Emory Healthcare and Select Medical finalize joint ventures

Effective July 1, Emory Healthcare finalized an agreement with Select Medical to form joint ventures in providing rehabilitation and long-term acute care (LTAC) services (the latter for patients with chronic critical conditions who need additional recovery time following hospitalization in a regular acute care hospital).

Rehab joint venture—EHC will become the majority owner in the rehab joint venture, with all current employees remaining EHC employees. Emory's Center for Rehabilitation Medicine has been renamed Emory Rehabilitation Hospital in Partnership with Select Medical and is now the seventh hospital in the Emory Healthcare Network.

Eric Garrard

The majority of the management team at Emory Rehabilitation Hospital is composed of Select Medical employees who already have been working on site for several months in preparation for the transition, with Eric Garrard serving as CEO.

Select Medical has 23 outpatient rehab clinics in metro Atlanta and the surrounding area, which are part of the joint venture and collectively are now named Emory Rehabilitation Outpatient Center in Partnership with Select Physical Therapy. All of its employees will become EHC employees.

LTAC joint venture—Select Medical will become the majority owner of the LTAC services at Emory Wesley Woods Hospital (EWWH) and will have sole responsibility for operating the newly named Select Specialty Hospital-Northeast Atlanta (the name applies only to the LTAC portion of the hospital). Current EWWH LTAC employees will become Select employees, and these positions will continue to be part of the joint venture.

Two other LTAC hospitals included in the joint venture are Select Specialty Hospital - Atlanta, located in space leased by Select from Emory University Hospital Midtown since 2000, and Regency Hospital in East Point.

Jen Schuck

All services at EWWH except the LTAC will become part of Emory University Hospital (EUH), with Jen Schuck serving as associate administrator and Annette Branan as CNO. Other facilities on the Wesley Woods campus, Budd Terrace skilled nursing facility and Wesley Woods Towers retirement residential facility, will remain separate from EUH, reporting to Susan Grant, EHC chief nursing executive.

According to EHC CEO John Fox, the "synergistic" partnership with Select will help EHC grow and enhance services in addition to providing more locations for patients. Read more.

Nursing school now home to popular continuing education program in wound care

WOCNEC students in a foot and nail care clinic at Wesley Woods Towers

When Emory's continuing education (CE) program in the Wound, Ostomy, and Continence Nursing Education Center (WOCNEC) migrated from the Department of Surgery to the School of Nursing last fall, the school became home to one of the best CE programs of its kind in the nation, with an annual enrollment of more than 250 nurses from this country and abroad.

The program originated in the 1970s under the direction of the late Emory surgeon, Bill McGarity, who helped pioneer the profession of enterostomal therapy, which evolved into a nursing specialty eventually known as wound, ostomy, and continence care.

Rose Murphree

A postbaccalaureate degree certificate program for RNs, WOCNEC is offered in three formats: online (by far the most popular), a traditional 10-week on-site program, and a split option of traditional and online. Rose Murphree became WOCNEC director in April after the retirement of Dorothy Doughty, who directed the program for more than 30 years.

WOCNEC marks the nursing school's first online CE offering to help meet the demands of today's health care climate, says Murphree.

"Patients in acute-care settings are sicker and have more issues," she says. "With shorter hospital stays, patients are being placed into home care or long-term acute care settings. These health care agencies need nurses who are strong in promoting wound, continence, and ostomy care outcomes for these individuals across the health care continuum. Our program helps open doors for our graduates to fill this growing need." Read more.—Pam Auchmutey

Better containers in the brain for treating Parkinson's

In a recent PNAS paper, Gary Miller and colleagues at Rollins School of Public Health outlined what could be described as a potential "Container Store" therapeutic approach to Parkinson's disease. Problems in Parkinson's can be traced back to a lack of effective containers for dopamine.

In patients with Parkinson's, brain cells that produce dopamine are dying, so neurologists treat them with drugs that help the remaining dopamine-producing cells produce more dopamine or that serve as a substitute for it.

Gary Miller

But having dopamine floating around inside cells is actually stressful for them. The dopamine is unstable and can damage the cell's machinery.

Miller's team has been studying a protein called VMAT2. It packages dopamine into membrane-clothed bags called vesicles. The vesicles sequester the dopamine in a safe container before it is spritzed outside to do its job of signaling to other brain cells.

Researchers already knew that having inadequate levels of VMAT2 leads to a Parkinson's-like condition in mice. But until this paper, nobody had looked at what happens if mice are forced to make more VMAT2 than usual.

Brain cells from mice with an extra VMAT2 gene take up more dopamine and package it better. Their vesicles are larger. The authors write that they hypothesized that the mice would display increased anxiety-like or mania-like behaviors, but this didn't turn out to be the case.

The mice that make extra VMAT2 were more resistant to MPTP, a toxin that is often used to produce a model of Parkinson's disease. That's good news, but in this experiment, the protective treatment (growing up with an extra VMAT2 gene) came before the neurotoxic damage induced by MPTP. A more strenuous test would be asking whether somehow inducing VMAT2 after MPTP exposure can mitigate its effects.

People who make more VMAT2, because of variation in the VMAT2 gene, appear to have less risk of developing Parkinson's. And a recent paper shows that VMAT2 function is impaired in tissue samples from Parkinson's patients. What is now needed is a convenient way to spur human brain cells to visit the Container Store: that is, stimulate VMAT2 function or make more VMAT2.

"If only it were as easy as going to the store," Miller says.

In 2012, he and a colleague described a laboratory tool—a cell line that fluoresces under the right conditions—that can be used to look for drugs that activate VMAT2. Increasing VMAT2 function might also be a viable tactic for other disorders, such as depression.—Quinn Eastman (from Lab Land)

U.S. News ranks Emory hospitals among best in Atlanta and Georgia

Emory University Hospital ranked first in Atlanta and Georgia for the third consecutive year.

U.S. News & World Report has ranked Emory University Hospital (EUH) the No.1 hospital in both Georgia and metro Atlanta in its 2014-2015 Best Hospitals guide for a third year in a row. EUH includes Emory Wesley Woods Geriatric Hospital and Emory University Orthopaedics & Spine Hospital.

Emory University Hospital Midtown (EUHM) is ranked fourth in Georgia and third in metro Atlanta, while Emory Saint Joseph's Hospital ranks 11th in Georgia and seventh in metro Atlanta.

Nationally, EUH ranked in 11 adult specialty areas:

• Cancer, 24 (up from 44)
• Cardiology and heart surgery, 16 (up from 44)
• Diabetes and endocrinology, 23
• Ear, nose and throat, 24
• Geriatrics, 21
• Gastroenterology and GI surgery, 41
• Gynecology, 42
• Nephrology, 42
• Neurology and neurosurgery, 15 (up from 40)
• Ophthalmology, 14 (up from 16)
• Urology, 25

EUHM is noted as high performing in 11 specialty areas, including cancer; cardiology and heart surgery; diabetes and endocrinology; ear, nose and throat; gastroenterology and GI surgery; geriatrics; gynecology; nephrology; neurology and neurosurgery; orthopaedics; and urology.

Emory Saint Joseph's Hospital is listed as high performing in ear, nose and throat and in orthopaedics.

"We are thrilled with this year's ranking, especially with so many categories moving up significantly," says John Fox, president and CEO of Emory Healthcare. "This clearly reflects the dedication displayed every day by our faculty, nurses and staff members."

To be ranked, metro areas must have at least 1 million residents and at least two hospitals in that area that are either nationally ranked in at least one specialty or considered high performing in at least four specialties.

State rankings follow the same methodology with two or more nationally ranked specialties or being named high performing for inclusion. Just 19 hospitals ranked this year out of 181 in Georgia. Read more.

Note: As of today (10:40 a.m.), Emory Healthcare's facebook entry about its hospital rankings had more than 2,100 "likes."

"You're at Emory now"

Wright Caughman

Earlier this week, I was passing through Emory University Hospital (EUH) and saw a patient in a wheelchair being pushed through the lobby by an Emory Healthcare attendant. The young woman was visibly nervous, and I overheard the attendant gently tell her, "Don't you worry, baby. You're at Emory now." This small but meaningful act of kindness made me reflect on what it is that makes that one word—"Emory"—bring so much comfort and hope to so many people in need.

Clearly, our well-deserved reputation for providing the highest quality, most innovative care plays a part in it. Just this week, U.S. News & World Report ranked EUH (which includes Wesley Woods and Emory University Orthopaedics and Spine Hospital) the No. 1 hospital both in metro Atlanta and in the state for a third consecutive year. (See story.) Emory University Hospital Midtown ranked fourth in Georgia and third in Atlanta, with Emory Saint Joseph's Hospital ranking 11th in the state and seventh in Atlanta. These independent ratings result from rigorous objective review, and to have our health system again dominate the list reflects the other quality that causes our community to have so much faith in us—our extraordinary people.

To be sure, the young patient being wheeled through EUH took comfort in knowing with certainty that she would receive the finest, most cutting-edge care available in the state. And it was clear to me that she took equal comfort in the warmth of the attendant who understood, acknowledged, and assuaged her anxiety. It's people like this attendant, whose name I wish I knew, who propel us into the top echelons of every ranking system and, most important, into the sacred trust of the people we serve. We are indeed "all in this together," and I'm honored to be together with people like you.

Please direct questions and comments to evphafeedback@emory.edu.

In Brief

Reducing/diverting waste in the hospital

Emory Healthcare and Emory University have set a combined goal of diverting landfill waste by 65% across all of Emory by 2015. As part of this effort, Emory University Hospital Midtown (EUHM) kicked off a program in May to recycle operating room and other waste, and Emory University Hospital is beginning a similar program.

Anesthesiologist Jane Duggan leads the OR Green Team at EUHM.

The hospitals are aligning with several companies to do this: Medical technology company Stryker has placed bins in every operating room at EUHM to collect used medical equipment (laparoscopic devices, arthroscopic/orthopaedic devices, and energy devices), which will be taken to a facility in Florida for recycling.

Stericycle, a medical and hazardous waste company, will collect all clean plastic containers, clean plastic wrap, and clean cardboard boxes, many of which package surgical and sterile medical equipment, for recycling. Stericycle has also partnered with EUHM's Environmental Services team to collect recyclable plastic, aluminum, glass, and paper from common spaces such as waiting rooms, lobbies, and administrative spaces. Educational efforts on what to recycle and what to place in regulated medical waste bins are ongoing.

Both hospitals have also joined the Healthier Hospitals Initiative's Less Waste Challenge. A conservative estimate from Practice Greenhealth is that US hospitals produce almost 6 billion tons of waste annually, or 33 pounds per bed per day. Read more.

Seven faculty named as "highly cited" researchers

Dana Boyd Barr

Seven Emory faculty made the 2014 Thomson Reuters list of researchers who authored the most influential and highly cited papers over a 10-year period. (See methodology.) These researchers rank among the top 1% most cited for their subject field, earning them the mark of exceptional impact. They include Rafi Ahmed (director, Emory Vaccine Center), Dana Boyd Barr (public health), Eric Hunter (vaccine center, Yerkes), Bali Pulendran (vaccine center, Yerkes), Leslee Shaw (cardiology), Peter Wilson (cardiology), and Younan Xia (biomedical engineering). Read more.

Administrator for new initiative

Kevin Clark, executive administrator for the Emory Transplant Center, now serves also as chief administrator for the emerging Brain Health Initiative. He will now hold administrator responsibility for psychiatry and neurology in the medical school and Emory Clinic.

Emory receives continued full AAALAC accreditation

Emory University has received continued full accreditation into 2017 from the Association for the Assessment and Accreditation of Laboratory Animal Care International, with no mandatory items or suggestions for improvement. This accreditation applies both to the Division of Animal Resources and Yerkes. Site visits and accreditation reviews occur every three years.

Atlanta accolades

Congratulations to the 155 Emory doctors listed in the annual "Top Doctors" insert in the July issue of Atlanta magazine. Castle Connolly Medical Ltd., a New York-based health care research firm, compiles the list of doctors nationwide, representing leading physicians in key US regions and cities. Read more.

Also, in the June 20 issue of Atlanta Business Chronicle, President James Wagner and EVPHA Wright Caughman were named among the top 100 most influential Atlantans.

Emory opens four new heart rhythm clinics

Emory Healthcare is opening new clinics to screen for and treat arrythmias. Three locations are already up and running in Villa Rica, Conyers, and Johns Creek, and a fourth one will open soon in Decatur. Read more.

ACTSI announces intellectual property agreement

David Stephens

The ACTSI recently secured an intellectual property agreement between Emory and Morehouse School of Medicine clarifying exclusive copyright, trademark, and patent rights on discoveries made by collaborating research investigators. The same agreement was already in place between Emory and Georgia Tech.

The agreement states that jointly developed/owned intellectual property will be jointly owned by the institutions and gives licensing and commercialization procedures for jointly developed discoveries. The agreement also clarifies payment of expenses and division of royalty income.

Since the ACTSI's creation in 2007, the program has expanded IRB reciprocity and data-use agreements across all ACTSI partners to help reduce roadblocks to collaboration, says David Stephens, ACTSI principal investigator and WHSC VP for research.

New website supports international work at Emory

A new Global Program Support website is available to augment support for global research and scholarship at Emory. The site provides information and guidance on many aspects of global work, including travel abroad, establishing in-country operations, and hosting international visitors. Developed through a collaboration between the Emory Global Health Institute and the Office of International Affairs, the site is intended to help simplify the process of conducting and supporting international work at Emory.

Sept 27: Registration is now open for the Winship Win the Fight 5K. Event info.

Oct. 2-3: HIV & Aging: From Mitochondria to the Metropolis. Decatur Marriott, Atlanta. More info.