Moving Medicine Forward

Partnership of Excellence

The State of Florida designated Memorial Cancer Institute and Florida Atlantic University a Cancer Center of Excellence. The research partnership combines Memorial’s clinical expertise with the university’s precision research to provide patients access to clinical trials, leading to advances in cancer care and treatment.

“We have achieved this designation because we are a comprehensive center for quality research and deliver a very high level of cancer care for our patients,” said Luis E. Raez, MD, Medical Director and Chief Scientific Officer, Memorial Cancer Institute, and Co-Director for the Cancer Center of Excellence. “We have been working very hard for several years to achieve this level of care.”

The Center of Excellence designation was created to encourage preeminence in cancer care, to attract and retain the best cancer care providers, and to help Florida hospitals like Memorial be recognized nationally as a preferred destination for quality cancer care.

Florida has more than 80 oncology centers, but the Memorial-FAU partnership is one of just five designated Cancer Centers of Excellence in the state. The distinction further solidifies Memorial’s presence as a leading cancer treatment provider.

Research PACT Drives Innovation

The partnership started in November 2020, when Memorial formed a Research Partnership to Advance Clinical Trials, or Research PACT, with Florida Atlantic University.

The PACT combines the organizations’ expertise and resources in clinical research, clinical trials, basic research and translational biomedical research. Its mission is to facilitate clinical trials that lead to advances in patient care and treatment for diseases such as melanoma, lung cancer, breast cancer, pancreatic cancer and blood cancers.

The partnership with FAU began as a Research PACT.

The research affiliation also leverages the two organizations’ state-of-the-art facilities, as well as proficiency in various areas, from cancer to cardiology and biomedical engineering to big data analytics and artificial intelligence.

The scope of the agreement, limited to research and research-related education, is designed to enable clinicians and researchers from each institution to collaborate with their peers and access available resources at each partner institution.

“This is a giant step forward,” said Candice Sareli, MD, Vice President and Chief Medical Research Officer. “Through this research partnership, we will continue to expand Memorial's academic infrastructure and research portfolio and offer hope to our community and patients.”

This Research PACT is the foundational element that led to Cancer Center of Excellence designation.

Ever forward thinking, the center has big plans to develop new drugs, medical devices, software applications and other novel treatments for diseases that affect both children and adults.

Having earned the state’s endorsement, the Cancer Center of Excellence stands apart as a facility that is well-equipped, provides advanced training for personnel and moves health forward with leading cancer care.

Learn more about clinical trials at Memorial

‘Hot Chemo’ Offers Renewed Hope for Abdominal Cancer Patients

Memorial Cancer Institute has added Hyperthermic Intraperitoneal Chemotherapy — known as “hot chemo” — to its arsenal for treating abdominal cancers. The procedure has proven to be an effective alternative when all other treatment options fail.

“The prior chemo was tearing me down,” said Eddie, 51, whose cancer spread from his colon to his abdomen. “I was doing chemo every other week. When I’d get off it, I wouldn’t eat for at least three or four days. By the time I built up a little strength, I’d be right back to start chemo again. When they told me there was something else I could do, I was ecstatic.”

The treatment is the latest breakthrough in targeting gastrointestinal tumors that have spread to the lining of the abdominal cavity and surrounding areas, including the colon, appendix, rectum and ovaries.

The procedure involves flling the abdomen for 90 minutes with a chemotherapy solution heated to 104-plus degrees Fahrenheit. The aggressive technique bypasses healthy highways in the body to target the cancer cells directly and deeply, thereby reducing the side effects often seen with traditional chemotherapy, said Omar Llaguna, MD, Surgical Oncologist.

To date, Memorial Cancer Institute has treated nearly 20 patients using hot chemo, including Eddie.

“I walked out of there feeling like my old self, like there was something better than what I was going through. I believed there were better days coming,” Eddie said.

I walked out of there feeling like my old self, like there was something better than what I was going through. I believed there were better days coming.”

Eddie, who had cancer

Telehealth Becomes Viable Cancer Care Solution During Pandemic

Memorial Cancer Institute has remained fully operational since the onset of COVID-19. Even with a shift in care delivery with the increased use of telehealth, patients undergoing cancer treatment continued to receive chemotherapy and radiation therapy or undergo surgical procedures.

Cancer patients receiving treatment require frequent medical visits, which usually are in person. Because of the pandemic, Memorial’s oncology team turned to telehealth to remain connected to patients in the safety of their own homes.

In addition, enhancements to Memorial MyChart, our patient portal and electronic health record, also helped the team to stay connected with patients throughout the pandemic, said Meredith Feinberg, MBA, FACHE, Vice President Oncology Services.

And when patients did come to the hospital or medical offces, highly enhanced safety precautions were in place at all times.

First seen as a quick fx, telehealth actually proved to be a long-term solution for creating a better model for cancer care.

“Memorial Cancer Institute is recognized as a leader of innovative cancer care delivery and continues to set high standards, demonstrating leadership in clinical research, outreach and education," said Feinberg.

Whether virtually or in person, the oncology team continued to provide Memorial-quality care and compassion.

EP Innovation Continues Despite Pandemic

They now send more than 90% of their patients home on the same day following their procedure and have nearly eliminated the radiation that patients experience during heart ablation procedures thanks to new technology.

Electrophysiologists diagnose and treat heart arrhythmias and other kinds of heart electrical problems. Memorial’s electrophysiology labs are some of the most active in the region — more than 1,500 procedures are performed each year.

The team began sending patients home on the same day of their procedure when it became imperative to have fewer patients remain in the hospital overnight because of the pandemic. After elective procedures were postponed due to an influx of COVID-19 patients, electrophysiology procedures were one of the first to be reinstated, Danielle, seen here with her son, partly due to the reduced overnight stays.

“We’ve had minimal readmissions and have seen great success,” said John Cogan, MD, Chief of the Electrophysiology Program at Memorial. “Patients love it, too, because they love sleeping at home.”

Memorial also opened a new, state-of-the-art electrophysiology lab where doctors are using the latest technology to deliver enhanced care.

“The room is beautiful and filled with all of the latest and greatest technology — two different mapping systems, wireless technology, headsets for communication for the team in and outside the lab and more,” Dr. Cogan said.

Memorial is a referral center for complex ablation procedures and is now performing them without fluoroscopy, which is an imaging technique that exposes patients and staff to radiation.

“The less radiation we all receive the better,” Dr. Cogan said. “We now have other technology that can replace this technique, which is safer for us all.”

Memorial specialists are also using the latest model of the WATCHMAN FLXTM Left Atrial Appendage Closure Device, which reduces the risk of stroke in those with atrial fibrillation by preventing blood clots from entering the bloodstream. The newer device can be used on more patients with different anatomies.

Beyond all the technological improvements, Dr. Cogan said the team is still what sets the program apart from others.

“You can have all the machines and technology you want, but you need the right people,” he said. “It’s a great feeling to have amazing partners who you would send your mom to in a second and knowing that the quality of care we are providing is par to none.”

Memorial Performs Its 1st Essential Tremor Procedure

Christopher DeMassi, MD, FACS, Chief of the institute and Chief of Neurosurgery, and Howard Kreger, MD, Neurologist, performed the surgery. The patient was a highway patrol officer who retired from the force due to her condition.

Dr. Kreger had been treating her for less than a decade when she agreed to try the procedure. Until then, it had been used at Memorial only to address the symptoms of Parkinson’s disease.

Essential tremor, or intentional tremor, is a movement disorder in which the patient experiences uncontrollable shaking while trying to perform a task. Similarly, Parkinson’s patients suffer tremors but usually only while sitting still.

Medication is initially used to treat essential tremor. However, the disease progresses to the point where medicine is no longer effective. This is when deep brain stimulation becomes a viable option.

Studies show that the procedure also could be effective in treating other drug-resistant conditions, including obsessive compulsive disorder, depression, obesity, epilepsy and substance abuse.

How It Works

Deep brain stimulation involves surgically inserting a thin wire lead attached to electrodes into the part of the brain that causes tremor. With essential tremor, that would be the thalamus. In a separate surgery, a pulse generator, or battery, is placed into the chest wall and connected to those electrodes.

Following surgery, a doctor directs the battery with a remote control to send electrical impulses to the electrodes. Ongoing stimulation regulates the abnormal impulses that cause tremor.

“There's a lot of different possible settings. You start a little conservatively, increase the voltage, then cut back and find something that's working. After that first time it's more fine-tuning. Symptoms generally improve a couple of weeks after you do the programming,” said Dr. Kreger.

Deep brain stimulation presents a lower risk of side effects than medications. It also protects the brain’s integrity better than older procedures, which burn and permanently destroy the affected tissue. Settings, frequency, amplitude and direction of the current can all be controlled with long-lasting precision.

The goal, said Dr. DeMassi, is to reduce, if not eliminate, the use of medication. Every patient is different, however, so immediate and future outcomes are unpredictable.

“The problem with both Parkinson’s and essential tremor is they slowly worsen over time. We don't have a treatment for that. We can’t slow it down. We can't stop it. All we can do is treat the symptoms, whether it's medication, exercise or deep brain stimulation,” said Dr. Kreger.

So far, the procedure has proven dramatically effective for Memorial’s first recipient. She is now able to hold a cup and a spoon without hitting her face or spilling scalding liquid on her hand.

“I was joking with the patient recently and said to her, ‘Let's go to the range. Let's get you certified again.’ She said she'd be willing to do that now,” said Dr. Kreger.

Epilepsy Program Continues to Innovate

First, the National Association of Epilepsy Centers recertified the program’s Level 4 ranking — a designation for programs that offer the highest level of comprehensive and specialized care.

And to further the program’s growth, the epilepsy program brought on board fellowship-trained epileptologist Donald Barr, MD. Dr. Barr will expand the program to Memorial Hospital West and into the West Broward region. Dr. Barr has special interest in brain modulation and brain responsiveness stimulation as a treatment option for patients with intractable epilepsy.

“We have a multidisciplinary team that now consists of adult epileptologists, pediatric epileptologists, neuropsychologists, neuroradiologists, neurosurgeons and psychologists," said Tarek Zakaria, MD, Medical Director, Comprehensive Epilepsy Program and Adult Neurology. "We meet every month to discuss individual patients and their treatment options. This is very important communication to be sure that we are providing the best care to our patients.”

Innovative Technology

Over the past year, the program also has implemented some of the most advanced technology-based protocols to diagnose and treat patients with epilepsy. One example is ROSA, or Robotized Surgical Assistant, a non-invasive diagnostic tool that allows neurosurgeons to localize the seizure onset without opening the skull and exposing the brain.

This specific procedure opens the door for multiple treatment options, including surgery to remove the onset zone or implementing a NeuroPace. Memorial’s epilepsy program was the first center in South Florida to use this small, battery-powered “pacemaker of the brain” that is implanted in the skull to record electrical activity and send electrical impulses to the brain to prevent seizures.

Dedicated Stroke Clinic Helps Patients Avoid Additional Strokes

The dedicated stroke clinic is part of the Comprehensive Stroke Program at Memorial Neuroscience Institute, where approximately 1,900 patients are treated every year. Combining initial high-quality, acute treatment with a thorough diagnostic workup on potential etiologies, or causes, is key to secondary stroke prevention.

“Our goal is to review the patient’s history for any modifiable stroke risk factors, such as high cholesterol, smoking, diabetes and high blood pressure. We want to make sure that patients are on the right medications to address these risk factors,” said Brijesh Mehta, MD, Medical Director, Comprehensive Stroke Program and Neuro-Interventional Surgery.

He added: “Beyond the medical issues, we also want to make sure that if a patient needs ongoing speech, occupational or physical therapy, they’re receiving care at Memorial Rehabilitation Institute following discharge. We’ve seen that this plays such an important role in getting patients back to their prior neurological function and quality of life.”

The clinic is also an educational platform for physicians to observe and practice the continuity of care that is so important in stroke recovery. Neurology residents work closely with neurologists from the Memorial Neuroscience Institute to learn all aspects of the patient’s experience, from the initial acute treatment to rehab and recovery.

Grateful Patient Receives Lifesaving Stroke Treatment at Memorial

Brijesh Mehta, MD, Medical Director of the Comprehensive Stroke Program and Neuro-Interventional Surgery, diagnosed Eric with “a perfect storm” that led to his stroke.

A CT scan of Eric’s brain and a CT arteriogram revealed that the 29-year-old had a blood clot obstructing flow to the right side of his brain. Diagnostic work-up revealed he had a small hole between the two upper chambers of his heart, as well as a blood clotting disorder. Combined, these conditions threatened the life of the Broward County firefighter and paramedic.

“Eric suffered a large vessel stroke, which is not very common in young patients. In these situations, unfortunately, the clot-busting medication, IV tPA, is not as effective. The blockage of the artery was so extensive that he needed a clot retrieval procedure in the cath lab called mechanical thrombectomy,” said Dr. Mehta.

This procedure, which has been around only for a few years, is now the standard of care because of its effectiveness in opening major blockages of arteries in the brain.

Eric had been working out at the gym that day when he started experiencing paralysis on his left side. First his thumb wouldn’t move. Then he lost function in his left leg. His trainer called 911 when he saw that Eric’s face was drooping, followed by weakness in his arm and leg on one side — classic signs of stroke.

He was rushed from the gym to Memorial Hospital West, where Dr. Mehta and his team quickly diagnosed and treated the young man.

“With Eric’s situation,” said Dr. Mehta, “it was the best of both scenarios: He came in early after the onset of symptoms, and he had good collaterals going to the affected area. It takes so many different parts to deliver timely treatment. Everyone works together to make this a seamless process.”

Today, Eric is regaining his strength and experiencing no functional or neurological deficits. He’s back at the gym, nailing the rope climb and pumping iron.

“Dr. Mehta, along with the other team members who were involved at Memorial, saved my life. I am in a much better position than I was before,” said Eric.

Making Miracles During a Pandemic

During fiscal year 2021, they made miracles happen for 64 people through heart and kidney transplants. This included performing two pediatric heart transplants within 24 hours — twice — and performing four kidney transplants within 48 hours.

“I’m very proud of our team for believing and doing the right thing for our patients, each other and the community,” said Juan Arenas, MD, Chief of Memorial Transplant Institute. “They have been flexible and also extremely compliant with additional safety precautions to protect themselves and our patients. Everyone continues to be resilient.”

One of the challenges during the pandemic, Dr. Arenas said, was ensuring everyone involved — from staff to patients and their families — were willing to comply with additional safety precautions that were critical for transplant patients because of their weakened immune systems.

Despite the risks, surgeons knew many transplants were urgently needed.

Maintaining Focus and Flexibility

When the COVID-19 pandemic hit, elective and non-emergency surgeries were suspended at Joe DiMaggio Children’s Hospital. The number of patients quickly diminished. And many team members were redeployed to the front lines, caring for adult patients in other Memorial hospitals, emergency departments and the COVID-19 drive-through testing site in C.B. Smith Park.

Visitors and family members had to be restricted like never before — a stark and distressing change for a children’s hospital that has always involved families and caregivers in all aspects of care and operations.

Instead of focusing on the obstacles at hand, team members put their attention and energy into supporting their colleagues serving adult patients, preparing for how COVID-19 might affect children and teens, and perfecting the children’s hospital’s quality and safety protocols to enhance care.

“One of the most remarkable things to me was how far we have been able to advance our quality and safety programs during the pandemic,” said Ronald Ford, MD, MBA, Chief Medical Officer. “We have always had this culture of safety, but we made tremendous advances in expanding our programs during the pandemic. There was such a high level of engagement from our physicians and staff.”

Joe DiMaggio Children’s Hospital is part of the Solutions for Patient Safety (SPS), a group of more than 150 children’s hospitals working together in an all-teach, all-learn format to improve hospital processes and outcomes. While quality and safety data at Joe DiMaggio Children’s Hospital have always been impressive, the Heroes for Zero initiative is always striving for a zero-harm environment.

At the same time, teams also prepared for how COVID-19 might affect children and adolescents. The focus was on multisystem inflammatory syndrome, also known as MIS-C, which became apparent in some children with COVID-19.

“Even before we saw the first case, we set up a multidisciplinary team that had connected with other experts from around the world — including Italy and the U.K. — to learn from their experience. We created a plan for how to best care for and treat these patients,” Dr. Ford said. “So when we had our first patients present with this, we were ready.”

That multidisciplinary team included specialists from cardiology, infectious disease, critical care, immunology and others.

“Throughout it all, everyone, despite everything that was coming at them every day, was so resilient and nimble. I am so astounded by their resiliency,” Dr. Ford said.

Serving Families Close to Home

The 33,000-square-foot facility is a specialty clinic where patients can access doctors with expertise in a broad range of specialties. Within recent months, the center added a Cystic Fibrosis Clinic, and services include therapy/ rehabilitation, imaging including MRI and ultrasound, and an outpatient surgical center.

“Our overall goal for this location, and one of the reasons we opened it, was to keep the care closer to home for as many kids as possible,” said Dawn Quaranta, Vice President of Regional Operations for Joe DiMaggio Children’s Hospital.

The center also helps to coordinate care for children with complex and chronic conditions, allowing them to see multiple specialists at the center.

“We’re listening to the community — families, local pediatricians and providers — to find out what services are needed and what needs aren’t being met, and work to bring those services to our families,” Quaranta said. “We also coordinate and partner with local pediatricians, specialists and providers to connect patients to other services that we may not have at our Wellington facility. In the end, our goal is to work together to care for our community.”

20 Years of Caring for Children with Facial Differences

The center has become a leading craniofacial center in the nation. The team cares for children with cleft lip, cleft palate, craniosynostosis and other conditions involving the face and head.

Since the start of the coronavirus pandemic, the team reorganized the clinic without significant disruption to continue providing care through telehealth and inperson visits. It continues to provide comprehensive, multi-specialty in-person care to about 50% of its patients each week.

The center also expanded services to Joe DiMaggio Children’s Health Specialty Center in Wellington, where it runs a monthly clinic that allows families living in Palm Beach and surrounding areas to access the same great care closer to their home.

“We provide comprehensive care not only to our patients but to the entire family who has to deal with a patient’s special needs,” said Roman Yusupov, MD, Medical Director and pediatric genetics specialist.

Catch the Love Campaign on Its Way to $56M Goal

The nonprofit Joe DiMaggio Children’s Hospital Foundation has established a $56 million capital campaign goal to help support the vertical expansion of Joe DiMaggio Children’s Hospital from four to eight floors. By May 2021, the organization raised more than $35 million through the Catch the Love campaign.

The number 56 is symbolic, as it reflects Joe DiMaggio’s hitting streak across 56 consecutive games in 1941. The Yankees player’s record remains unbroken.

“It was important to us that philanthropy significantly contribute to the estimated $170 million cost of the children’s hospital expansion, since donors have made it clear they are committed to having the space and resources to be the finest pediatric facility in America,” said Andrew Greenfield, MD, board chairman of the Joe DiMaggio Children’s Hospital Foundation.

Construction at the children’s hospital is ongoing, with estimated completion in late 2022. The additional floors will feature 72 new patient rooms, two cardiac hybrid operating rooms, two surgical suites, intensive care and cardiac intensive care units, an intraoperative MRI, play zones, rehabilitation and family support areas.

“This project will ensure that Joe DiMaggio Children’s Hospital remains uniquely qualified to treat the most complex and critical conditions, so that South Florida kids and families won’t have to travel elsewhere to receive quality medical care,” said Brett Rose, campaign chairman. “By making a gift toward our goal, donors are ensuring the future of a critically important resource and personally making a difference in our community.”

Joe DiMaggio Children’s Hospital is one of the nation’s leading pediatric hospitals and is ranked by U.S. News and World Report. The children's hospital offers a comprehensive scope of healthcare services and programs in a caring, compassionate setting designed specifically for children.

“They do a remarkable job of making the hospital not feel like a hospital,” said Jeff Conine, a former major league ballplayer who knew Joe DiMaggio and has been a philanthropic supporter of the children’s hospital for more than 25 years. “They treat you like family, and Catch the Love embodies the belief that together we can create something even more special.”

Will you help us meet the healthcare needs of South Florida’s children and their families? Donate at JDCH.com/Give.

Orthopedic Center Expands Reach and Services

Joe DiMaggio Children’s Hospital Orthopedic Center continues to enhance and expand its services, resulting in the hospital being ranked the top children’s hospital in Florida for orthopedics by U.S. News & World Report for the third year in a row.

The center has the largest group of fellowship-trained pediatric orthopedic specialists in South Florida. The team has grown from one physician to 10 over the past three decades and has about 60 employees with six locations, stretching from southern Broward to Palm Beach counties.

“All of the members of our team are trained at the leading children’s hospitals in the nation, and our department is now equal to any of them,” said Michael Jofe, MD, Surgeon-In-Chief at Joe DiMaggio Children’s Hospital and Chief of the Department of Pediatric Orthopedics. “We are now one of the busiest and most comprehensive programs in the country.”

“At Joe DiMaggio Children’s Hospital, patients and families can receive world-class care in one location,” he said. “Memorial and Joe DiMaggio have the best medical specialists and staff to cover all patient needs and enable us to collaborate and deliver comprehensive care across all specialties.”

Orthopedic Program Growth

The Orthopedic Center is home to several specialized programs including spinal deformity, sports medicine, hip preservation, limb lengthening, performing arts and dance medicine, and a concussion clinic.

“With every new physician who joins our practice, we are able to expand our services and specialties,” said Melissa Vale, Director of the Orthopedic Center.

The two newest members of the orthopedic surgery team — Michael Aversano, MD, and Andrew S. Gupta, MD — have created a new Hand and Upper Extremity Program to provide specialized care for children and adolescents with traumatic and congenital conditions. See related story.

The Center for Hip Preservation is a nationally recognized resource for patients from infancy to young adulthood for the care and treatment of congenital and acquired hip conditions, hip dysplasia and femoroacetabular impingement. It is one of the few comprehensive programs in the country, due to the specialized training and expertise required to perform the complex procedures and the resources necessary for pre- and post-operative care.

The concussion program also continues to expand as the community’s needs grow. Specialists now consistently see several patients every day with sports-related concussion injuries.

“Having so many subspecialists within the orthopedic department and at Joe DiMaggio Children’s Hospital elevates the experience for patients and providers alike,” Dr. Gupta said.

[U18] Sports Medicine Program Expansion

The [U18] Sports Medicine Program continues to flourish. It expanded its school sports outreach program, making it one of the largest school-based athletic training programs in the country.

Twelve schools joined the program, bringing the total number of public high schools covered to 41, spanning Broward and Palm Beach counties.

“Our team has a vision of being able to provide best-practice services to athletes even beyond the scope of our own program,” said Matthew Fazekas, MD, FAAP, CAQSM, Medical Director of the Pediatric Sports Medicine Program. “Despite COVID, despite school districts modifying athletics and school itself, we’ve still grown to provide Certified Athletic Trainers for about half of Palm Beach County. This is not something you see happening in a lot of other communities.”

The program also offers student athletes guidance on injury prevention, injury assessment and evaluation, connections to pediatric orthopedic specialists and rehab services at Joe DiMaggio Children’s Hospital and return to play evaluations at their schools.

Advocating for Athletes in Florida and Beyond

Members of the orthopedic and sports medicine team are advocating and providing care for athletes on a state, national and international level. In addition to working with Broward County schools, Dr. Fazekas serves as a board member for the Florida Alliance for Sports Medicine and as a consulting physician for USA Figure Skating.

Michael Dressing, MD, is a consulting physician for USA Soccer and is an affiliate team physician for the Washington Nationals major league baseball team.

This past year, Jeremy Frank, MD, has continued to travel internationally with the United States National Wrestling Team, serving as a team physician. He’s been working with the team for more than 14 years, and this year traveled to both France for the French Grand Prix and Norway for the World Wrestling Championships.

“My specialty is taking care of pediatric, adolescent and young adult athletes who get injured and either surgically or non-surgically help them get back to full function," Dr. Frank said. “It’s an honor to take care of people who represent the United States and to represent Memorial and Joe DiMaggio Children’s Hospital while doing so.” Any family with a child with orthopedic needs can feel secure in knowing that they will get worldclass care at the Joe DiMaggio Children’s Hospital Orthopedic Center.

Hand and Upper Extremity Program Grows

Joe DiMaggio Children’s Hospital Hand and Upper Extremity Program continued to expand in its first year, growing its staff of highly specialized experts who care for children, adolescents and teens.

The program, which started in 2020, is part of the hospital’s Orthopedic Center — the largest group of fellowship-trained pediatric orthopedic surgeons in South Florida.

The Hand and Upper Extremity team — led by pediatric orthopedic surgeons Michael Aversano, MD, and Andrew S. Gupta, MD — cares for children with sports-related and traumatic injuries, as well as those with neurological and congenital conditions that affect the hand, wrist, forearm, elbow and shoulder.

Drs. Aversano and Gupta have both completed several specialized fellowship training programs to become experts in the care of children and adolescents with hand and upper extremity needs.

“I think that an essential part of the growth of the program and a big part of its success comes from the support of the entire Joe DiMaggio Children’s Hospital community. We’re growing a very specialized team with an emphasis on providing a complete continuity of care experience for our patients,” Dr. Aversano said.

This year, the team welcomed a pediatric interventional radiologist for upper extremity diagnostic and procedural studies.

“We have our support staff, physicians, radiologists, occupational and physical therapists all in one place,” he said. “This environment not only results in better outcomes, but also helps build a better relationship with our patients and families.”

An Evolving Field

The field of pediatric hand and upper extremity surgery is constantly evolving and continues to expand as technology and innovation unite. The children’s hospital team constantly seeks to enhance methods of treatment through evidence-based practice and connect with physicians across the globe to learn new and exciting treatments for hand and upper extremity conditions.

Children and adults have different orthopedic needs that should be considered during care and treatment.

“Kids are still growing, and our treatment must take into account what will happen as they develop,” Dr. Aversano said.

He added: “Medicine is changing and evolving. Everything is becoming more and more specialized, and treatments are becoming more complex as we learn new and exciting things. It is our goal at Joe DiMaggio Children’s Hospital to be at the forefront of high-quality and life-changing care both locally in South Florida and nationally.”

Children’s Hospital Receives Highest Surgical Verification

Joe DiMaggio Children’s Hospital received Level I Children’s Surgery Verification from the American College of Surgeons Children’s Surgery Verification Program. The hospital is one of only two in the state with Level I verification and joins an elite list of only 33 hospitals nationwide with this honor.

“Achieving Level I speaks to the caliber of the surgical team at Joe DiMaggio Children’s Hospital and attests to our capability for meeting the most complex surgical needs of our pediatric community,” said Jill Whitehouse, MD, Vice-Chief of Pediatric General Surgery. “It also demonstrates our team’s passion for excellence and our dedication to safety and quality that extends to every patient we touch.”

The verification is given to centers that show a commitment to quality care, have highly trained staff, participate in cutting-edge research and have surgeon leaders who review outcomes throughout the year.

Food Pantry Opens to Help Nourish Hospital Patients and Families

Joe DiMaggio Children’s Hospital is doing its part to stamp out hunger in South Florida. In February 2021, the hospital opened a food pantry for patients and their families to provide healthy, nutritious foods they can take home and that will help in their healing and recovery. Created in partnership with Lions Club International and Feeding South Florida, the Food Pantry is expected to benefit about 750 families in 2021.

OB and NICU Collaborate on Care Delivery

Collaboration between pediatric specialists at Joe DiMaggio Children’s Hospital and obstetrical teams at Memorial Healthcare System enables the delivery of highly personalized care to mothers and their babies born with complex medical conditions.

In December 2020, the teams collaborated to successfully perform an ex-utero intrapartum treatment procedure — also called an EXIT procedure — in which doctors provided care to a newborn during birth via cesarean section.

“The entire team invested months of preparation to get it right,” said Holly Neville, MD, Chief of Pediatric General Surgery and Associate Program Director of the Surgical Residency Program.

Coordinated Care for Complex Pregnancies

When a woman has a pregnancy that is considered high risk or other maternal and/or fetal complications arise, they are referred to Memorial’s Maternal-Fetal Medicine program run by Laurie Scott, MD.

The program coordinates care between Memorial OB specialists and pediatric specialists at Joe DiMaggio Children's Hospital — including those from the Wasie Neonatal Intensive Care Unit, which provides Level ll and Level lll neonatal intensive care services for about 850 babies a year. Together, they provide seamless, expert care for both mother and baby throughout the pregnancy, birth and beyond.

Pediatric specialists also meet with the mom-to-be and family prior to the delivery to answer questions about the treatment and care that may be required for their child once the baby is born.

"We meet monthly with perinatology, nurse navigators, neonatology, pediatric cardiology and pediatric surgery to create and refine care plans,” said Lester Mc Intyre, MD, Chief of Neonatology. “The key is anticipation, so you know what you’re dealing with and you have all of the necessary resources available.”

Nurse navigators arrange care throughout the process and alert all doctors, nurses and specialists involved with the patient as the pregnancy progresses and when a mom is set to deliver.

“Everyone knows the plan of care; all of the subspecialists and providers are kept in the loop. We all have the plan and know what will happen the second the baby is born,” said Janessa Alonso, MSN, MHA, RNC-NIC, Director of Nursing in the NICU.

If unknown complications arise during a delivery, the NICU team is notified immediately and on hand to provide the emergency care needed.

“There is an established relationship between the OB and NICU teams,” said Barbara Glassman, MSN, Clinical Project Manager in the NICU. “On the nursing side, we are in constant communication throughout our shifts, so when something arises, collaboration is natural.”

Once a baby is delivered, mom and baby both have access to the specialty care they need in one place.

“Since the care plans are refined each month, there is a seamless handover that happens at the time of delivery,” Dr. Mc Intyre said.

EXIT Procedure

The collaborative processes between pediatric specialists at Joe DiMaggio Children’s Hospital and obstetrical teams at Memorial Healthcare System were critical when they came together to perform the first EXIT procedure at Memorial. The procedure was performed to successfully deliver a baby with a mass on the tongue that would interfere with the baby’s ability to breathe. Pediatric ENT and head and neck surgeon Sweeti Shah, DO, was able to intubate the baby during the C-section, while the baby was still attached to mom via the placenta for support.

Since the procedure was a first at Memorial, the team prepared for months, doing research, planning and performing run-throughs.

“Everyone brought their knowledge and practical experience together for the benefit of these patients,” said Dr. Neville.

After the C-section, the baby was brought to the NICU and is now being followed by Dr. Shah.

Dr. Neville said this is a perfect example of the collaborative care delivered at Memorial. “Everyone went above and beyond for that baby.”

Weight-Loss Surgery Program for Teens

The new Joe DiMaggio Children’s Hospital Adolescent Weight-Loss Surgery program is helping teens and young adults lose weight and gain confidence with specialized programs tailored to meet their unique needs.

While surgeons at Memorial have performed weightloss procedures on adolescents in the past, they realized that teens have different needs from adults and had nowhere to turn for specialized services and support.

“Young adults are in a different place in their life and have different needs than adults,” said Brett Cohen, MD, Chief of Adult General Surgery and Bariatric Surgery at Memorial. “And there aren’t many programs out there tailored to meet their emotional, psychological and physical needs, as well as the support that can help them achieve their long-term health and weight-loss goals.”

Since the program’s inception in 2020, surgeons have helped more than 30 young adults lose weight via sleeve gastrectomy, a type of bariatric surgery in which part of the stomach is removed, limiting food intake. Others have utilized our medical weight-loss programs for patients who do not qualify for or want to undergo surgery.

The program has been successful thanks to the collaborative team approach by the surgical teams and pediatric specialists, including Lital Reitblat, MD, Pediatric Endocrinologist, who works with teens and young adults before and after surgery.

"I promise them that I'm going to be with them throughout this journey," Dr. Reitblat said. "We take into consideration the multiple things that adolescents need. We provide that sort of wraparound care."

All patients must go through a four-to-six-month program before undergoing surgery. They work with a mental health specialist and nutritionist, both of whom are experienced in working with young adults.

“The program is about much more than an operation. It’s about making changes, and the surgery makes these changes easier to be successful with,” Dr. Cohen said.

Memorial Welcomes Female Surgeons to General Surgery Team

Two female surgeons have joined Memorial Healthcare System’s general surgery team. Mia Shapiro, MD, joined Memorial in 2019 and Kristina C. Khazeni, MD, in 2020.

While the number of female medical students and doctors continues to rise, women have remained underrepresented in many surgical fields. That is changing.

“The trends in representation in the field of surgery have changed dramatically across the United States,” said Dr. Shapiro. “I went to school in New York, and in my graduating general surgical residency class, I was one of eight female chiefs in an all-female class. While the hospital surgical department was predominantly male, there were women represented in each specialty and plenty of female mentorship.”

“I think that as a whole, the surgical fields have become more family-friendly, which has led to an increase in the number of female surgeons,” said Dr. Khazeni.

As general surgeons, Drs. Khazeni and Shapiro join the Memorial team in caring for patients with a wide variety of conditions and ailments.

Dr. Khazeni specializes in intra-abdominal pathologies and hernias, and cancer.

Dr. Shapiro treats soft tissue conditions and performs hernia, gastrointestinal and weight-loss procedures.

“I am lucky to be in a place that takes a collaborative approach to patient care. We strive to do things with the most minimally invasive approach possible so that patients can recover quicker," Dr. Khazeni said.

Now both are looking forward to working with patients, medical students and the community.

“We are looking forward to continuing to grow Memorial’s general surgery practices in South Florida. We will also be opening up a bariatric surgery office in the Midtown Miami area, and I am looking forward to increasing access to what I believe is life-altering surgery,” Dr. Shapiro said.

A Leader for Hernia Surgery

Memorial Healthcare System Hernia Program is working toward becoming a Center of Excellence and continues to offer specialized and personalized care for patients.

The center is home to surgeons with expertise in hernia treatment using standardized procedures and offering a unified approach to care. While the COVID-19 pandemic slowed the certification process, the team hopes to become a Center of Excellence by the end of 2021.

The initial program was a pilot out of Memorial Hospital Pembroke with four surgeons but now includes surgeons at other Memorial hospitals as well.

“This program has enhanced our ability to work together using the latest, evidence-based protocols, helped us improve services as we track our results and provided patients with education and support as they heal,” said Joe Stuczynski, CEO of Memorial Hospital Pembroke.

The center will enable patients to come to one place and find an experienced surgeon who specializes in their specific type of hernia, which is important as hernia procedures become more complex.

“Hernia treatment has evolved immensely, from the tools available to the techniques that we use,” said Jeremy Gallego Eckstein, MD, Medical Director of the Hernia Program and Associate Medical Director of Bariatric Surgery.

The Hernia Program will also be providing a unique, minimally invasive procedure pioneered by Dr. Eckstein at Memorial Hospital Pembroke called Rectus Abdominis Minimization (RAM) that fixes hernias and stretched stomachs in women after pregnancy.

“We don’t box ourselves into one particular technique or technology,” Dr. Eckstein said. “We use everything that is available so that we can create a customized treatment plan for each patient.”

Embracing Virtual Solutions to Serve Patients

Digital technology and virtual connections proved especially useful to the team at Memorial Rehabilitation Institute during the pandemic. These tools allowed physicians, therapists and nurses to connect with patient families in order to provide virtual training to caregivers and to keep the patient safe after discharge.

"Adaptive sports and recreation activities have continued and are being offered virtually,” said Dawn Broksch, Associate Administrator, Memorial Regional Hospital South.

“These online groups help participants feel less isolated while encouraging them to remain active by considering activities like gardening. These are not necessarily group activities, but things people can do at home to stay active.”

Digital tools also aided professional development and knowledge sharing. Rehabilitation Grand Rounds, Multidisciplinary rounds and Memorial Sports Medicine Journal Club and Lecture series were held virtually to allow multiple locations across Memorial Healthcare System and our community to participate in education.

The virtual Memorial Sports Medicine Journal Club and Lecture Series was established as a means for surgeons, physicians and therapists to exchange ideas and knowledge about the latest clinical evidencebased research and practice in orthopaedics and rehabilitation.

The Memorial Graduate Medical Education Physical Medicine and Rehabilitation Residency Program at the institute remained connected as well. In February, participants “attended” the first virtual conference for the Academy of Academic Physiatrists.

“Although the pandemic has changed some workflows, Memorial Rehabilitation Institute is still able to offer quality programs to our community,” said Douglas A. Zaren, FACHE, Administrator and Chief Executive Officer, Memorial Regional Hospital South, Memorial Rehabilitation Institute and Memorial Rehabilitation Institute Post-Acute Care Network.

Orthopaedic Surgery and Sports Medicine Center Opens in Fort Lauderdale

Fort Lauderdale and North Broward County hailed the grand opening of Memorial Orthopaedic Surgery and Sports Medicine Center at the Cypress Creek Medical Pavilion. The virtual opening and ribbon-cutting ceremony took place in March 2021 via Facebook Live.

Centrally located near the Fort Lauderdale Executive Airport, the center is the first of its kind in the area to offer joint replacement surgery in an outpatient surgical facility.

The 9,000-square-foot center is unique since patients can receive evaluations, scans, procedures and physical therapy all under one roof. The multidisciplinary team includes board-certified, fellowship-trained surgeons, physicians and therapists who specialize in sports medicine, joint replacement, fracture care, image-guided injections and physical therapy. They use the latest medical advances to realize individualized treatment plans and to produce quality patient outcome, regardless of age or activity level.

Daniel B. Chan, MD, Chief, Orthopaedic Surgery and Sports Medicine at Memorial Healthcare System is the center’s medical director. He works closely with Marvin Smith, MD, Sports Medicine Orthopaedic Surgeon, and Geden Franck, MD, Sports Medicine Primary Care, who are also part of the center’s topnotch medical team.

“Our outpatient anterior hip replacement surgery has been a game changer for patients. Patients are literally walking within 30 minutes of surgery,” said Dr. Chan. “We’re sending total hip and total knee patients home the same day.”

The new Fort Lauderdale facility follows in the footsteps of the Hollywood-based center at Memorial Regional Hospital South. With the opening of the new center, Memorial’s services and care will reach even more residents in South Florida.

“This facility is very special,” said Dr. Smith. “It allows us to branch out and serve even more of our community and really bring that top-flight orthopaedic care and sports medicine that we’ve been providing for many of our South Broward and Miami-Dade County residents.”