER’S WALLS. local partners to expand its commitment to creating affordable housing in other child is taken to the emergency FINDING WHAT WORKS communities throughout the state. department for asthma, is “Traditionally, the way in which • FOOD SECURITY: A Wellness on A treated and sent home—to an institutions like ours have delivered Wheels mobile greenhouse travels to apartment where leaky pipes cause mold healthcare has been to wait for people communities throughout the entire that triggers her asthma. to come to us,” says Michellene Davis, RWJBH region. Additionally, youth in A man is given a prescription for high Esq., Executive Vice President and Chief Newark created a documentary, “Food for blood pressure but can’t afford to get it Corporate Affairs Officer for RWJBH, who Thought,” to explore the impact of food filled. heads the SICI effort. “Now we’re acting on insecurity on a community’s health. A woman is counseled about healthy the fact that health disparities begin and Davis believes the SICI effort will eating to help control diabetes but doesn’t continue outside our doors. We’re looking inspire and energize not just RWJBH have access to fresh fruits and vegetables. at the whole patient and the context in employees, but community members as Because social conditions play a critical which he or she lives.” well. “People will want to come to an entity role in wellness, The range of approaches is broad. that has high-quality, culturally competent RWJBarnabas “Every RWJBarnabas Health hospital clinical care, and at the same time invests Health (RWJBH) conducts its own community health needs in creating good in the world,” she says. has ramped up assessment, because each community is “This is about being the change you wish its commitment unique,” Davis explains. Recent examples of to see in the world. Everyone is welcome to to communities’ SICI-related efforts include: join us on this journey.” whole health • BUY LOCAL: RWJBH has made a through its deep commitment to buy from local Social Impact and minority- and women-owned To learn more about RWJBarnabas and Community businesses. For example, Newark Beth Health’s social impact initiatives, Investment (SICI) Israel Medical Center has a contract visit www.rwjbh.org/socialimpact. MICHELLENE DAVIS, ESQ. Practice. with Newark vendor Rock Ya Socks to
Healthy Together | PB | Spring 2019 RWJBarnabas Health | RWJBH.ORG | 9
System_SICI_Spring19_final.indd 9 4/5/19 1:21 PM BETTER CARE FOR OLDER ADULTS HEALTHCARE PROVIDERS ARE TAKING A FRESH LOOK AT HOW TO TREAT THE ELDERLY.
n elderly man who’d been A NEW APPROACH Two areas stood out as ripe for admitted to the hospital was The American Hospital Association, in expansion. One was the James and Sharon A disoriented. “He thinks he’s partnership with the Catholic Health Maida Geriatrics Institute at Monmouth talking to his father, who died years ago,” Association of the United States, the Medical Center Southern Campus, where the man’s daughter told his doctor. “Does Institute for Healthcare Improvement Dr. Israel is the Director, which specializes this mean he has Alzheimer’s?” and the John A. Hartford Foundation, has in all aspects of inpatient and outpatient He did not. What he did have was created the “4M Model” to guide hospitals geriatric care. The other is Better Health, delirium, brought on by the many changes and health systems in providing age- a senior membership program offered by in his routine caused by his admission friendly care. The four elements are: the Institute, with a full range of health, to the hospital. It’s a common problem What Matters: taking the time to wellness and social events. Both the for elderly patients, according to Jessica sit down for a discussion with an older Institute and the Better Health program Israel, MD, Corporate Chair, Geriatrics patient to understand his or her concerns, will be replicated at Saint Barnabas and Palliative Care, for RWJBarnabas goals and preferences for treatment. Medical Center in Livingston and Robert Health (RWJBH). Medications: taking additional care Wood Johnson University Hospital “Family members get alarmed, but in with drugs. “Giving a new prescription Hamilton this year, with other RWJBH many cases, that confusion is treatable— to someone who is 90 years old is not the hospitals to follow. though we may have to be a bit of a same as giving it to someone who is 19,” The RWJBH system is moving detective to find out what the problem says Dr. Israel. “As we age, medications ahead on multiple other fronts. Eight is,” she explains. “It could be anything don’t work the same way in the body, and hospitals have or are working toward from untreated pain, to an electrolyte there’s a greater risk of interactions.” Nurses Improving Care for Healthsystem disturbance, to a urinary tract infection, Mentation: identifying and managing Elders (NICHE) certification, and all to a sleep/wake cycle disturbance.” depression, dementia and delirium. hospitals will ultimately have Geriatric Sensitivity to changes in routine is Mobility: making sure a patient is Emergency Department Accreditation just one of many reasons older patients helped to move safely every day so he or (GEDA). As part of the RWJBH need thoughtful care, Dr. Israel says. As she doesn’t lose the muscle tone needed partnership with Rutgers University, the U.S. population ages—by the year for everyday tasks. the geriatrics team also is working to 2030, 1 of every 5 residents will be older enhance existing geriatrics fellowship than 65, according to the U.S. Census BEST PRACTICES training programs for physicians. Bureau—RWJBH facilities are at the When Dr. Israel took on her role And all RWJBH employees will take a forefront of a national drive to develop as Corporate Chair, Geriatrics and computerized learning module, currently age-friendly care. Palliative Care, almost two years ago, in development, that will help them “Throughout she knew that the RWJBH system understand what it means to be older. the system, we’re already had some exemplary age-friendly The possibilities are endless, because taking a very programs. To extend their reach and to geriatrics itself is so wide-ranging. close look at what share ideas across hospitals, she created “Sometimes the best person to reach out it means to be a geriatrics collaborative. “Every hospital to is not a doctor, but a physical therapist, age-friendly, not in our system has a multidisciplinary nutritionist or social worker,” says Dr. just in hospital team focused in geriatric care that may Israel. “The thing I love most about care, but in all include doctors, nurses, social workers, geriatrics is that it’s not some group of areas in which we physical therapists, administrators, doctors telling you what to do. It’s a team treat patients,” pharmacists and health educators,” says of people looking at your life and helping JESSICA ISRAEL, MD says Dr. Israel. Dr. Israel. you live it to your best.”
Healthy Together | 10 | Spring 2019
System_AgeFriendly_Spring19_final.indd 10 4/5/19 1:22 PM HOW TO GET BETTER CARE Jessica Israel, MD, Corporate Chair, Geriatrics and Palliative Care for RWJBarnabas Health, offers these tips for older adults. • Have an advocate. “Sometimes four ears are better than two when it comes to a doctor visit or hospital stay,” says Dr. Israel. • Ask questions. If you don’t understand something or it isn’t the way you thought it was going to be, ask. • Keep an accurate list of medications and physician contact numbers with you. This will help doctors treat you more quickly if an emergency arises. • Explore advance directives. “Patients of all ages should assign a healthcare proxy,” advises Dr. Israel. “But then also be sure to tell that person what your wishes are in the event that complicated medical decisions must be made.”
To learn more about age-friendly programs and services at RWJBarnabas Health, visit www.rwjbh.org/seniorhealth.
Healthy Together | 10 | Spring 2019 RWJBarnabas Health | RWJBH.ORG | 11
System_AgeFriendly_Spring19_final.indd 11 4/5/19 1:22 PM Where to Get the BEST CANCER CARE FOR PATIENTS, WHAT DOES IT MEAN TO HAVE ACCESS TO A COMPREHENSIVE CANCER CENTER THAT IS DESIGNATED BY THE NATIONAL CANCER INSTITUTE?
To learn more about programs and services at Comprehensive RWJBarnabas Health and the Rutgers Cancer Institute Cancer Center
of New Jersey, visit www.rwjbh.org/beat cancer. A Cancer Center Designated by the National Cancer Institute
Healthy Together | 12 | Spring 2019
System_CancerCare_Spr19_final.indd 12 4/5/19 1:24 PM THE CUTTING EDGE: BLOOD AND BONE MARROW TRANSPLANTS For some cancer patients, a blood and bone marrow utgers Cancer Institute of New Jersey, a partner of transplant (BMT) can be an effective treatment and RWJBarnabas Health, is the state’s only National Cancer even a potential cure. The Blood and Marrow Transplant RInstitute-Designated Comprehensive Cancer Center. Only Program at Rutgers Cancer Institute of New Jersey is the 50 cancer centers in the U.S. have earned that classification. It’s an only such program in New Jersey that’s integrated within impressive achievement—but what does it mean to cancer patients an NCI-Designated Comprehensive Cancer Center. and their families? “All blood and immune cells are made in the bone We asked Steven K. Libutti, MD, FACS, Senior marrow,” explains Roger Strair, MD, PhD, Chief of Vice President of Oncology Services, Blood Disorders at Rutgers Cancer Institute. “Blood RWJBarnabas Health, to explain. cells carry oxygen, fight infection and prevent bleeding. Dr. Libutti is also Director, Rutgers Immune cells also fight infection by attacking anything Cancer Institute of New Jersey in the body that’s perceived as not belonging, or and Vice Chancellor for Cancer foreign.” In a BMT procedure from a donor, a patient receives a transplant of healthy blood and immune Programs, Rutgers Biomedical Health cells and those cells in turn grow and make new cells, and Sciences. including immune cells that can attack cancer cells. If the person’s own cells are used, there is no immune If a person who has been attack of cancer, but the cells allow a rapid recovery diagnosed with cancer asks your from high-dose chemotherapy. advice, what do you tell him or her? At Rutgers Cancer Institute, BMT is used to treat a A diagnosis of cancer can feel overwhelming, and variety of blood and immune disorders, including acute people want to know where they should go for treatment in order and chronic leukemias, various types of lymphoma, to get the best possible outcome. Hodgkin’s disease, multiple myeloma and more. I always tell people that cancer doesn’t travel well. It’s more the rule than the exception that a patient requires multi-modality treatment, such as surgery, chemotherapy and radiation therapy. The patient is best served by staying as close to home as possible information. When a patient goes to an NCI-Designated while getting exceptional treatment. Comprehensive Cancer Center, he or she gets the benefit of their Patients should listen to the advice given by their physician, collective knowledge, clinical trials and research. and get more than one opinion. They also need to be able to cut through the noise and static of the marketplace. That means they Does a patient need to travel to New Brunswick, should understand the meaning of the word “comprehensive” where Rutgers Cancer Institute is located, in order when it refers to cancer treatment. to take advantage of its services? No. We have built a network across all 11 RWJBarnabas Health What does it mean to be a Comprehensive Cancer hospitals so that the outstanding treatment and care provided by Center? Rutgers Cancer Institute is available as close to home as possible Many cancer centers will use the word “comprehensive,” but for all New Jerseyans and those in our region. it doesn’t have the same meaning as a Comprehensive Cancer If, for example, a patient lives near Saint Barnabas Medical Center that’s designated by the National Cancer Institute (NCI), Center in Livingston, that patient will find that the cancer which is very specific and prestigious. program there is anchored by Rutgers Cancer Institute; that he or An NCI designation is a five-year grant that is acquired she has access to many of the same clinical trials as those taking through an arduous, competitive, years-long process. Only 70 place in New Brunswick; and that experts in surgery and radiation cancer centers in the country are chosen and of those, only 50 oncology and so on are partnered with Rutgers Cancer Institute. receive the designation Comprehensive Cancer Center, meaning Now, let’s say that a patient needs a specialized service— that they do for example, a bone marrow transplant, which we do in New laboratory Brunswick. Because we have a coordinated system, we can research and seamlessly transfer care of that patient to New Brunswick. Our clinical trials, as partnership with RWJBarnabas Health allows patients to enter well as provide the world of an NCI-Designated Comprehensive Cancer Center services directly through multiple doors. to patients. We’re also creating an extensive cancer navigation program to All of help patients throughout and after treatment. Our goal as a cancer these centers program is not only to have the best treatments, physicians and collaborate clinical trials. It is also to give the best care in helping patients STEVEN K. LIBUTTI, MD ROGER STRAIR, MD and share navigate what can be the most challenging period of their lives.
Healthy Together | 12 | Spring 2019 RWJBarnabas Health | RWJBH.ORG | 13
System_CancerCare_Spr19_final.indd 13 4/5/19 1:24 PM THE GOAL: ZERO ERRORS THE RWJBARNABAS HEALTH SYSTEM IS ON A MISSION TO ACHIEVE THE HIGHEST SAFETY STANDARDS.
To learn more about RWJBarnabas Health, visit www.rwjbh.org.
Healthy Together | 14 | Spring 2019
System_HRO_SPR19_final.indd 14 4/5/19 1:34 PM f a nuclear power plant has a serious they can actively prevent accident, it’s big news. In large part, harm,” says Dr. Bonamo. The Ithat’s because organizations in this goal of zero defects is seen as and other high-risk industries, where everyone’s responsibility. errors can be catastrophic, have developed robust safety policies to prevent mistakes TOOLS FOR from being made. In industry parlance, SUCCESS they’re what’s known as High Reliability To aid in this quest, staff Organizations, or HROs. members have a number of The parallels to healthcare systems, tools and techniques to use. with their high-stakes, highly complex They include: operations, are clear. “At RWJBarnabas Stopping the line. “In Health, we’re on a journey to becoming the past, if a staff member an HRO,” says John Bonamo, MD, MS, had a feeling something For Seth Rosenbaum, MD, MMM, SVP, Chief Medical Officer at FACOG, FACPE, Executive Vice President wasn’t right, he or she might Robert Wood Johnson University Hospital Hamilton, his team, and all and Chief Medical and Quality Officer at have buried that instinct, RWJBH employees, HRO values are a daily priority. RWJBarnabas Health (RWJBH). “There’s no thinking ‘I’m probably end point, no HRO certification. Instead, wrong,’” says Dr. Bonamo. being an HRO is a way of doing business. “Now they’re empowered to say, ‘I’m not MANY VOICES Ultimately, it delivers the highest-quality comfortable with X, Y or Z.’” “Each of our employees has a new voice, a care and safest experience for our patients Recently, he recounts, a nurse was chance to practice at the top of their skills and for our employees.” preparing a young woman to go into and be heard,” says Dr. Bonamo. “We’ve The aim of the initiative, called “Safety surgery for gall bladder removal when the made significant progress in our safety Together,” is clear—and bold. “Our goal patient mentioned she had a “funny feeling” event rate, and we’re confident it’s going to is zero incidents of preventable harm to in her chest. The nurse called an EKG continue to go down.” patients and employees,” Dr. Bonamo says. (electrocardiogram) tech and refused to send Each RWJBH hospital has created “That’s it.” the patient to the OR until the test was patient-family advisory councils to get done. As it turned out, the woman was in more insight into how they can improve THE THREE-LEGGED STOOL the middle of having a heart attack, and the delivery of care. In any circumstance, Dr. “When people are interviewed in large-scale delay may well have saved her life. Bonamo says, patients should demand the focus groups about what they want from a Clarifying questions. If a staff member is highest quality in their healthcare. “You hospital, they tend to mention three things,” not sure about something that’s happening, wouldn’t take a flight on an airline that says Dr. Bonamo. “One is, ‘Help me’—that’s he or she can be comfortable asking for didn’t have the highest-quality standards about excellence in the quality of clinical clarification. In addition, every order gets and a great safety record,” he says. “It’s the care. The second is, ‘Be nice to me’—and repeated back. If the dosage ordered is 50 same thing in healthcare. You should be that’s about the patient experience, the milligrams, the pharmacist or nurse will seeking care in a facility that’s on a journey communication and kindness. clarify, “That’s five-oh, right?” If the verbal to becoming an HRO.” “Then there’s ‘Don’t hurt me.’ That’s order is for a urology test, there will be an about safety, the third leg of the stool. For alphabet check to be sure it wasn’t for a a long time, hospitals didn’t pay enough neurology test. attention to that. Cross-checks. “That means that if you THE ABCs OF “Now, the best hospitals realize that you see me making a mistake, you correct me or BECOMING AN HRO can have the most expert surgeon and the ask if I’m sure that’s right,” says Dr. Bonamo. At RWJBarnabas Health, all team greatest bedside manner, but those things “In the past, people were afraid they’d be members follow these principles aren’t enough if a patient falls out of bed or told to mind their own business. of safety: gets an infection from a catheter.” “But now we realize that if I have a 1 in peak up for safety. Over the past 1,000 chance of making a mistake and you S year, all employees have a 1 in 1,000 chance and we cross-check A ccurately communicate. at every RWJBH each other, there’s a million in one chance facility have of making a mistake. We’re realizing that F ocus on the task. received in-depth healthcare is a team sport.” E xercise and accept a training in safety, Safety huddles. Every unit in every questioning attitude. error prevention building has a stand-up safety huddle each and performance morning to go over the previous T houghtfully interact. excellence. “We’re 24 hours and forecast the next 24. An hour giving employees later, there’s a facility-based huddle, a larger Y ou and me together. JOHN BONAMO, MD a new skill set so gathering with the same purpose.
Healthy Together | 14 | Spring 2019 RWJBarnabas Health | RWJBH.ORG | 15
System_HRO_SPR19_final.indd 15 4/5/19 1:34 PM Therapy dog Burton helped ease demanding A BABY’S therapy sessions for toddler Ava Finelli. time,” her mother, Laura, says. “These kids require a whole team, and we’re very well versed in treating children with respiratory issues as well as various BEST FRIEND neuromuscular disorders,” says Dr. Fantasia. HOW A THERAPY DOG HELPED The doctor acknowledges that the team also ONE LITTLE GIRL RECOVER had a secret weapon: Burton, a 2-year-old therapy dog. “She loooved Burton,” she says. HER STRENGTH. EYES ON BURTON espiratory Syncytial Virus, known During therapy sessions, Burton would as RSV, is an infection in the An RWJBarnabas Health facility position himself across from Ava so that R respiratory tract that can lead to she could work on stretching and moving serious problems. It’s always a matter of her arms to reach him. He ran back and concern when a baby gets it, but is even Ava contracted RSV in January 2018, at forth across the room so that she’d work on more so when the child has an underlying not quite 2 years old, she could not cough turning her head from side to side. Because medical condition. strongly enough to rid her airways of mucus. Ava focused so intently on Burton, her That was the case for little Ava Finelli, She had trouble swallowing, and became therapy sessions were eased. “Burton was her who was born with Spinal Muscular weaker, struggling to lift her head and move motivator,” Laura says. “He’s so friendly and Atrophy (SMA), a genetic disease affecting her arms and legs. energetic, he really helped her forget how part of the nervous Ava was sent to Children’s Specialized difficult the movements were.” system that leads Hospital for treatment. “She had an Ava was discharged after two months. to weakness in the intensive therapy program,” says Michele She continues to get outpatient therapy limbs. Children Fantasia, MD, the physiatrist and specialist and to take Spinraza, a promising new with SMA have in pediatric rehabilitation medicine who medication for SMA. “She did very well weak intercostal oversaw the plan. After several weeks of with us overall,” Dr. Fantasia reports, “and (between the respiratory, physical, occupational and pool was able to go back to her home, family and ribs) muscles, and therapy, Ava showed remarkable progress typical toddler activities.” underdeveloped and was able to lift her head and to better For more information about Children’s lungs and chest move her arms and legs. “It was incredible Specialized Hospital, call 888.244.5373 or MICHELE FANTASIA, MD muscles. When to see the progress Ava made in such a short visit www.childrens-specialized.org.
At Children’s Specialized Hospital, we provide world-class care for children and young adults who face special health challenges across the state of New Jersey and beyond. Our locations in Bayonne, Clifton, East Brunswick, Egg Harbor Township, Hamilton, Jersey City, Mountainside, New Brunswick, Newark, Toms River and Warren treat everything from chronic illnesses and complex physical disabilities like brain and spinal cord injuries, to developmental and behavioral issues like autism and mental health.
Healthy Together | 16 | Spring 2019
System_CSH_Spr19_final.indd 16 4/5/19 1:32 PM SAVING MORE LIVES A NEW, STATE-OF-THE-ART NEUROCRITICAL CARE UNIT IS DESIGNED FOR PATIENTS WITH LIFE-THREATENING CONDITIONS, SUCH AS MASSIVE STROKE, MENINGITIS AND SPINAL CORD INJURY.
hen it comes to saving the lives of critically ill and injured neurology and W The new Neurocritical Care Unit, set to open in May, will feature sophisticated technology for monitoring neurosurgery patients, having the right patients in real time, a CT scanner and dedicated spaces for family members. equipment can make all the difference. That’s one reason Robert Wood Johnson University Hospital (RWJUH) New FIRST IN THE STATE Another important feature of the Brunswick will open a state-of-the-art This will be the first Neurocritical Care 15,000-square-foot unit is its dedicated Neurocritical Care Unit in May. The unit Unit in an academic medical center CT scanner. This will help ensure the will feature technology for monitoring in New Jersey to use the Moberg CNS safety of patients who require brain patients who have suffered from stroke, Monitor, which enables physicians to imaging, explains Dr. Lee. “It can be risky aneurysm, brain or spinal cord injuries, monitor patients in a variety of ways. to move a critically ill patient to another meningitis and brain tumors. “Unlike a CT scan or MRI, which gives area of the hospital for imaging because “Patients need to be monitored you a snapshot of the brain, this monitor cardiac arrest may occur,” he says. so we can answer the million-dollar gives us information on how the injured The unit will feature 15 patient rooms, question: Are we headed in the right brain is doing in real time,” says Dr. Lee. which are double the size of the previous or the wrong direction?” says Kiwon “We can quantify the amount of oxygen rooms, as well as dedicated spaces for Lee, MD, FACP, Chief of Neurology at in the brain, for instance.” The data is family members. Every room will be Rutgers Robert Wood Johnson Medical displayed on a dedicated screen next to equipped with the neuromonitoring School and RWJUH New Brunswick, conventional cardiac monitoring. The technology. Glass walls will provide Medical Director of the Comprehensive new monitoring system will help guide unobstructed views of patients to Stroke Center, and Director of the physicians’ decisions about the intensity optimize monitoring. “These features Neuro Intensive Care Unit at RWJUH and length of therapy. “We’ll be providing will enable us to save lives beyond New Brunswick, which is a Center of cutting-edge care—among the best in expectations,” says Dr. Lee. “They will Excellence in Neuroscience and a Level I New Jersey—for patients with complex, improve the quality of patient care and Trauma Center. challenging conditions,” says Dr. Lee. long-term outcomes.”
For more information on neurocritical care at Robert Wood Johnson University Hospital New Brunswick, contact The Comprehensive Stroke Center at 732.418.8110 or visit www.rwjuh.edu/stroke.
Healthy Together | PB | Spring 2019 Robert Wood Johnson University Hospital New Brunswick | RWJBH.ORG/NEWBRUNSWICK | 17
NB_Neurocritical_Spring19_Rev1.indd 17 4/8/19 9:55 AM PRECISION
Tamara Francis became certified as a family nurse practitioner after receiving treatment for brain cancer. THE POWER OF
AN ADVANCED TYPE OF RADIATION THERAPY HELPED ONE YOUNG WOMAN BEAT A LIFE-THREATENING BRAIN CANCER.
RWJBarnabas Health and Robert Wood Johnson University Hospital New Brunswick, in partnership with Rutgers Cancer Institute of New Jersey—the state’s only NCI-Designated Comprehensive Cancer Center—provide close-to- home access to the latest treatment and clinical trials. Visit www.rwjbh.org/beatcancer.
Healthy Together | 18 | Spring 2019
NB_ProtonTherapy_Spring19_Rev1.indd 18 4/8/19 9:57 AM PRECISION
fter finishing work one day in “Tamara was a great candidate for October 2017, Tamara Francis, proton therapy because of the cancer’s Aa 32-year-old graduate student location—high, on the right side of the who was earning her master’s degree as a head and very superficial,” says Joseph family nurse practitioner, went to get her P. Weiner, MD, Tamara’s radiation purse so she could drive home. Suddenly, oncologist at Rutgers Cancer Institute BEST CANDIDATES she became disoriented, forgetting where of New Jersey and RWJUH New FOR PROTON she was and what she was doing, and had Brunswick. “Since we can reduce the THERAPY a seizure that rendered her unconscious. dose to the opposite side of the brain Many patients who need radiation A medical assistant found her convulsing and the hippocampus, where memory is can benefit from proton therapy, on the floor, and an ambulance was processed, we can maximally protect her but it’s especially useful for called. By the time Tamara regained brain and function. We think it may lead challenging cases, says Rahul R. consciousness, she was at Robert Wood to a better quality of life.” Parikh, MD, medical director of Johnson University Hospital (RWJUH) The Center, which opened in 2016, the Laurie Proton Therapy Center New Brunswick. is unique. “We’re the only facility in at RWJUH New Brunswick and In short order, she was diagnosed New Jersey to use this technology Associate Professor of Radiation with a rare form of cancer called in the setting of a National Cancer Oncology at the Rutgers Cancer Institute of New Jersey and anaplastic meningioma, which arises from Institute-Designated Comprehensive Rutgers Robert Wood Johnson the lining of the brain. In November 2017, Cancer Center,” says Rahul R. Parikh, Medical School. Patients with she had a craniotomy at RWJUH New MD, medical director of the Laurie a tumor located near a critical Brunswick to remove the tumor, which Proton Therapy Center at RWJUH New brain structure or the heart or was occupying a quarter of her brain. Brunswick and Associate Professor of lungs stand to benefit because After the surgery, her oncology team Radiation Oncology at Rutgers Cancer “the more refined beam of recommended radiation therapy. Tamara Institute of New Jersey and Rutgers radiation enables us to spare was concerned that traditional radiation Robert Wood Johnson Medical School. neighboring healthy organs more therapy could cause collateral damage to than traditional X-ray radiation other parts of her brain, so she researched A PAINLESS TREATMENT therapy,” he says. “We can other options. “I wanted a treatment that In December 2017, Tamara began having control exactly where the beam is delivered, which is important would have the fewest side effects,” says 30-minute sessions of proton therapy five because breathing can cause Tamara, who lives in Brooklyn, NY. “I days a week. She continued the protocol tumors in the chest and abdomen didn’t want any cognitive changes.” for six weeks. During the sessions, “I to move.” didn’t feel anything,” she says. “I just had FINDING A SAFER OPTION to sit really still so the beam could target Tamara discovered the Laurie Proton the same site every time.” In fact, she Therapy Center at RWJUH New would wear a customized, immobilizing months for an MRI and a check-up. The Brunswick, which uses energy from mask to prevent her from moving her plan is to space out these visits to every positively charged particles instead of head during the treatment sessions. six months. “We’re cautiously optimistic,” X-rays to destroy cancer cells. Proton After a few weeks, Tamara began says Dr. Weiner. “We don’t see any beams target tumor tissue more precisely experiencing side effects, including nausea, evidence of the tumor on repeated scans, and can be stopped at a certain depth. vomiting and headaches. She completed the but we have to be vigilant because it’s the This technique destroys any microscopic treatment in February 2018, and the side most aggressive type of meningioma.” cancerous cells while minimizing damage effects stopped over the summer. In the meantime, Tamara works as to healthy tissue near the tumor site. a family nurse practitioner and travels Another benefit is that proton therapy LIVING LIFE TO THE FULLEST as often as she can. She doesn’t have any can be given a second time if the cancer In the summer of 2018, Tamara graduated restrictions on her lifestyle or take any returns. “When I was diagnosed, the from her master’s degree program and medications. “I feel fortunate to have doctors said it was an aggressive cancer took her board exams to become certified received the kind of treatment and care and the chances of it coming back were as a family nurse practitioner. She returns that I did,” says Tamara. “God forbid, if I high,” says Tamara. to RWJUH New Brunswick every three get this again, I will go the same route.”
To learn more about the Laurie Proton Therapy Center, call 732.253.3176 or visit www.rwjbh.org/rwjuhprotontherapy.
Healthy Together | 18 | Spring 2019 Robert Wood Johnson University Hospital New Brunswick | RWJBH.ORG/NEWBRUNSWICK | 19
NB_ProtonTherapy_Spring19_Rev1.indd 19 4/9/19 2:32 PM Greg and Cyndi Tufaro funded improved technology for the Gorrie Teen Lounge to commemorate what would have been the 15th birthday of their late daughter, Marisa.
HELPING YOUNG PATIENTS HEAL A COUPLE WHO LOST THEIR TEENAGE DAUGHTER TO A RARE DISEASE PROVIDES GENEROUS SUPPORT FOR MEDICAL AND CHILD LIFE PROGRAMS AT THE BRISTOL-MYERS SQUIBB CHILDREN’S HOSPITAL AT ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL NEW BRUNSWICK.
Healthy Together | 20 | Spring 2019 Robert Wood Johnson University Hospital New Brunswick | RWJBH.ORG/NEWBRUNSWICK | 21
NB_Foundation_Spring19_final.indd 20 4/5/19 8:51 AM “AFTER RECEIVING SO MUCH SUPPORT FROM OUR hen Greg and Cyndi COMMUNITY, WE FEEL BLESSED THAT MARISA’S LEGACY W Tufaro think CAN BE ONE OF GIVING BACK TO OTHERS.” Greg Tufaro of their late 13-year- old-daughter, Marisa, they picture her warm, sparkling brown eyes framed by long, dark lashes. for an emergency This year, the Tufaros made a generous They remember her singing hospitalization or to visit donation to BMSCH’s art therapy in the chorus of a local children’s her longstanding physician, program for the second year in a row. theater production of the “Wizard of Joseph Gaffney, MD, Associate “Marisa was an artist who loved to make Oz” or interacting with her beloved horses Professor of Pediatrics and Chief, Division things,” says Cyndi. “Art therapists helped in a therapeutic riding program. of Pediatric Cardiology, at Rutgers her get through her very difficult and, at These images give the Tufaros comfort Robert Wood Johnson Medical School and times, lengthy hospital stays. She’d forget when they recall the long, painful last RWJUH New Brunswick. she was hooked up to an IV or needed few months of Marisa’s life. She died on “We spent a fair amount of time at a new test because she was so involved January 30, 2017, nearly seven months the hospital, which was only five minutes in a project. She always said she wanted after receiving a heart transplant at a New from our house, for both emergencies to be an artist when she grew up.” Art York hospital. She suffered from post- and routine procedures,” says Greg. “We therapy encourages patients to share their transplant lymphoproliferative disorder, felt blessed to have such an outstanding thoughts and feelings through the creative a rare but deadly blood cancer that can medical center near us. Dr. Gaffney was process, helping to alleviate stress and develop as a postoperative complication. always accessible to us and whenever anxiety. “She kept her spirits up until she was Marisa was sick, he expedited her In addition, the Tufaros commemorated too sick, drawing and crafting from her admission to the ER. We were treated so what would have been Marisa’s 15th hospital bed,” says Greg Tufaro, Marisa’s well every time we went there.” birthday by funding improved technology father, a sports writer for the Home News for the newly renovated Gorrie Teen Tribune. “Everyone was so impressed by GIVING BACK Lounge. “During the last months of her her dignity and grace.” When Greg and Cyndi, an Edison life, Marisa used the Xbox, gaming systems Township elementary school principal, and iPads in her hospital room,” says GRATEFUL PARENTS launched The Marisa Tufaro Foundation— Cyndi. “These things made her days more Marisa was born with hypoplastic left- whose mission is to assist children in bearable.” Indeed, technology provides heart syndrome, a congenital defect need throughout the greater Middlesex teens with opportunities to interact with in which the left side of the heart is County area—they decided to partner with others, become more independent and underdeveloped. The condition required BMSCH. In 2018, the Tufaros provided express themselves. frequent hospitalizations. “She spent more funding for an extracorporeal membrane The Tufaros are confident that Marisa than two years of her life in hospital beds oxygenation (ECMO) program for children would approve of their donations. “She and underwent six open heart surgeries,” and teens in need of cardiopulmonary would be elated to know that other says Greg. Despite her health problems, support. With ECMO, which is similar children and families like ours would be Marisa thrived. An honor roll student to a heart-lung bypass machine, a pump helped,” says Cyndi. “She always looked in elementary and middle school, she circulates blood through an artificial out for others. When we told her that she served as student council vice president, lung back into a patient’s bloodstream. needed a heart transplant, for instance, wrote for the school newspaper, sang in It provides oxygen to the body while she kept trying to comfort me by hugging the choir, and played percussion in the allowing time for the heart and lungs to me and rubbing my hand.” orchestra. Marisa’s illness forced her to be rest and heal. ECMO may be used when a The Foundation has allowed the home-schooled in seventh grade. patient has a heart attack, severe asthma, Tufaros to turn their mourning into Throughout Marisa’s life, the or pneumonia, for instance. “An ECMO advocacy. “It enables us to invest our time Tufaros often found themselves at machine kept Marisa alive for the first six and energy in a positive way,” says Greg. The Bristol-Myers Squibb Children’s days after her 2016 heart transplant,” says “After receiving so much support from our Hospital (BMSCH) at Robert Wood Greg. “It saved her life, and we are elated community—including BMSCH—we feel Johnson University Hospital (RWJUH) that BMSCH is one of the few pediatric blessed that Marisa’s legacy can be one of New Brunswick, whether it was hospitals in New Jersey to have it.” giving back to others.”
To support programs at Robert Wood Johnson University Hospital New Brunswick and The Bristol-Myers Squibb Children’s Hospital, visit www.rwjuhgiving.org or call 732.937.8750.
Healthy Together | 20 | Spring 2019 Robert Wood Johnson University Hospital New Brunswick | RWJBH.ORG/NEWBRUNSWICK | 21
NB_Foundation_Spring19_Rev1.indd 21 4/8/19 9:58 AM Left: A ribbon-cutting for the new Pediatric Emergency Department. Above, top to bottom: FASTER, BETTER Exterior of the ED and an adult patient room. be a CT scan and two X-ray rooms, which will result in a reduced wait time for these EMERGENCY CARE tests—and a decreased length of stay, says Dr. Eisenstein. “Our goal is to get patients A NEWLY EXPANDED ED IS ENABLING PATIENTS TO GO HOME SOONER. to a provider as quickly as possible,” he explains. s one of only three Level I size of the ED from 40,000 to 60,000 To achieve this goal, patients with Trauma Centers in New Jersey, square feet. When the renovations less severe illnesses may have their initial A Robert Wood Johnson University are complete, there will be more than evaluation in our new “care initiation Hospital (RWJUH) New Brunswick cares 100 beds, including 55 for seriously rooms.” They will have their initial for patients with some of the most serious ill patients. A new receiving area will assessment by their provider and nurse. illnesses and accident-related injuries accommodate eight ambulances. From there, they will get any required in the state. To better serve the 95,000 imaging. They will wait for their results in Emergency Department (ED) and Trauma EMERGENCY CARE FOR KIDS our “results waiting area.” patients seen annually, the hospital The first few phases of the project embarked on a major expansion of the ED have been completed. A new Pediatric NEW ADVANCED starting in 2017. Emergency Department recently opened TECHNOLOGY “Our patient volume was increasing to accommodate the 25,000 pediatric The new ED also has improved technology. and the medical problems were becoming emergency patients the hospital sees each “Information will be wirelessly transmitted more complex,” says Robert M. Eisenstein, year. Having a separate Pediatric ED will from patient rooms to computers,” says MD, FACEP, Chief of Ambulatory enable patients up to age 21 to receive Dr. Eisenstein. “Instead of printing out Services at RWJUH New Brunswick and more efficient, pediatric-focused care. a patient’s vital signs, for instance, the Chair of the Department of Emergency The Adult Emergency Department has information will be transmitted from Medicine at Rutgers Robert Wood three new, state-of-the-art resuscitation bedside monitors to electronic medical Johnson Medical School. “We wanted to rooms, which are designed to care for the records.” Also, there are now large screens improve the space and technology in the most critically ill and injured patients. In in the resuscitation rooms that allow ED to provide optimal care.” addition, the expanded space allows for physicians to view radiology images. The project called for expanding the radiologic imaging in the ED. There will The project is in its final phases and all patient rooms are expected to be complete by the end of 2019. “Our patient volume To learn more about the Emergency Department expansion, visit exceeded our capacity, so this is a huge www.rwjbh.org/rwjuhedexpansion. improvement,” says Dr. Eisenstein. “We’re using our new space efficiently.”
Healthy Together | 22 | Spring 2019
NB_EDUpdate_SPR19_Rev1.indd 22 4/8/19 10:06 AM Casey Cattell (left) helped lead a blood drive as part of Maternal Health Awareness Day. She was joined by Labor and Delivery nurses Noelia Burgos, RN (seated), Calvarina Nwachuku, RN (center), and Carla Boyle, RNC, Nursing Director, Perinatal Services.
A MOST GENEROUS GIFT DONATING BLOOD SAVES LIVES, AS ONE NEW MOTHER KNOWS ONLY TOO WELL.
arely a day goes by that Casey PAYING IT FORWARD is Maternal Health Awareness Day in New Cattell of Bridgewater doesn’t In January, Casey teamed up with RWJUH Jersey. “We want to raise public awareness of R think of the 22 blood donors who New Brunswick to hold a blood drive the warning signs of perinatal complications helped to save her life. “One of the reasons for Maternal Health Awareness Day. She and empower women to speak up if there’s I’m alive is because I had access to safe hosted another one the next day with the something wrong,” says Casey. The “Stop! blood products,” says the 39-year-old patient Woodside Chapel Mothers of Pre-Schoolers Look! And Listen!” campaign encourages advocate. “I want to ensure others have this in Fanwood. “We had a great turnout,” she new mothers to let their healthcare resource so they can survive their crisis too.” says. “More than 50 people came for the providers know if they don’t feel well When Casey was pregnant with her blood drive at the hospital, and we collected during pregnancy or after delivery and son, now 3, she was diagnosed with 31 units of blood. The following day, we urges providers to listen to their patients’ blood clots in both lungs. Her physician had 33 donors and collected 23 units.” Both concerns and conduct an examination. prescribed blood-thinning medications. drives support RWJUH Blood Services. Donating blood is a painless process One week after giving birth, she wasn’t “We’re a Level I Trauma Center, so we keep that takes only one hour. The amount feeling right and went to the Emergency a large supply of blood on hand,” says Sally donated is typically 480 to 500 milliliters Department at Robert Wood Johnson Wells, Business Development Liaison for of blood. The average person has 20 times University Hospital (RWJUH) New RWJUH Blood Services. “Nationally, the that amount in their body. “You won’t feel Brunswick. “My blood pressure had rates of obstetric transfusions have risen.” the loss,” says Wells. “In fact, you’ll gain dropped to 37/25, and I was bleeding The blood drive at RWJUH New something because you’ll give three people internally,” she recalls. Casey needed Brunswick was held on January 23, which the opportunity to live.” surgery to stop the bleeding from six locations, lost five liters of blood, and was hospitalized for 11 days. “I’m grateful To make an appointment to donate blood, call the RWJUH Blood Center for the medical professionals and blood at 732.235.8100, extension 221. For questions about eligibility, donors who helped me walk away from call extension 248. Visit our website at www.rwjuhdonorclub.org. this so I can raise my son,” she says.
Healthy Together | PB | Spring 2019 Robert Wood Johnson University Hospital New Brunswick | RWJBH.ORG/NEWBRUNSWICK | 23
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Proton therapy. The next generation of cancer treatment.
Available at Robert Wood Johnson University Hospital’s Laurie Proton Therapy Center, proton therapy is pinpoint accurate, allowing physicians to isolate problems in children and adults for fewer side effects and better results. That’s why RWJBarnabas Health has partnered with national experts from the Rutgers Cancer Institute of New Jersey to create the only center in New York or New Jersey that’s part of an entire campus devoted to bridging the gap between cancer and a cure. Learn more at rwjbh.org/proton
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