2009 A n n u A l R e p o R t 110 Years of Coordinated Care and Prevention Our Mission since 1899 is to heal, to discover, and to educate as a preeminent healthcare institution. We serve by providing the best integrated and innovative care for patients and their families; by understanding and finding cures for the diseases we research; and by educating and training the next generation of healthcare professionals to be leaders in medicine and science. Message from the President 2 Stories of Coordinated Care and Prevention 4 Financial Report 27 Leadership 31 Awards 38 Support 40 Events 47 Giving 50 Coordinated Care and Prevention at National Jewish Health As the nation debated healthcare Coordination, communication and reform this past summer, the problem responsibility are part of the culture of fragmented care came up time and at National Jewish. We actively again. Too many physicians work in encourage clinicians and researchers to isolation, which can limit their ability share observations, insights and ideas. to see the whole patient. Allergists Such exchanges can lead to exciting see only allergies; pulmonologists see new research endeavors, as you can Michael SaleM, MD, FACS President and CEO only lungs, and cardiologists see only read on pages 20 and 21. And when The Carole and Albert Angel hearts. It is increasingly difficult to a physician has a question about a Presidential Chair find a “field general” to assume the difficult patient, he is more likely to responsibility for coordination of care. turn to a nearby colleague than refer At National Jewish Health, we Part of this challenge relates to the vast a patient to another specialist across strive to see the whole patient amounts of new medical information town. When pulmonologist Gary and technology available in the care Cott, MD, suspected a new patient of clearly, with a model of care of patients. Part, of course, relates his may have lupus, he called Aryeh that emphasizes and innovates to communication. Fischer, MD, who came over from his nearby office, examined the patient, through coordination and As a result, patients can troop from looked at her charts, and made a lupus doctor to doctor, receiving many communication…I hope diagnosis and provided optimal care. different diagnoses, but none that that this integrated model of accurately encompass the whole This approach leads not only to research and care can serve as patient, and lead to successful higher quality healthcare, but to prevention, diagnosis, coordination, more efficient healthcare. Patients a model for the nation, one targeted treatments and follow up. stop traipsing futilely from doctor to doctor for unnecessary tests and that is valued and thrives for At National Jewish Health, we strive ineffective treatments. With our model to see the whole patient clearly, with the benefit of patients around of coordinated and differentiated care, a model of care that emphasizes and the country. they find answers to their medical innovates through coordination and mysteries. That leads to appropriate communication. In the pediatric day care, better health, prevention of unit, a weekly Plan of Care meeting complications and worsening disease, brings together pulmonologists, and reduced healthcare costs. allergists, gastroenterologists, nutritionists, psychologists and nursing There are many good ideas circulating staff to share information, knowledge about how to improve outcomes and and ideas. On page 4 you can read deliver more cost-efficient healthcare an excellent example of this preventive in America. At National Jewish Health strategy in action with the case of three- we have seen how our model of year-old Lilac Secaur, a severe asthma coordinated, individualized care can patient who, for the first time in her life, do both. I hope that this integrated has stayed healthy, active and out of the model of research and care can serve hospital since she visited us this summer. as a model for the nation, one that is valued and thrives for the benefit of patients around the country. 2 3 Keeping the Momentum In 2009 at National Jewish Health, been a labor of love serving this fine we continued executing our ambitious institution as its Chair. I am proud of 10-year strategic plan. Patient visits our many accomplishments during to National Jewish Health increased my tenure, including our continued 35 percent. Almost 75 investigators ranking as the number one respiratory received a record $56.8 million hospital in the nation, the adoption of in funding from the NIH and other a thoughtful and ambitious strategic federal sources. We hired 29 new plan, and our delivery of personalized faculty members. Our ability to medical care and cutting-edge maintain institutional momentum during research. challenging times is a tribute to our Without question, the greatest hard-working clinical, scientific, and satisfaction has been knowing and other staff as well as to our supporters Stephen W. arent working with so many fine individuals across the country. Chairman, Board of Directors who comprise our administration, This is my last report to you as faculty, staff, board members and Chairman of the Board; my three-year national trustees, including Dr. Michael term ended in October. I passed the Salem, a true visionary in the field of gavel to Tom Gart, a friend, long-time medicine. This truly is an institution that supporter of National Jewish Health, transforms lives throughout the world. and a most capable leader. It has True Friends Step Up In Tough Times It was a year of recession and While fiscal 2009 was a challenge, unemployment. The housing market our national support helped to sustain declined, and so did charitable us. We held dinners and events where contributions. honorees and volunteers stepped forward. Old friends brought new 1893 was also a year when a very faces to events, where they learned dedicated group of people erected a about world-class patient care and state-of-the-art tuberculosis sanatorium landmark science. in Denver. Then came a depression that prevented the hospital from opening. During tough times, people and institutions find out who their friends Our founders refused to give up. are. National Jewish Health found They persuaded a nationwide service over the past year that we have organization, B’nai B’rith, to run and Steve anD WenDy Siegel wonderful friends, ones who enabled support the hospital. And so, 110 Co-Chairs, Council of National us to accomplish the achievements you years ago, National Jewish Hospital Trustees will see in the pages to follow. To them for Consumptives opened its doors. and to the thousands of others who Going national made all the helped us during this time, we extend difference. With friends from across a most heartfelt thanks. the country, National Jewish was assured a reliable stream of support. Equally important were the ideas that came in with the contributions. Coordinated Care Finds Solutions for Lilac’s Asthma “We’ve learned more about Lilac’s lungs and allergies in two days here than in two years before. I feel like I have been given a miracle.” For the Secaur family, a cold was more than the minor their findings. Among other things, Lilac had severe acid nuisance it is for most families; it was a life-threatening reflux, a bacterial infection, allergies to two trees common episode. Colds invariably led to an asthma attack and a in Kentucky, and exercise-induced asthma. race to the emergency room for three-year old Lilac; she “There was no great Aha! moment for Lilac, no single had spent more than 100 nights in the hospital during thing that explained what was causing her so much the previous 18 months. Even on the best of days, Lilac trouble,” said Professor of Pediatrics Joseph Spahn, MD. was listless and struggled to breathe. “We just did what we do for every patient; thoroughly The Secaurs had seen pediatricians, pulmonologists, evaluated her from a variety of perspectives. Then we allergists and others near their home in Kentucky. They pooled our knowledge, developed a treatment strategy had even moved out of a moldy house on physician’s that addressed her unique situation.” advice. But no one could help Lilac get her breath back. They began adjusting Lilac’s medications, teaching Then the Secaurs learned about National Jewish Health, the Secaur family how to monitor her disease, how and drove 1,100 miles hoping and praying for answers. to manage worsening asthma, and how to properly Last hope and option administer medications, as well as how to cope “National Jewish Health was our last hope and our last emotionally with such a difficult situation. A week later option,” said Lilac’s mother, Kristin. the team met again to evaluate Lilac’s progress and to adjust her personalized treatment plan. Lilac and her family spent two weeks at National Jewish Health, seeing a team of experts who evaluated every Healthy at home possible factor that might contribute to her severe By the time the Secaur family headed back to Kentucky, asthma. Lilac received a pH probe to look for acid Lilac was a happy, energetic girl who could run and reflux, skin tests for allergies, a bronchoscopy to obtain play once again. She was no longer taking oral steroids tissue samples and to look for physical abnormalities and grew two inches in the first month back home. Then in her airways, CT scans of her lungs and sinuses, she got a cold. But Lilac was healthier this time, and the a barium swallow test, psychological evaluations, Secaurs knew much better how to care for her. She did pulmonary function tests, exercise tests and more. not go to the hospital. “We’ve learned more about Lilac’s lungs and allergies in “We learned how to better manage Lilac’s asthma,” said two days here than in two years before,” Kristin wrote in Kristin.