Graduate Medical Education Program Prepares for First Residents

What’s one way to help solve the anticipated shortage of both specialty and primary care physicians? Grow your own. Memorial Healthcare System continued to make progress this year on its Graduate Medical Education (GME) program, adding residency spots and developing more programs that will train the physicians of tomorrow.

“Because one-third of physicians end up practicing close to where they’ve completed their residencies, investing in Graduate Medical Education helps ensure that, in the future, even more high-quality physicians will be serving our South Florida community and helping Memorial safeguard population health,” said Eric Quirion, Administrative Director, GME.

With all four GME programs – internal medicine, pediatrics, physical medicine and rehabilitation, and podiatry – receiving initial or continuing accreditation, Memorial began planning the recruitment phase for its upcoming classes of physicians, the first of whom are scheduled to arrive July 1, 2018.

At the same time, planning began for additional residency programs. With the approval of the Board of Commissioners, Memorial received the green light to submit accreditation applications for programs in neurology and psychiatry, plus a transitional-year program to help residents complete their required year of general medicine.

The additional programs will increase Memorial’s overall resident spots from 166 to 212, making Memorial one of the largest community-based residency programs in Florida.

“Memorial is particularly well-poised to carry out this ambitious plan,” said Saima Chaudhry, MD, Vice President and Chief Academic Officer. “We’re a very large public health system – one of the largest in the nation – and we have the expertise, from basic primary care all the way up to very advanced tertiary and quaternary care, in our hospitals. We have the talent as well – the faculty and medical staff members who can run these clinical programs and train young doctors well.”

Memorial’s GME team also made progress organizationally, increasing its staff and launching its presence on Memorial’s website. “I’m very proud of the hard work and dedication displayed by the entire GME team here at Memorial,” Dr. Chaudhry said. “We’re in a great position to welcome our first residents in July 2018.”

The latter part of the fiscal year was devoted to planning the grand opening of the new $20 million GME building at Memorial Hospital West, the ribbon-cutting for which took place in June 2017.

Overall, GME enjoyed a positive year of accomplishment toward its goals and objectives.

“The statistics are clear,” Mr. Quirion said. “Supporting future physicians in their residency education pays Memorial important dividends: Many will stay in South Florida and pursue their careers with us – caring for patients and families in ways that exemplify the mission and values of Memorial Healthcare System.”

New Rehabilitation Unit Offers Telemetry Monitoring

Memorial Rehabilitation Institute at Memorial Regional Hospital South now offers a Medically Complex Rehabilitation Unit with telemetry monitoring for patients who require more specialized care.

The new unit provides a unique blend of medical and rehabilitation services that allow patients to potentially begin rehab sooner while remaining in a supportive medical setting that monitors their progress.

Accredited by the Commission on Accreditation of Rehabilitation Facilities (CARF), the 15-bed unit features private rooms and an 8,000-square-foot gym with specialized equipment and technologies designed to treat patients with complex medical conditions:

  • Cancer patients who need rehab to continue chemotherapy or radiation sessions
  • Transplant patients with multiple system problems
  • Neutropenic patients
  • Bariatric patients (up to 1,000 pounds)
  • Heart and renal failure patients, including those who may require telemetry monitoring
This unit represents an expansion and yet another milestone in our commitment to serving South Florida as a world-class destination rehabilitation hospital. Our team of physicians, therapists, nurses, social workers, case managers and other healthcare professionals works directly with patients and families to set and go beyond their goals and expectations for recovery.”
– Douglas A. Zaren, FACHE, Administrator and CEO, Memorial Regional Hospital South

Our new 31,693-square-foot Graduate Medical Education Building will welcome its first class of physicians in July 2018

Memorial Rehabilitation Institute’s new 15-bed, CARF-accredited Medically Complex Rehabilitation Unit opened March 23, 2017

The first Memorial Primary Care Center opened in Silver Lakes in April 2017

Two new Urgent Care Centers are in progress – one, at 3,100 square feet, to open in fall 2017 in Pembroke Pines, and the other to open next year in Hollywood

Memorial Regional Hospital added a 1,302-space parking garage, a large auditorium and meeting space to support education and training

Joe DiMaggio Children’s Hospital will open an approximately 30,000-square-foot Pediatric Specialty Center in Wellington in fall 2018

Memorial Physician Group: Maintaining Excellence As It Grows

Memorial Physician Group – the physician-led organization through which employed Memorial physicians collaborate to help ensure outstanding, high-quality care – has experienced significant growth since its creation in 1999.

Back then, it represented just seven medical practices and 31 physicians. Now, with more than 250 physicians and 62 mid-level providers, Memorial Physician Group has wrapped up the fiscal year seeing not just growth but a continuous improvement in quality – ranking in top percentiles in satisfaction surveys by the Consumer Assessment of Healthcare Providers and Systems.

Sustaining and enhancing quality during a time of growth is a challenge for most organizations, but it was one that Memorial Physician Group was able to accomplish thanks to its operational infrastructure, explained Aharon Sareli, MD, Chairman of Memorial Physician Group’s Advisory Board.

“We improved our infrastructure to help ensure that it penetrated to our department directors and to the physicians themselves,” he said. “From new physician orientation right through to practice meetings and business meetings, our physicians are hearing the same message: to offer the strongest patient experience possible, and remain accountable for providing high-quality care.”

It is also vital that Memorial Physician Group’s communications structure goes both ways, Dr. Sareli added.

“We have a variety of mechanisms in which we can receive feedback from physicians,” he said, “ranging open forums at the different hospitals all the way up to the Advisory Board. Feedback from every member of the group is equally important, because it helps us take ownership together of the goal of providing the most complete experience for patients and families.”

Continued communications and alignment of goals will remain crucial as Memorial Physician Group continues to expand. This year, Memorial opened new adult and pediatric multispecialty centers in Weston. In the virtual world, Memorial Physician Group introduced its new mobile app, to provide easier access to physician profiles and to make scheduling appointments simpler and hassle-free.

The key to maintaining quality throughout all this growth? “A continued focus on improvement,” Dr. Sareli said.

“Our philosophy is focused on the pursuit of ongoing improvement,” he said. “We gain insight from current and new physicians, who bring experience from other National Centers of Excellence. We continuously strive for improvement by adapting new best practices to our own organization.”

Another must: continued vigilance of high-quality care and outstanding patient outcomes.

We must never lose sight of patient- and family-centered care while adapting to the changes in healthcare that are happening around us. Even as the complexities of delivering great care increase, at the end of the day, we’re all here to serve our patients and families.”
– Aharon Sareli, MD, Chairman, Memorial Physician Group’s Advisory Board

Memorial Physician Group Advisory Board

Memorial Health Network’s Fourth Year Brings More Growth, Improved Metrics

Memorial Health Network is a physician-led Memorial organization that manages and operates a clinically integrated provider network. Its goals: Improve clinical outcomes and lower costs.

Now in its fourth year, Memorial Health Network has continued to reach targeted benchmarks in growth, cost-efficiency and quality, including:

  • Implementing its new shared savings arrangement with United Healthcare, adding 30,000 patients to the network to reach a total of 105,000 covered lives
  • Reducing total medical costs across its three health plans by more than $16 million from previously forecasted
  • Reaching or exceeding the 90th percentile on nine quality metrics (up from eight last year), and reaching the 75th percentile on three others
  • Entering into shared savings arrangements with Community Care Partners and Employers Health Network, effective January 1, 2017

Memorial Health Network’s efforts have continued to show improvement in Memorial’s quality metrics. For 2015, the last year that national data are available, Memorial ranked in the 90th percentile in measurements that included:

Memorial Health Network plays an important role in helping Memorial further its population health initiative. That’s because our high-performing network of physicians is extremely focused on three objectives: providing quality outcomes, reducing medical costs and striving to keep the patient experience second to none. We’re pleased at the progress that we’ve been able to make in just four years, and we anticipate even more success in the future.”
– Esther Surujon, CEO, Memorial Health Network

Memorial Health Network Board and Committee Members

Memorial Lays Groundwork for Adult and Pediatric Kidney Transplant Program

Kidneys are the most commonly transplanted organs, with more than 400,000 procedures accounting for 59 percent of all organ transplants every year. Memorial Healthcare System spent this fiscal year laying the foundations for its own adult and pediatric kidney transplant program and welcomed Juan D. Arenas, MD, FACS, MBA as Medical Director of Memorial Transplant Institute in September.

“One of the reasons that kidney transplants are so common is that patients who have had other organs transplanted can also need a kidney transplant,” Dr. Arenas explained. “Either their original disease, or the medications they’re taking, can affect the kidneys as well.”

With Dr. Arenas’ arrival, Memorial began assembling its kidney transplantation team: two surgeons, an adult nephrologist, and pediatric and adult transplant coordinators, just to name a few. A comprehensive transplantation program like Memorial’s will also require a broad range of professionals in positions like living donor coordinator, living donor advocate, living donor social worker, clinic RN, patient access secretaries for adults and children, surgical services ARNP and clinical program manager. Memorial already has in place the dietitians, pharmacists and financial coordinators whose skills and services will be called upon for the kidney program once it’s up and running.

As the fiscal year drew to its close, Memorial’s kidney transplant team was busy preparing its 800-plus-page application for institutional membership in the US Department of Health and Human Services’ United Network of Organ Sharing (UNOS). Membership in the network has been granted, and Memorial is moving forward as an active clinical kidney transplant provider.

Memorial Pembroke 24/7 Care Center Provides Minor Emergency Care

Memorial Hospital Pembroke Urgent Care Center marked 40 years of providing outstanding minor-emergency outpatient care by renaming itself Memorial Pembroke 24/7 Care Center.

The name change, which took effect this fiscal year, reflects their higher level of care and service and builds on Memorial Pembroke 24/7 Care Center’s core commitment – to provide care from board-certified physicians for a variety of illnesses and injuries in patients of all ages, from infancy to adulthood.

Memorial Pembroke 24/7 Care Center is open 24 hours a day, including weekends and holidays – and patients can book their appointments in advance online.

Memorial Pembroke 24/7 Care Center is a true fixture in our South Florida community, with:

  • More than 70,000 patient visits last year,
  • More than 4,600 patients to a higher level of hospital care, and
  • Maintaining a patient satisfaction ranking of 95 percent for the year!

Mind/Body Wellness Project Expands Services

Memorial Healthcare System now provides South Broward residents with integrated primary and behavioral health services under one roof after receiving a federally and county-funded grant.

The Mind/Body Wellness Project – administered by Memorial Outpatient Behavioral Health Center and South Broward Community Health Services – has formed a core team offering the services at its newly expanded outpatient clinic in Hollywood.

As part of this initiative, telepsychiatry units will be installed in two South Broward Community Health Centers and the Memorial Outpatient Behavioral Health Center so patients can access behavioral health providers via video as part of their primary care visit. Each ancillary program targets behavioral changes toward promoting health outcomes of the patient, said the center’s medical director, Clara Alvarez Villalba, MD.

Logistically, The Mind/Body Wellness Project and the telepsychiatry will increase the access to a full range of medical care for patients. It will help improve coordination of care among providers.”
– Clara Alvarez Villalba, MD, Medical Director,
Memorial Outpatient Behavioral Health Center

The federal grant, awarded by the Substance Abuse and Mental Health Services Administration with additional funding through the Broward County Department of Human Services, provides for a dedicated nurse practitioner, an RN care coordinator, a medical assistant, an integrated care manager/social worker, a peer wellness coach and a psychiatric pharmacy resident. They will complement the center’s established multicultural team of licensed psychiatrists, advanced registered nurse practitioners, licensed psychotherapists and certified peer support specialists.

Additional services will include exercise classes, nutritional services, smoking cessation and chronic disease self-management support.

Project Director David Freedman said having a clinic that provides both mental and physical healthcare will benefit patients who often seek help in one area, but not both.

“While mental disorders including substance use issues are common in the United States, the burden of chronic illness is particularly concentrated among these patients,” Freedman said.

Adult Transport Services Specializes in Caring for the Most Critical Patients

In 2015, a senior citizen in cardiogenic shock – a rare condition in which your heart can’t pump enough blood – became the first patient transported to Memorial Regional Hospital from a South Florida hospital through its Critical Transport Services. If he hadn’t been treated in time, his condition could have quickly worsened and might have been fatal. Instead, he received lifesaving care at Memorial Cardiac and Vascular Institute.

Available 24 hours a day, seven days a week, Memorial’s critical care ambulance is maintained and operated by American Ambulance for the urgent needs of adults. The team focuses on patient evaluation, stabilization and transportation of patients experiencing the following critical conditions:

  • Cardiovascular
    • Patients in cardiogenic shock requiring mechanical circulatory support including ventricular assisted devices (VADs), an intra-aortic balloon pump, or extracorporeal membrane oxygenation (ECMO)
    • Severe respiratory failure requiring high levels of mechanical ventilator support accompanied by severe unstable blood flow
  • Neurology
    • Traumatic brain injury
    • Spinal cord injury
    • Neurovascular disorders
    • Unstable brain or spine tumors
    • Aneurysms
  • Maternal Fetal Medicine
    • Severe pre-eclampsia/eclampsia less than 28 weeks
    • Pre-term labor/premature rupture of membranes less than 28 weeks
    • Any anticipated delivery less than 28 weeks
    • Maternal cardiac disease
    • Maternal neurological/neurosurgical conditions requiring inpatient management or surgery
    • Placenta accreta/percreta
    • Any other maternal critical care conditions
    • Fetal abnormalities requiring inpatient pregnancy management
    • Fetal abnormalities requiring neonatal intervention in a Level III NICU or pediatric surgery

The clinical team includes a critical care nurse, respiratory therapist, perfusionist and physician or surgeon if necessary. These specialists provide emergency care and communicate with Memorial’s team en route to the hospital to facilitate seamless care upon arrival. If needed, a portable ECMO or mechanical circulatory support is also provided for patients who require management of heart and lung failure.

Throughout the process, Transfer Center nurses coordinate patient transfers by identifying the appropriate accepting physicians and specialists to create a seamless process.

© 2017 Memorial Healthcare System