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Grand Rounds August


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 Feature Profiles

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Dr. David Vanderpool dispenses hope and smiles as he works with those impacted by poverty and disaster.
Physician Spotlight: David Vanderpool, MD
There is little cause for hope for the 20 million people living in modern day Mozambique. It’s a country where the average life expectancy is only 34 years; 60 percent of children die before reaching the age of five, succumbing to HIV-AIDS, malaria and childhood diseases that are seldom fatal when vaccines are available.
KELLY PRICE

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 Nashville Archives

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Helping Tennessee’s Tiniest Residents
Statewide Effort Launched to Improve NICU Standards

When the annual KIDS COUNT survey measuring more than 100 indicators of child wellbeing came out in July, no one in the state was particularly surprised to find Tennessee near the bottom of the list.

The state has routinely been among the nation’s worst performers, particularly in areas such as low birth weight and infant mortality. Coming in at 42nd actually represents a one-place increase from last year and a five-place increase from 2000/2001, when Tennessee made its worst showing at 47th.
CINDY SANDERS

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Susan Dentzer, editor-in-chief, Health Affairs Magazine, addresses guests at a luncheon sponsored by the Nashville Health Care Council.
Nashville Health Care Council Luncheon: Dentzer Looks at Health Policy Issues
At the July 11 Nashville Health Care Council luncheon, Tom Aaron of Deloitte & Touche, whose Center for Health Solutions sponsored the event, introduced Susan Dentzer, editor-in-chief of Health Affairs magazine and admitted to “Googling her,” finding a rich lode of accomplishments and honors.
KELLY PRICE

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Nashville Firm Releases Hospital Value Index
When it comes to delivering the best value in hospital care in the Nashville area, the winner is Nashville General Hospital at Meharry. That’s according to a new Hospital Value Index™ released by Data Advantage, with offices in Nashville and Louisville, Ky. The index also ranked the Nashville-Davidson-Murfreesboro market 29th out of the 98 large markets examined.
SHARON H. FITZGERALD

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Dr. Shari Barkin, director of the Division of General Pediatrics at the Monroe Carell Jr. Children’s Hospital at Vanderbilt
Preventing Child Violence
Vanderbilt Leads Study of Office-Based Interventions

As a physician, how much time would you be willing to invest to curb violence and ensure a safer, healthier environment for children? Could you carve out an hour … 30 minutes … 15? According to a groundbreaking study led by Vanderbilt’s Shari Barkin, MD, physicians have the power to affect change in less than five minutes.
CINDY SANDERS

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Squaring Off on Vaccine Safety
Between the recent decision of the Department of Health and Human Services’ Division of Vaccine Injury Compensation in the Hannah Poling case and the media splash earlier this summer that accompanied actress Jenny McCarthy’s “Green Our Vaccines” march on Washington, D.C., groups that have long espoused the underlying dangers of the U.S. immunization program believe they have reason to feel vindicated.
CINDY SANDERS

Vital Signs
With summer officially on the back nine — and with the national business media still bloviating about whether the recession has finally hit — deal flow among Nashville healthcare companies has slowed to a veritable crawl.
Sources I lean on for story ideas are starting to lean back, asking for any gossip tidbits I can spare. Unfortunately, I’ve got to tell them the well is looking pretty dry.
Walker Duncan

Technologies Come of Age
We’re living in remarkable times. The Information Age has swiftly evolved from a lofty promise to a reality, right before our eyes.

In the past, many non-accounting technologies were seen as peripheral or excessive in the healthcare sector. Yet in recent years, as newer technologies facilitate enhanced quality of care and core operations, they are migrating into to the very heart of healthcare enterprises.
JOHN RANDALL DENNIS

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Larry Van Horn, Vanderbilt University Owen Graduate School of Management
Vanderbilt Offers New Healthcare Master’s Degree for Clinicians and Administrators
It’s tough for physicians, nurses and other healthcare professionals to return to the classroom. There’s just not enough time. Yet the business of healthcare evolves rapidly, and continued higher education in healthcare management has the potential to improve medicine and enhance careers.
SHARON H. FITZGERALD

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THA Focuses on Quality to Combat HAIs
Through the Tennessee Center for Patient Safety, more than 100 Tennessee hospitals have formed a collaborative effort to reduce healthcare-acquired infections (HAIs). In June, the Tennessee Hospital Association (THA) outlined the state’s plans in a letter to Congress in response to a request by the U.S. House of Representatives Committee on Oversight and Government Reform that state associations report on the measures their hospitals are taking to combat HAIs.
CINDY SANDERS

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Baptist Delivers a New Attitude About Decision-Making
Each year, Baptist Hospital delivers more than 7,000 new babies in Nashville, but the way key decisions were made was decidedly old school … until now.

With the beginning of the new fiscal year on July 1, Baptist Hospital has rolled out a co-manager model that takes a team-oriented, frontline approach to operations. Prior to the rollout, the department had been managed in a traditional manner by a nursing director and several nursing managers who oversaw labor and delivery.
CINDY SANDERS

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Alan S. Bean, Gideon & Wiseman
Tennessee Supreme Court Weighs in on Notice of Physicians as Hospital Contractors
When the Tennessee Supreme Court in May reversed two appeals court decisions regarding the notice given patients that physicians in hospitals may be independent contractors, it left hospitals with a big question: Just what is sufficient and meaningful notice that doctors and other providers may not be hospital employees?
SHARON H. FITZGERALD

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Medicare Reduction Blocked
Congress Overrides President’s Veto

Calling passage of the Medicare Improvements for Patients and Providers Act of 2008 “a long and winding road,” AMA President Nancy H. Nielsen, MD, applauded the U.S. Congress’ move on July 15 to override President Bush’s veto of the legislation. It is now law, averting a 10.6 percent Medicare physician payment cut.
SHARON FITZGERALD

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Administrator’s Corner: Brenda Plunkett
For more than two decades, Brenda Plunkett has efficiently and effectively overseen the controlled chaos that marks a busy pediatric practice. As administrator for Old Harding Pediatric Associates (OHPA), Plunkett relies on flexibility, technology and her master’s degree in counseling … a skill set that has served her well in her 30 years of working young patients, worried parents, providers and staff.
CINDY SANDERS

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Alive Hospice, Hospices Nationwide Gear Up For Medicare Changes
Hospices nationwide that care for Medicare beneficiaries have until Dec. 2 to be compliant with a new set of regulations, the first Medicare update regarding end-of-life care since 1983.

“One of the hallmarks of hospice care in the past has been that the patient is, of course, the center of care and is active in the decision-making process, but these regulations do make that even more clear,” said Karen York, executive vice president of organizational excellence and mission at Nashville-based Alive Hospice, a nonprofit organization that provides compassionate end-of-life care and bereavement support services in 12 Middle Tennessee counties.
SHARON H. FITZGERALD

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Best Practices: Diagnostic Tools for Cardiomyopathy
Magnetic resonance imaging (MRI) is recognized as a useful tool for the noninvasive evaluation of the heart by providing clinicians with high quality diagnostic images, in any imaging plane, without interference from surrounding soft tissue or bone, using only a peripheral intravenous catheter, and administration of MRI contrast agents characterized by a favorable safety profile. Recent technological advances in gradient performance and surface coil design allow for short acquisition times, high signal-to-noise ratio and contrast-to-noise ratio, and improved spatial and temporal resolution.

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Dr. David T. Tayloe Jr.
Building a Healthy America from Kids’ Minds, Bodies
As president-elect of the American Academy of Pediatrics, David T. Tayloe Jr., MD, will be taking the reins of the Academy as a new administration takes hold in Washington. Regardless of the outcome of November’s elections, Tayloe and other AAP leaders are working now to educate government officials on how healthcare reforms can affect America’s children.
LUCY SCHULTZE

Corporate Corner


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Dana Ryan, RyMed Technologies president and CEO
Healthcare Enterprise: RyMed Technologies Offers Hope in the Battle Against Hospital-Acquired Infections
When Dana Ryan, president and CEO of RyMed Technologies in Franklin, met Victoria and Armando Nahum, the three had a lot to talk about. The Nahums of Atlanta, Ga., spearhead a nationwide initiative, called the SAFE CARE CAMPAIGN, to bring awareness to and help prevent healthcare-acquired infections. Here’s why: Within one year, three members of the Nahum family contracted hospital-acquired infections at three different U.S. facilities.
SHARON H. FITZGERALD

Putting More Into Patient Care & Less Into Administration Essential to Reform
In America’s debate regarding healthcare reform, access for all individuals who need care seems the only component on which everybody agrees. Where the debate gets complex lies in deciding how to accomplish universal access and then who should pay for it.
CRAIG A. BECKER

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Caption: Woman at sewing school in Mozambique producing Grace Bag for sale in the United States.
Selling Grace
Successful Microeconomics Bringing Health, Well-Being

Recently, while Tennessee physician David Vanderpool and a medical team were on a mission trip to Mozambique, something caught their eye. A few of the women in the poverty-stricken South African country of 20 million were sporting beautifully handcrafted bags they had fashioned themselves.
LYNNE JETER