Moving Forward


When emergencies have to wait

Arthur Kellermann, Emory’s chair of emergency medicine, has watched emergency departments (EDs) become stretched more thinly year after year. On any given night, emergency services at Grady and Emory hospitals reflect the typical problems of emergency rooms across the country—overcrowding with long wait times, frequent diversion of ambulances, and resources stretched to the max. In the United States, ambulances are turned away from emergency departments on average once every minute, and patients in many areas of the country may wait long hours or even days for a hospital bed.
     For more than a decade, Kellermann has been an outspoken proponent for improving emergency medical care, and over the past three years, he has served on a committee of the Institute of Medicine (IOM) investigating the future of emergency care in the United States. The committee’s final reports delivered a devastating verdict and an urgent call to action. In short, the emergency medical system is (in the words of the committee) “at the breaking point”—barely able to handle daily caseloads, much less a surge of casualties from a disaster.
     “If we are struggling to deal with tonight’s 911 calls in city after city across the United States, how in the world are we supposed to handle an epidemic of pandemic flu or a major terrorist attack or the next natural disaster?” Kellermann asked a National Public Radio reporter upon release of the reports in June.
     The critical condition of today’s emergency medical system stems from insufficient funding and steady growth in uncompensated emergency care, according to the IOM. In the early 1980s, federal funds for enhancing emergency response services declined abruptly, leading to haphazard development of EMS services. In 1986, Congress passed a law that made emergency care a right for everyone in the United States, but it provided no mechanism to pay for this care. Over the next 20 years, patient volumes increased while hundreds of emergency departments closed. In 2003, EDs received nearly 114 million patients—a 26% increase over the previous decade—but the country lost 703 hospitals and 425 emergency departments during the same period. Despite these challenges, emergency medical services received only 4% of funding distributed by the U.S. Department of Homeland Security for emergency preparedness in 2002 and 2003.
     Compounding the problem are the 45 million people in the United States who lack health insurance. Many who are turned away from other clinical settings because of inability to pay end up in the emergency room. Another IOM committee on which Kellermann served calculated that U.S. hospitals and doctors lose billions annually in uncompensated care of the uninsured, which in turn creates enormous stress on the health care system. In the 2004 fiscal year, uncompensated care provided by Emory physicians at Grady totaled $22 million. (Emory Healthcare provided $51.7 million that year
in charity care and $66 million in 2005.)
     When hospitals are full, as is increasingly the case, admitted patients often back up in the ED. When EDs become dangerously overcrowded, the staff may ask inbound ambulances to divert to other facilities. In 2003, U.S. hospitals diverted more than 500,000 ambulances because of overcrowding in the ED. Diverting ambulance patients from one hospital to another puts additional stress on patients, family members, and the community, Kellermann says. And when other hospitals go on ambulance diversion as well, a community can experience the health care equivalent of a “rolling blackout.”
     Conditions in the Grady ED, which handles more than 100,000 visits each year, reached a record low in 2002 and 2003 when, because of crowding, average throughput times exceeded seven hours and the ED was on diversionary status more than 20% of the time. To counter those trends, Leon Haley, vice chair and chief of emergency medicine at Grady, implemented a model to identify major bottlenecks in patient flow, instituted new diagnostic test-ordering processes, and improved staff coordination in the ED’s fast track for people with minor illnesses or injuries. Those efforts produced results: the ED reduced average time from arrival to bed placement from 219 minutes to 94, a 57% decrease.
     With the support of the Robert Wood Johnson Foundation and later the Healthcare Georgia Foundation, Haley also created an ED-based “care management unit” with seven beds staffed by four nurses and four case managers. This unit is used to evaluate and treat patients with chest pain, heart failure, asthma, and hyperglycemia—conditions that would otherwise mandate hospital admission. While these patients undergo rapid treatment, case managers teach them how to better manage their health and arrange follow-up with a primary care provider. The goal of the program is to decrease the number of short-stay admissions and repeat visits to the ED.
     To promote injury prevention and public health surveillance, Emory’s Department of Emergency Medicine is developing programs to reduce the root causes that result in ED visits, such as child neglect and abuse, firearm violence, and head injuries and to improve outcomes when emergencies do occur. Start-up support to develop innovative ideas comes from a fund created by the Seaman family and their business, Rooms to Go. The partnership has produced results. For example, Bryan McNally is leading Cardiac Arrest Registry to Enhance Survival (CARES), an initiative funded by the Centers for Disease Control and Prevention. CARES is a national registry designed to help communities across the United States identify when and where cardiac arrest occurs, which elements of their EMS system are functioning properly and which are not, and what changes are needed to improve outcomes. Emory researchers are compiling and analyzing preliminary CARES data to drive improvements in treatment in Fulton County, soon to be expanded to all of metro Atlanta, and ultimately, nationwide.
     In another cardiac care initiative, Emory emergency physicians partnered with Grady and the Emory Heart Center to improve the prehospital treatment of heart attack victims. With the support of Medtronic/Physio-Control, Cingular Wireless, and Nokia, Grady ambulance crews were trained and equipped to obtain 12-lead ECGs in the field and transmit them via cell phone to an emergency physician at Emory Crawford Long hospital. If the ECG showed signs of a major heart attack, the patient was offered the option of direct transport to the cath lab at either Emory University Hospital or Emory Crawford Long. The pilot program was so successful that a consortium of Atlanta’s leading hospitals is joining Emory to expand it throughout the metro area. The initiative will operate under a new name, Timely Intervention in Cardiac Emergencies (TIME). Like CARES, TIME has the potential to transform emergency cardiac care nationwide.
      From yet another tack, Emory’s interdisciplinary emergency nurse practitioner program—offered through its schools of Nursing and Medicine and one of only four of its kind in the nation—is helping improve ED patient flow by training nurse practitioners to provide cost-effective health care in emergency settings.
     According to the IOM report, innovative solutions like these are needed to strengthen the nation’s emergency care system. The report calls for reform of reimbursement policies to reward hospitals that end ED boarding and stop diverting ambulances. Penalties might be assessed for those that willfully fail in this area.
     The report also calls for a pool of at least $50 million to reimburse hospitals for uncompensated emergency and trauma care as well as substantial increases in federal funding to provide hospitals with resources needed in disasters. And it recommends the allocation of $88 million in seed grant funding over five years for pilot projects to promote coordination and regionalization of emergency care.
     If getting the word out helps Congress open its wallet for emergency care, then Kellermann is doing his part. Covered in more than 172 news sources across the United States, including NPR, CNN, the Associated Press, and USA Today, the chair of emergency medicine may finally have a soapbox tall enough from which to be heard.

This fall, Kellermann is on sabbatical as a Robert Wood Johnson Health Policy Fellow in Washington, DC.

Mission possible

The idea is no small one: to relocate Emory University Hospital to the east side of Clifton Road alongside a new clinic cluster for outpatient care, medical faculty offices, and medical research. But the Emory Board of Trustees is thinking large-scale and long-term, and in June, it officially accepted the results of a nine-month feasibility study. Following the recommendation of the Woodruff Health Sciences Center board, the University’s Board of Trustees authorized preparation of architectural schematic designs for new hospital and outpatient facilities that could take as long as a decade and as much as $2.2 billion to realize.
     The new medical complex will enable Emory to achieve its vision to transform health and healing in the 21st century, says Michael Johns, CEO of the Woodruff Health Sciences Center. That vision involves integrated care centered on the patient with an emphasis on predictive medicine. “These new facilities will support research, patient care, and medical training in a new and more nimble way that sets the standard for teaching hospitals everywhere,” Johns says.
     At the centerpiece of the plan is a new 700-bed hospital that will feature underground parking, a spacious atrium, and retail shops for the convenience of patients and visitors. The new hospital will combine beds from the current 84-year-old Emory University Hospital facility and other Emory facilities on Clifton Road.
     However, a new hospital and clinic are far from a done deal. Several remaining decision points in the next few years will determine the eventual size and configuration of the new health sciences complex. “The trustees have made it clear that we must proceed through this process in deliberate step-wise fashion with periodic reality checks on funding, feasibility, and advisability,” says John Fox, CEO of Emory Healthcare. “We will always be planning many steps ahead, but our ability to get to the end depends on world-class execution at every stage. Convenient and accessible transportation for our patients, doctors, nurses, and staff will be job one, and that’s where we are starting.”
     Beginning in the summer of 2007, the Turman Residential Center will be demolished to make way for construction of a 720-space parking deck. That deck, which will connect by a pedestrian tunnel to the eventual site of the new clinic and hospital, should be available for use by the summer of 2008. The spaces will replace parking that will be lost in the physicians and Scarborough parking decks and in one-third of the Lowergate deck when site preparation for the new clinic is scheduled to begin.
     The hospital and clinic development are part of a larger ambitious strategy by Emory to enhance the livability, accessibility, and vibrancy of its campus and the surrounding community. Goals include restoring a walkable environment, creating a landscaped public realm, transforming Clifton and North Decatur roads, and expanding transportation options for the area. Emory also is making plans to develop a campus in midtown Atlanta encompassing Emory Crawford Long Hospital.
     The mission is large but not impossible. In the words of Fox, “Over the next 10 years, we will build an Emory that is a source of pride and hope for everyone who needs the support of a more accessible, more navigable, and more patient-friendly health care system.”

A verdict for the common good

BeSupport for creating specialized health courts is growing. U.S. Senate Majority Leader Bill Frist and the Progress Policy Institute, known in the 1990s as President Clinton’s “idea mill,” have endorsed the concept. So have more than 80 leaders in U.S. health care, including Woodruff Health Sciences Center CEO Michael Johns, and a broad coalition of patient advocates and health care providers, including Emory Healthcare. Known as Common Good, the bipartisan legal reform group is championing such courts as a way to restore reliability to medical justice.
     These health courts would be devoted exclusively to addressing health care issues, just as existing specialized courts already focus on taxes or drugs, for example. The hallmark of the courts would be full-time judges with training in health care issues, enabling them to define and interpret standards of care in malpractice cases. Other key features of the courts would include neutral experts, efficient proceedings to reduce attorney’s fees and administrative costs, and predictable damages with compensation for pain and suffering set by a predetermined schedule. State policy makers would decide jurisdiction and selection of judges.
     Six health systems have signed on to express a strong interest in participating in a pilot project to set up such courts. In addition to Emory Healthcare, they are Duke, Jackson Health System at the University of Miami, Johns Hopkins, New York-Presbyterian, and Yale. Common Good is leading the effort in partnership with the Harvard School of Public Health and funding from the Robert Wood Johnson Foundation.
     At press time, senators had introduced a bill to establish pilot courts. To follow the progress, see

Protein pieces of the Parkinson's puzzle

Emory scientists are making advances in uncovering the mysterious function of the protein DJ-1. The ultimate goal for the search? To find potential cures for nonhereditary Parkinson’s disease and other neurologic degenerative disorders, such as Alzheimer’s.
     The function of the DJ-1 protein is unknown, but what scientists do know is that abnormalities in DJ-1 directly cause hereditary (familial) Parkinson’s disease. Approximately 10% of Parkinson’s cases are hereditary forms caused by a deletion of a gene or mutations resulting from substitutions of amino acids.
     But what causes the other 90% of cases that are uninfluenced by genetics? Pharmacologist Lian Li wondered if DJ-1 mutations play a role in nonhereditary (sporadic) Parkinson’s, too. In research funded by the National Institutes of Health, she has discovered that DJ-1 in patients with sporadic Parkinson’s showed signs of oxidative stress, an imbalance of antioxidants (agents that prevent oxygen from combining with other substances) and pro-oxidants in cells. The damage included structural changes as the protein accumulated additional oxygen molecules.
     In essence, this imbalance results in an excess of reactive oxygen species (harmful oxygen-containing molecules that can cause damage to proteins). These modifications to DJ-1 caused by the oxidative stress are irreversible and irreparable. As with familial Parkinson’s disease, structural changes to the DJ-1 protein in sporadic Parkinson’s signal an abnormality, leading to eventual degrading and loss of the protein.
     “The protein unfolds and cannot function normally,” Li says. “Not recognizing the unfamiliar shape of the protein, the cell breaks it down. The end result is the same: you lose your protein. Any mutation or modification causing this protein to lose its function will then lead to neurodegeneration seen in Parkinson’s disease.”
     Li and her team are now building on the research, published in the April 21 issue of the Journal of Biological Chemistry, to better understand the role of DJ-1. Based on biochemical analysis, Li believes that DJ-1 may serve as a protease, a protein-splitting enzyme that activates and deactivates a protein by cleaving the bonds that connect its amino acids. If DJ-1 serves as an antioxidant, then the cell may be left unprotected when they protein is mutated or damaged.
      Results of Li’s study may lead scientists to develop drugs to target DJ-1, thereby stopping or reversing Parkinson’s or Alzheimer’s diseases. In the meantime, Li suggests alternative health approaches such as the antioxidants found in green tea or vitamin C supplements as prevention measures.

Home is where the transplant is

In June, the Mason Outpatient Transplant Clinic dedicated a comprehensive, state-of-the-art clinical and patient education center in Emory Clinic, more than tripling its former size. The new clinic, funded by a $1.8 million grant from the Carlos and Marguerite Mason Trust, features a waiting room that seats more than 80, computer and Internet access for patients, education classrooms, evaluation suites with multi-media capability, 20 exam rooms, increased infusion room capacity, advanced biopsy procedure rooms with high-tech ultrasound equipment, and expanded clinical lab space.
     “In the early years of transplantation, the focus was simply to get a surgeon and an organ to save a life, but this is too narrow a perspective,” says Christian Larsen, Carlos and Marguerite Mason Professor of Surgery and director of the Emory Transplant Center. “To truly restore life and health for the whole person requires a team of physicians, surgeons, nurses, social workers, infectious disease specialists, psychiatrists, and dermatologists—matched with an administrative team, financial coordinators, and more. This clinic gives those teams a home.”
     Michael Johns, CEO of the Woodruff Health Sciences Center, describes the Emory Transplant Center as “a model of the integrated, patient-center research and clinical care we are pioneering and perfecting at Emory. Transplantation is one of the first investments the health sciences center is making to truly enable the transformation of health and healing.”
     In 2005, the Mason Transplant Outpatient Clinic had more than 17,000 patient visits, including 7,000 lab visits, 400 infusions, and 10,000 provider visits. With the increased capacity, the clinic projects more than 20,000 patient visits in 2006 and more than 23,000 in 2007.

Labor of love

“Being a midwife is the best job in health care,” says Jane Mashburn, specialty coordinator for Emory’s Nurse-Midwifery Program and herself a graduate of its first class in 1978. “Midwifery lets you work closely with patients, take a holistic view of women’s health and pregnancy, and view labor as a normal process, not a medical problem.”
     Mashburn is not alone in her thinking. The program’s core faculty are all practicing midwives, who have taught and worked together for more than 20 years. According to Mashburn, they provide a personal learning environment that empowers students, who have one of the highest pass rates on certification exams in the country. Another marker of success is the program’s consistent top 10 ranking in U.S. News & World Report (it currently places seventh).
     The Nurse-Midwifery Program in the Nell Hodgson Woodruff School of Nursing also draws on partners at the Centers for Disease Control and Prevention (CDC), the Rollins School of Public Health, and the Lillian Carter Center for International Nursing.
     For Kitty MacFarlane, who received both her undergraduate nursing degree and a dual master’s degree in nursing and public health at Emory, the midwifery program opened doors to CDC’s Division of Reproductive Health. There, she works as part of a multidisciplinary team that implements community-based perinatal surveillance in developing countries. MacFarlane’s role on the team is to teach midwives how to collect and interpret surveillance data to improve the use of scarce resources for maternal and child health program management.
     Recently she was awarded funding from the Gates Foundation to develop a pilot midwife case-management training program in Afghanistan. The goal of the new initiative is to introduce safe water systems into the homes of very low birth weight infants born at a women’s hospital in Kabul. “Training Afghan midwives for this new, nontraditional role will benefit the families of these fragile infants, broaden the professional development of midwives in Afghanistan, and help link the hospital to local community resources,” says MacFarlane.
     Other graduates have chosen to practice close to where they trained. “Many of our clinical sites are staffed by alumni,” says Mashburn. “Not many schools have that.” In addition to working as midwives, the program’s graduates are involved in careers in health care services research, nursing education, health care counseling, and community health education.
     This holistic approach to women’s health reflects the coordinator’s own motivation for entering the field. “I chose midwifery to be present in a woman’s life, more than just during her labor,” says Mashburn. “I wanted to be there for the whole pregnancy.” —Jennifer Williams

The RUTH effect

An international team of researchers recently completed a clinical trial to see if the drug raloxifene could affect the heart health of more than 10,000 women from 26 countries who had experienced coronary heart disease or were at high risk for a heart attack. It turns out that raloxifene, marketed as Evista in the United States for the prevention and treatment of osteoporosis in postmenopausal women, had no significant effect on coronary events in this trial group.
     However, the study showed positive impacts in other areas. Raloxifene did reduce the risk of invasive breast cancer and spinal fractures in the participants, who were followed for an average of 5.6 years.
      Results of the RUTH study (Raloxifene Use for the Heart) are published in the July 13 issue of the New England Journal of Medicine. Nanette Wenger, professor of medicine and chief of cardiology at Grady Memorial Hospital, served as principal investigator of RUTH at Emory and was the co-principal investigator for the international study.
     “Overall there was no effect on coronary events—no increase or decrease,” Wenger says. “The lack of increase is important, given
the adverse coronary events that were seen with estrogen/progestin therapy.”
     The investigators identified several harmful effects, including an increase in fatal stroke risk and an increased risk of obstruction of a blood vessel by blood clots. In deciding whether to prescribe raloxifene, clinicians should weigh the benefits in reducing the risk of invasive breast cancer and spinal fractures against the increased risk of blood clots and fatal stroke, concluded the researchers.

Three strikes

mplTheir cause is unknown, their treatment is difficult, and as of now, their outcome is questionable. Triple negatives are a newly identified aggressive form of breast cancer that brings anxiety to women much too young for such a devastating disease.
     Epidemiologist Mary Jo Lund presented her findings on triple negatives at the recent annual meeting of the American Association of Cancer Researchers. Preliminary results of the study indicate that black women may be at higher risk for worse breast tumors and at an earlier age. Building on these findings, Lund and a team of researchers from the Rollins School of Public Health and Winship Cancer Institute are developing a multidisciplinary project to examine triple negative breast tumors. Key collaborators include Otis Brawley and Ruth O’Regan.
     Triple negatives are characterized by three biologic components that make this form of breast cancer difficult to treat. Oncologists base treatment decisions on the presence of three receptors known to fuel most breast cancers—estrogen receptors, progesterone receptors, and human epidermal growth factor receptor 2 (HER2). The most effective agents against breast cancer, such as tamoxifen and trastuzumab (Herceptin), work by targeting these receptors. Women with triple negative tumors lack all three.
     What is most alarming in the understanding of this type of breast cancer is its high rate of existence in young black women. Its chance of occurrence in this population is almost three-fold more likely than in white women, according to Lund.
      Overall, black women are at lower risk for breast cancer compared with white women. However, for women under the age of 50, black women are at increased risk over white women of the same age. And evidence exists that younger black women have breast tumors with more aggressive features. While factors such as socio-demographics and systematic disadvantages may affect the development of these “worst-case scenario” tumors in black women, the actual cause goes deeper. It reaches into the genes.
     Lund and her colleagues hypothesize that black women have a genetic disadvantage, which encourages development of these tumors. The researchers want to learn why this susceptibility exists. Their multidisciplinary study includes a questionnaire, blood tests, and collection of tumor samples. It is ongoing at three Emory-affiliated hospitals in Atlanta among black and white female patients who live in Fulton and DeKalb counties. These two metro Atlanta counties account for the majority of breast cancers diagnosed among black women, particularly those under the age of 50. The researchers are analyzing tumors and searching for other protein markers, besides the existing receptors, which occur consistently in triple negatives. They hope to find other protein markers that occur consistently enough to open doors for new, protein-targeted treatments. That approach is good news for women because it will target the tumor independently, unlike chemotherapy, which “indiscriminately attacks tumor and normal cells,” Lund says.
     Ultimately, the research will give us a biologic and a non-biologic perspective on this type of breast cancer, collecting information on genetics, tumor biology, and socio-demographic factors, she says. “We believe that risk and outcome are inextricably connected.” —JW

We've come a long way baby

Used to be, repair for a broken hip required invasive surgery with a 12- to 18-inch incision, and the replacement of the ball and socket lasted an average of only 15 years. However, that scenario has changed dramatically, thanks to recent advances in hip reconstructive surgery. “With longer-lasting implants and less invasive surgeries, total hip replacement (THR) now ranks among our most successful procedures,” says Emory orthopedist Greg Erens.
     Emory orthopedic surgeons perform approximately 600 THRs each year. The American Academy of Orthopedic Surgeons estimates that more than 193,000 THRs are performed annually in the United States.
     Part of the success orthopedists have had in extending the life of replacement implants comes from advances in material science, metallurgy, and manufacturing. Alternative bearing surfaces, such as the ones Erens uses in his practice, wear less and last longer. These include cross-linked polyethylene, ceramic-on-ceramic, and metal-on-metal. By contrast, materials used in previous generations—a metal ball and polyethylene liner—led to release of small polyethylene particles as the liner wore out, starting a cascade of events that could lead to severe bone loss around the hip and eventually loosening and failure of the implant.
     Another advantage of today’s alternative bearings is that patients can be fitted with a larger head or ball to replace the top of the femur. In the past, larger head sizes were avoided because they were associated with increased polyethylene wear, according to Erens. However, the new materials make it possible to use larger head sizes and thereby increase hip stability and reduce the risk of a dislocation.
     While alternative bearings are more expensive than standard polyethylene, with ceramic-on-ceramic being the most costly, the price is minimal when compared to the cost of a second surgery if the original replacement fails.
     Erens and James Roberson, professor and chair of the Department of Orthopaedics at Emory, are participating in ongoing studies to track how long this new generation of alternative bearings will last. Although it is too soon to have final numbers, their preliminary research is showing positive signs.
     In addition to use of innovative materials, the surgical procedure for THR has undergone dramatic improvements. THR can now be performed safely and effectively through a minimally invasive approach with an incision averaging between 3 to 4 inches. This approach minimizes tissue trauma under the incision and decreases blood loss. It shortens the surgery time and encourages faster recovery and rehabilitation. It even eases patients’ anxieties about the process: a 4-inch incision is less intimidating than an 18-inch scar.
     Erens’s long-term goal is to deliver the same good news to every THR patient: “Those new hips will last for a lifetime.” —Stacia M. Brown

First sight

Emory ophthalmic surgeon Diane Song is the only physician in Georgia and one of only a few in the Southeast who perform pediatric corneal transplants.
     While the surgery is one of the most common transplants among adults, few doctors are comfortable applying it to children. With a
high chance for tissue rejection and only an average one-in-three chance of success in this age group, they have reason for caution.
     Yet a successful surgery and recovery gives a child the possibility of learning to see rather than remaining partially blind.
     For babies born with vision-impairing conditions due to opaque cornea such as Peter’s anomaly or scars from infections, corneal transplants allow for proper development of vision. Without the transplant, the visual center of the brain is unable to receive stimuli necessary for development of the capacity to see. At birth, all babies have poor vision, and as the brain learns to recognize objects, life comes into focus.
     “Time is crucial for this surgery,” Song says. “The window of opportunity is between three and four months when the baby is first beginning to respond to visual stimulation. Most of visual brain development occurs during the first two years of life. By the time a child reaches school age, it’s too late.”
     However, undergoing the procedure too early also can be devastating. “The younger the baby, the higher the chance is for tissue rejection,” says Song.
     Unlike other transplants, where organs are difficult to procure and match, patients needing a new cornea have just a short wait, and the procedure does not require matching blood types. After surgery, patients start a regimen of medicated drops (sometimes lasting for life) to prevent tissue rejection, infection, and glaucoma—a common association with Peter’s anomaly.
     “Parents and caretakers are crucial for a successful transplant,” Song says. “If they are good about applying the drops, taking the child for frequent follow-up visits, caring for contact lenses or glasses, and recognizing problems early, then the surgery has a better chance of succeeding.” Song performs between 10 and 12 pediatric corneal transplants a year.
     The corneal transplant is just the first step in the process of helping a baby see. Following surgery, a multi-specialty group of medical professionals is involved in years of rehabilitation. A specialist fits the baby for contacts, while a pediatric ophthalmologist treats amblyopia, or lazy eye, often by patching the good eye and thus training the brain to use the affected eye. Frequently, a glaucoma specialist is part of the rehab team.
     “A corneal transplant doesn’t give babies perfect vision,” Song says, “but it does clear a path for them to develop perfect vision.” —JW

Racing for life

Emory Healthcare was in the right place at the right time at the 2006 Peachtree Road Race. As the medical provider for the world’s largest 10K event, the Emory/Grady team successfully saved the lives of two people who experienced heart attacks at the finish line. Unfortunately, those stats don’t hold on other days in Atlanta, which has one of the lowest cardiac arrest survival rates in the nation, according to Eric Ossmann, medical director of Grady EMS. What is needed to win the larger daily race? A better coordinated 911 communications system, willing bystanders to start CPR before paramedics arrive, and more strategically placed defibrillators in communities and the work place with people trained to use them, says Ossman.


The Woodruff Health Sciences Center was among four organizations honored for its relief efforts to victims of Hurricane Katrina in the Atlanta Business Chronicle’s annual Healthcare Heroes awards. Of more than 400 patients who were hospitalized in Atlanta-area facilities in the early days following the disaster, more than 150 were sent to Emory hospitals. The university played an active role in ensuring that patients were quickly placed in appropriate hospitals, and faculty, staff, students, and alumni provided a cadre of volunteers, staffing shelters for evacuees and providing temporary housing.

The Emory Center for Global Safe Water (CGSW) had two winning proposals in the World Bank’s Development Marketplace 2006 global competition. A competitive grant program that funds innovative, small-scale development projects that deliver results and show potential to be expanded or replicated, the Development Marketplace will support CGSW projects that use income-generating local enterprises to increase access to safe water and improved sanitation in poor communities—one in Bolivia and one in Kenya. Only 30 winners out of more than 2,500 proposals were funded.

Emory University was named the top-ranked university and the No. 4 institution overall in the Best Place to Work for Postdoctoral Students 2006 survey, conducted by The Scientist magazine.

Emory University Hospital has been awarded Primary Stroke Center Certification for its rapid response in diagnosing and treating stroke patients using a multi-specialty approach and for efforts to foster better outcomes for stroke care. The hospital earned the distinction from the Joint Commission of Accreditation of Healthcare Organizations.

Solucient, the nation’s leading source of healthcare information products, has named EUH as one of 100 hospitals making the greatest progress in improving hospital-wide performance over five years. The hospital is setting a national benchmark for consistent improvement in clinical outcomes, safety, hospital efficiency, financial stability, and growth.

The Emory Clinic’s radiology department received the 2006 Outpatient Excellence Award for Oncology Centers from Outpatient Care Technology magazine.

The Carter Center has received a 2006 Gates Award for Global Health from the Bill & Melinda Gates Foundation in recognition of its work to fight neglected diseases such as Guinea worm, river blindness, and lymphatic filariasis. The $1 million award, the world’s largest prize for international health, honors extraordinary efforts to improve health in developing countries.



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