It was just the beginning. Brett spent the next six months in the hospital, the victim of a mosquito bite that gave him West Nile, meningitis, encephalitis, Zika and dengue — “the ultimate concoction,” as he puts it.

“You’ve heard of the billion-dollar lottery?” Jerry says today. “That’s what this was — his one in a billion chance. He can’t win the lottery, but he gets this!”

The combination of infections and his immune system’s response had damaged the spinal cord and led to quadriparesis for Brett, meaning his arms and legs were weakened and his mobility impaired.

“Quite frankly, at the time, I was scared,” Brett recalls, “because that’s when the reality of what was my new life hit me: Hey, I can’t get out of bed. I can’t put my socks on.”

Journey to Recovery

When Brett was admitted, Joanne Delgado-Lebron, MD, felt a bit overwhelmed.

“He had one of the worst clinical presentations of West Nile you can have, plus encephalitis, meningitis and the neuromyelitis,” she says. “It was different from other types of spinal cord injury or neuro diagnoses we commonly see.”

While Brett doesn’t remember much about this time, Jerry vividly recalls the stress he and his family experienced, but Memorial’s caring and compassion made a true difference.

“Never once did I not have a brother or sister at Memorial,” he says. “Never once did I feel like I was in the dark. Every single doctor and nurse answered my questions — sometimes two, three, five times a day.”

After four weeks in the ICU, Brett was well enough to enter rehabilitation, where the hard work really began.

“Brett really wanted to get back to where he was. He had a very happy life, a very rich family life, great work life,” says James Salerno, MD, Chief, Physical Medicine and Rehabilitation.

"In spite of his situation, Brett refused to be pessimistic,"" Dr. Delgado-Lebron says.

“One of the main things that helped was Brett’s personality,” she says. “He was always very positive and compliant with the therapy, which was good because when you have West Nile and neuromyelitis, it can go either way.”

Brett is a symbol of what Memorial is able to do. To see patients on their first day, when they’re feeling hopeless, and then see those same patients walk into your office months after completing their therapy, living their usual lives — that warms my heart.”

Joanne Delgado-Lebron, MD
Associate Program Director, Physical Medicine & Rehabilitation Residency Program

Memorial tailored Brett’s rehabilitation program specifically to his needs, to help him achieve each of the milestones he and the team set. With each goal he reached, the care team expanded the plan to help him achieve even more.

“He had a severe injury and required a lot of help, but he was very diligent and hardworking,” says Dr. Salerno. “And because of all the different aspects of care that Memorial Rehabilitation Institute puts on the table — like certified specialists in brain injury therapy that a lot of other centers don’t have to the degree we do — we were able to help Brett achieve the recovery he wanted.”

Brett underwent physical therapy for 20-plus hours a week as both an inpatient and outpatient. After his discharge, Rich Gach, PT, DPT, visited Brett’s home regularly to provide more therapy. “Seriously, it was the most wraparound healthcare imaginable,” Jerry says.

Drs. Salerno and Delgado-Lebron think of Brett as one of Memorial’s most remarkable success stories.

“Brett is a symbol of what Memorial is able to do,” Dr. Delgado-Lebron says. “To see patients on their first day, when they’re feeling hopeless, and then see those same patients walk into your office months after completing their therapy, living their usual lives — that warms my heart.”

Brett and physical therapist Kantica Arora, DPT

Members of the Family

The story of Brett’s rare illness and recovery is an example of the outstanding healthcare that patients receive at Memorial, from acute care to rehabilitation. It also sums up Memorial’s approach to transformational, 360-degree care — because while Brett is back to functioning at nearly 100 percent, Memorial remains a part of Brett and Jerry’s family and will continue to touch them throughout their lives.

“Memorial truly owns our experience,” Jerry says. “We can’t thank them enough for what they’ve given us. We’ve made friends for life there.”

I really got to experience almost every facet of the Memorial system,” Brett says. “I don’t think there was an MRI, CT scan or other test that I didn’t go through. I had an amazing team between cardiology, neurology, occupational therapy, general medicine and pulmonology. I got to experience the system at its finest.”

Brett Rose
Ft. Lauderdale

Brett with rehabilitation nurse Irma Valencia, RN; occupational therapist Carly Sheppard, OTR-L; and physical therapist Kantica Arora, DPT.

When they do get an appointment, they may not know what questions to ask and may not understand their doctor’s instructions. Or maybe their doctor can’t talk to them in their preferred language.

All of these factors affect access and contribute to healthcare disparities. Memorial is committed to leading change for the better.

“Health equity challenges us, as a system, to go beyond the four walls of our hospitals and provide equitable care for all populations we serve,” says Melida Akiti, Vice President, Ambulatory and Community Services.

She noted that Memorial began these efforts before COVID-19, but the pandemic made the world aware of just how disproportionately healthcare is provided in the developed world.

“The future of healthcare demands that we narrow the gaps in healthcare disparities and provide outstanding clinical access to guarantee healthcare equity for all,” Ms. Akiti says.

The future of healthcare demands that we narrow the gaps in healthcare disparities and provide outstanding clinical access to guarantee healthcare equity for all,” Akiti says.”

Melida Akiti
Vice President, Ambulatory and Community Services

Memorial is making a difference through a wide range of community initiatives:

• West Park COVID-19 Vaccine Initiative – A door-to-door campaign to offer doses of the Pfizer vaccine in West Park, home to the highest COVID-19 death rate and the lowest incidence of vaccination. The two-month program logged 4,011 household visits and 538 residents vaccinated.
• West Park Healthy Start – The city also had high incidences of low birthweights and low engagement with primary care. Memorial connected West Park women with its Healthy Start program, which provides prenatal and post-natal care coordination and home visits for at-risk moms.
• Health Literacy – The COVID-19 vaccine rollout gave Memorial an opportunity to improve understanding of basic health information and educate on the virus, prevention, testing and treatment. Memorial also hired a local survivor as a healthcare navigator. Supported by a grant from Broward County, the initiative recorded 4,361 encounters from July 2021 to April 2022. It continues through FY2023.

New parents and baby at the Family Birthplace

• Breast Imaging for Women of Color – Minority women were especially hesitant to visit medical facilities during the pandemic. So, with support from a $200,000 grant from the Community Foundation of Broward, Memorial and community partners promoted mammograms, ultrasounds, MRIs and breast biopsies among Black and brown women. Services were offered at Memorial Hospital Miramar’s Women Center, including evening and weekend appointments. Since July 2021, the campaign has reached 129 patients through 244 exams and interventions.
• Improving Obstetric Outcomes for Minority Women – With funding support from America’s Essential Hospitals, Memorial’s Maternal Program engaged an RN Navigator and OB Healthcare Navigator to serve about 400 pregnant women of color with high-risk conditions. Navigators taught patients how to self-monitor and connected them with OB physicians, facilitated communication between L&D and mother-baby teams, and monitored patients’ blood pressure for six weeks after birth. Evidence shows that outreach and follow-up within 14 days of delivery can help reduce pregnancy-related morbidity and mortality for Black and brown women.
• COVID-19 Long Haulers’ Clinic – From May 2021 to May 2022, with $750,000 in funding from Broward County, Memorial assembled a multidisciplinary team to offer specialized care and track a course of treatment for long-haulers’ ongoing symptoms. The team assessed 519 patients and connected them with pulmonary, hematology, neurology and physical medicine specialists.
• COVID-19 Vaccine Mobile Outreach – The bilingual and culturally diverse Mobile Health Program was already a visible presence in South Broward. Beginning in January 2022, with a $220,000 grant from the Broward Regional Health Planning Council, Memorial deployed a mobile COVID-19 vaccine initiative in the Dania and East Miramar neighborhoods. Five multidisciplinary staff educated members of the community — addressing vaccine hesitancy, debunking COVID-19 myths, and scheduling and administering vaccines. By April, 4,005 doses were administered.

“People want to be more proactive in their own process of care,” says Jeffrey Sturman, Senior Vice President and Chief Digital Officer. “A lot of it involves technology, but also exploring new ways to deliver care outside our walls.”

A lot of it involves technology, but also exploring new ways to deliver care outside our walls.”

Jeffrey Sturman
Senior Vice President and Chief Digital Officer

Extensive data management can help develop a full picture of patient health, including clinical and non-clinical information. Bringing this information together and managing it in a strategic way helps provide a patient with a lifetime of value-based care.

There has been a real shift in focus in primary care – we are taking on full responsibility for not just the health of the patient in the exam room, but the health of the patient’s entire community.”

Jennifer Goldman, DO, MBA, FAAFP
Chief, Primary Care

Changing the Healthcare Consumer Experience

Our digital team is working with Memorial Physician Group, Memorial Health Network, Marketing & Communications and all medical service lines to ensure consistent processes and to proactively educate patients and their families on their health.

In February 2022, Memorial established the Patient Access Center, offering more ways to connect with Memorial and get health information, make appointments, communicate with providers, manage prescriptions and coordinate follow-up care.

The center features new digital tools, including chat, text and self-service, in addition to existing tools like telehealth and remote patient monitoring.

Care Coordination Is Key

Memorial’s Care Coordination approach — with our six acute-care hospitals working together to manage patient care, flow, transfers and care after discharge — will take the patient experience to the next level.

Care Coordination requires innovative technologies for care inside and outside the hospital. For example, a virtual observation program places cameras in patient rooms to monitor patient needs and prevent incidents such as falls. The cameras connect to the Care Coordination Center.

Click image to view a 360-degree virtual image of the Care Coordination Center.

Sturman says it’s an excellent example of how Memorial is making care more efficient during and after patient stays.

Just as important is coordination after discharge, says Monica Puga, Vice President, Population Health and Digital Innovation. She notes that patients may face barriers once they get home, such as social determinants of health.

“If we don’t help address their socioeconomic needs, it’s going to affect their overall quality of care,” she says.

That’s why Memorial regularly contacts patients for 60 to 90 days after discharge to help them and their families better manage their conditions and provides medical devices in the home. Memorial’s electronic records system alerts when values get out of range, allowing providers to take immediate action for successful outcomes.

Home Monitoring Has the CHOPs to Improve Patient Experience

The 23,000 percent increase in telehealth consultations during the pandemic was just the beginning. Now, Memorial is extending its reach even further with the expansion of remote patient monitoring.

This allows Memorial to track changes in patients’ conditions at home and make changes to medication or care to help them avoid a return to the hospital or ER. And it’s fundamentally reshaping healthcare by placing the digital team squarely in the care delivery process, Sturman says.

One recent example is CHOP — Memorial’s COVID Home Oximetry Program, which monitors emergency department patients suspected of having COVID-19. CHOP provides patients with pulse oximeters to monitor their oxygen levels, registers patients in MyChart and uses the MyChart Care Companion for home monitoring on discharge.

Since its launch in 2020, CHOP has enrolled 3,691 patients through the end of May 2022 and successfully managed 2,700 patients, while keeping nearly 75 percent of all patients out of the hospital.

CHOP made a signficant difference during the COVID Delta surge, by safely caring for patients in their homes while decompressing our emergency rooms.”

Monica Puga, APRN
Senior Vice President and Chief Nurse Executive, formerly Vice President, Population Health and Digital Innovation

DEI policies and practices play a critical role in our ability to fulfill our mission as a safety-net provider and one committed to improving the health of our diverse community.”

Vanessa Nazario
Corporate Director and Chief Diversity Officer

In its first year, the Office of DEI has been able to improve nearly every practice, policy and procedure it examined, including:

• Updating key demographic fields in EPIC, Memorial’s electronic medical records system, to specify accommodation needs
• Adding DEI questions to Memorial’s annual Employee Engagement Survey
• Establishing an Employee Gender Transition Policy
• Launching Memorial’s Health Equity Strategy
• Observing cultural and heritage events and celebrations
• Adding DEI to New Employee Orientation
• Securing the system’s first Healthcare Equality Index designation from the Human Rights Campaign, which measures providers’ policies and practices related to LGBTQ+ inclusion
• Signing the American Hospital Association’s #123 for Equity pledge and the CEO Action Diversity & Inclusion pledge
• Renaming the Special Needs Council as the Ability, Accessibility and Inclusion Council, and
• Establishing a Physician DEI Advisory Council

DEI Advisory Council Executive Sponsors

Nina Beauchesne, FACHE
Executive Vice President and Chief Transformation Officer

Marc Napp, MD
Executive Vice President,
Chief Medical Officer

The 25-member physician council provides guidance and support for a comprehensive, integrated DEI approach that aligns with Memorial values and strategic priorities. In addition to instilling best practices across the system, council members’ critical insights and contributions promote a culture of belonging.

This work is important because healthcare organizations accept and care for anyone who comes through the door, notes council member Marc Napp, MD, Executive Vice President and Chief Medical Officer.

With a $200,000 grant from Community Foundation of Broward for breast cancer research, the MCIFAU partnership continued to break new ground. The grant’s purpose was to examine disparities of cancer occurrence in different population groups and identify possible biomarkers. Now, with a second foundation grant for $300,000, the partnership is building on that research by creating a cancer bio repository.

On the COVID-19 front, Memorial is working with the FAU Schools of Nursing and Engineering to develop an Artificial Intelligence (AI) model that will help evaluate and predict long-term health outcomes of the pandemic.

What’s next? Says Candice Sareli, MD, Vice President and Chief Medical Research Officer: “We’ll work to increase our scope of clinical trials, continue collaborating with FAU on the development of medical devices, and keep pursuing AI and predictive modeling — all of which will play a greater role in healthcare’s transformation.”

Candice Sareli, MD
Vice President and Chief Medical Research Officer

Luis Raez, MD
Medical Director and Chief Scientific Officer, Memorial Cancer Institute

For more than 12 years, Memorial earned high ratings for cardiac surgery.

Memorial has become a destination heart center by offering:

• Advanced care for any stage of life, including Broward’s first pediatric and adult transplant programs
• Comprehensive, lifelong treatments for congenital heart patients
• Innovative approaches that reduce risk and improve outcomes — like fluoroless cardiac ablation, ECMO, and radial cardiac catheterizations and angioplasties
• Highest 3-star rating from the Society of Thoracic Surgeons for coronary artery bypass grafting (CABG), mitral valve replacement and repair (MVRR), CABG+MVRR and transcatheter valve therapy
• A team approach by pediatric and adult electrophysiologists and surgeons to successfully treat the most complex cardiac rhythm problems
• Graduate Medical Education, training fellows in all aspects of cardiac care

Consistently earning a prestigious accolade like the three-star rating from STS is a demonstration of Memorial’s commitment to our cardiac patients and their families, who know they can count on us for excellence and quality in their TotalHeart care.”

Juan Plate, MD
Chief, Adult Cardiac Surgical Services

Now, Memorial Cardiac and Vascular Institute has forged new pathways with recent milestones:

• The Harmony valve – This year, Memorial performed South Florida’s first minimally invasive transcatheter valve replacement on a congenital heart patient using the Harmony valve. This allowed the patient to avoid open-heart surgery and go home the next day.
• Epicardial ventricular tachycardia ablation – Memorial offers one of South Florida’s most advanced ventricular ablation programs, and we are one of the few providers in the state with the expertise to map and treat complex arrhythmias that originate in the epicardial surface of the heart.
• The Gold Standard in Life Saving Support — The Extracorporeal Life Support Organization, an international body of experts who establish best practices in the provision of extracorporeal membrane oxygenation, or ECMO, has designated Memorial Regional Hospital and Joe DiMaggio Children’s Hospital as ELSO Gold Center of Excellence ECMO programs that provide support of failing organ system in infants, children and adults.
• Advanced Heart Failure Accreditation — Memorial Regional Hospital was the first hospital in South Florida to earn Advanced Heart Failure Accreditation from the American College of Cardiology, joining a small group of elite heart failure programs in the United States that have demonstrated the highest criteria in treating the most complex cases of heart failure.

We put into place a very comprehensive program to ensure the patient is getting the best possible care — and our outcomes bear that out.”

Michael Cortelli, MD
Chief, Memorial Cardiac and Vascular Institute

Continuing to Transform Cardiac Care

Vivian, who had microvascular angina and Kashmira
Bhadha, MD

Key areas of cardiac focus for the future include:

• Preventive care – Memorial emphasizes preventive techniques and working with patients to change their lifestyles, with the goal of eliminating the need for more advanced treatments in the future.
• Heart health for women – Because distinct differences exist between men and women in how they present with heart disease, Memorial is prioritizing prevention and cardiac care among women and is laying the groundwork for cardio obstetrics.
• Cardio oncology – The interaction between cancer and heart disease grows as cancer therapies continue to demonstrate some near- and long-term cardiovascular consequences. The TotalHeart team is collaborating with Memorial Cancer Institute colleagues to address these interactions.

In our team approach, cardiac patients are not ‘my’ patient, they’re our patients.”

Ralph Levy, MD
Chief, Adult Cardiac Medical Services

Improving Care Through Research

Memorial is committed to improving patient care through clinical research, and that includes clinical and academic studies.

Clinical

• Relieve-HF – Seeks to alleviate symptoms like shortness of breath in older patients with congestive heart failure by making a 5mm hole between the heart’s left and right atria and preventing blood backup into the lungs. Jonathan Roberts, MD, Medical Director, Interventional Cardiology Clinical Research and Education, and Program Director, Cardiology Fellowship Program, says the study explores whether the procedure can improve quality of life for older patients when other treatments may not be an option.

Academic

Fellows in Memorial’s cardiac Graduate Medical Education program, now in its second year, are conducting research that will help define the future of cardiovascular care:

• Developing a database tracking every Memorial patient with cardiac amyloid to determine the best ways to diagnose and treat it
• Analyzing the medical outcomes and mortality differences of heart attack patients with COVID-19 versus those without
• Studying methods of reversal of anticoagulation in patients undergoing transcatheter aortic valve replacement, and
• Examining the incidence of atrial fibrillation in young patients who experience stroke after a procedure to close the patent foramen ovale, a hole between the heart’s upper chambers that usually closes after birth

Our fellows aren’t just learning about the area they’re studying – they’re learning how to understand scientific techniques and processes, which, down the road, will help them make the best decisions for their patients.”

Jonathan Roberts, MD
Medical Director, Interventional Cardiology Clinical Research and Education, and Program Director, Cardiology Fellowship Program

Cardiac fellows Jorge Conte, MD; Fangcheng Wu, MD; Cameron Cu, MD; Kishor Khanal, MD; and Komal Imtiaz, MD

After 29 years at the Our Lady Health System, Mr. Wester sees similarities between its culture and Memorial’s, noting that both organizations emphasize the health and wellness of the whole person.

“At Memorial, every one of us is an owner of the concept that we are the place people turn to — not just when they’re having a difficult time in their lives, but at all times — the indispensable provider for complete health,” he says.

Mr. Wester will lead Memorial and its 14,000 employees as the organization enters a pivotal next chapter in its nearly 70-year history — emerging from the COVID-19 pandemic and pursuing innovative ways to provide Memorial’s nationally recognized patient- and family-centered care.

Memorial’s Graduate Medical Education program, its focus on health equity for all and its diversity and inclusion efforts will play important roles in that transition.

“GME will help evolve Memorial into a formidable academic enterprise,” he says. “It is a crucial element of a thriving system — one that is forward-thinking and that refuses to stay in the present.”

At Memorial, every one of us is an owner of the concept that we are the place people turn to ... the indispensable provider for complete health.”

Scott Wester, FACHE
President and CEO

This is a great example of value-based care — in which providers guide people through their entire health journey, at all times and in all places.

“It’s an essential transformation of healthcare: extending our services well beyond someone’s discharge from the hospital to make sure that person stays healthy,” says Matthew Muhart, Executive Vice President and Chief Strategy Officer. “We’re moving from being hospital-centric to health-centric.”

Memorial follows the Accountable Care Organization (ACO) approach. ACO providers give proactive, preventive care that will help patients avoid future ER visits, hospitalizations and readmissions. (Providers receive additional incentive in the form of increased reimbursement — shared savings payments — from payors).

For example, Memorial Health Network, with more than 1,700 physicians who serve 215,000 participants, negotiates value-based agreements with payors — working to lower the total cost of care by improving quality, efficiencies and communication between providers and anywhere patients receive services.

Memorial has built the infrastructure to go beyond being a hospital system and keep people as well as they possibly can be. It’s individualized care centered around the entire person.”

Matthew Muhart
Executive Vice President and Chief Strategy Officer

Memorial also is expanding value-based services by:

• Partnering in 2021 with the Oscar health insurance company and Holy Cross Health to offer a co-branded Medicare Advantage plan in South Florida
• Acquiring Broward Guardian ACO in 2020 to offer a broader network of value-based practitioners to Medicare recipients. This year, Broward Guardian ranked No. 1 among Medicare Shared Savings Programs (MSSPs), with the highest savings per capita than any other high-revenue ACO in the nation.
• Participating in a large number of other Medicare value-based (bundled payment) programs
• Exploring creative initiatives like Memorial Health Assurance, a self-funding healthcare plan for small and midsize businesses in South Florida

Overall, the savings realized under Memorial’s value-based initiatives have been substantial: more than $165 million in the total cost of care since 2013 and $4.5 million under Broward Guardian this fiscal year alone. And most important, these initiatives help ensure that Memorial keeps the whole person at the center of care.

“Our mission is to heal the body, mind and spirit of those we touch,” Mr. Muhart says. “It does not say, ‘Just while they’re in the hospital.’ Memorial has built the infrastructure to go beyond being a hospital system and keep people as well as they possibly can be. It’s individualized care centered around the entire person.”