When the Eustachian tube connecting the back of the nose and middle ear becomes inflamed, infected or blocked, people can experience pain, discomfort and possible hearing loss.

The Eustachian tube, which ventilates and drains secretions from the middle ear, also balances pressure in the ear. Allergies and upper respiratory or sinus infections are common ailments that can cause dysfunction of the Eustachian tube. Tumors, and in children, inflammation of the adenoids, can also be to blame in some cases.

In more mild cases, people can unblock the Eustachian tube by yawning or chewing gum to pop their ears.

If that doesn’t work, doctors typically prescribe medication to calm infection or inflammation, or surgery to place small tubes in the eardrum that can drain out liquid and relieve pressure.

While both treatments are still effective, a newer procedure, Eustachian tube dilation, offers a more permanent solution to chronic Eustachian tube dysfunction for adults.

Because a child’s Eustachian tube is shorter, smaller and in a more horizontal than vertical position, children are more prone to experience Eustachian tube dysfunction.

“By age seven, about 70 percent of children have had this at least once,” said Dr. Huseyin Isildak, director of otology/neurotology in the Department of Otolaryngology-Head and Neck Surgery at Penn State Health. “That’s compared with about 1 percent for adults.”

The dilation procedure, which is performed in an operating room, involves a tube with a balloon on the end which is fed through the nose into the Eustachian tube.

Once placed, doctors inflate the balloon to open the Eustachian tube. When the tube with the balloon is removed, the Eustachian tube remains open and functioning, alleviating symptoms much longer than tubes or medication can.

“It is ideal to open the Eustachian tube in a more natural way,” Isildak said. “Then patients do not have to keep coming back to get new tubes put in their ears.”

Isildak said the procedure is only recommended for adults who have persistent Eustachian tube dysfunction of more than three months despite medical treatment. Inflating the balloon in a child’s ear is not FDA approved at this point. It is under investigation.

It is also not the first option because of the chance for complications or bleeding.

“There is carotid artery, a big vessel near the Eustachian tube, so when we inflate the balloon, there is a chance we can damage that if any bone is missing,” he said.

To minimize that risk, doctors check the pressure of the middle ear before surgery and get a CT scan to check the bone structure and proximity of the tube to the blood vessel. Doctors also perform hearing tests both before and after the procedure.

The Medical Minute is a weekly health news feature produced by Penn State Health. Articles feature the expertise of faculty, physicians and staff and are designed to offer timely, relevant health information of interest to a broad audience.

Related content:

• The Medical Minute: Preventing hearing damage during summer activities
• The Medical Minute: Tinnitus is more than just background noise

Coming face-to-face with the chronic illness, poor living conditions and lack of medical care left in in the wake of Hurricane Dorian was an eye-opening experience for Alexandra Black, who recently completed her first medical mission to the Bahamas.

“In my heart, I thought, we don’t know how good we have it,” the Penn State Health St. Joseph certified nurse midwife recalls.

Black spent Sept. 28 through Oct. 5 in Nassau with International Medical Relief (IMR), as part of a team that provided medical aid to those devastated by the hurricane. Using a

Alexandra Black, third from right, and a team of clinicians, translators and a local church pastor gather after treating patients in a temporary church clinic.

local church as their base of operations, the team traveled each day to other churches where they would set up clinics and tend to the basic medical needs of the mostly Haitian refugees.

“A lot of the people came to Nassau from where the hurricane hit in Abaco. There was nothing left there,” Black explains, adding that residents had overwhelmed the health system. “Many of them suffer from chronic hypertension and chronic diabetes, living with blood pressure readings like 260/120 and blood sugars in the 400s. Others had leg and fungal infections.”

While the team could provide temporary symptomatic relief, many times what the patients were looking for had nothing to do with medicine.

“One woman came with chronic hypertension, but she wanted to talk because her husband passed away in the hurricane. She wasn’t eating. She wasn’t sleeping,” Black says. “Yes, she came to get a checkup, but the more important thing was that we sat, and we listened.”

Although the team’s impact was small in comparison to the work that lies ahead as the islands continue to recover, Black didn’t hesitate when asked if she would return.

“Definitely,” she says. “I would do it again in a heartbeat.”

A new diabetes education session for the Nepali-speaking Bhutanese population of Harrisburg.

A recording-setting Drug Take-Back Program last spring that netted more than 595 pounds of medications and 26 containers of needles and syringes.

These were just two of the many achievements recognized at Hershey Medical Center and Penn State College of Medicine’s Fall Recognition Celebration on Nov. 6.

The event, which honored 30 individuals and teams, included Employees of the Month, Employee of the Year, Patient Experience, Community Awards and other recognitions. Deborah Berini, president of the Milton S. Hershey Medical Center, and Dr. Kevin Black, interim dean of the College of Medicine, gave opening remarks and presented the awards.

Employees of the Month

• May 2018 – Kerry Keitrick, licensed practical nurse, Children’s Heart Group
• June 2018 – Daryl Detwiler, cardiac sonographer, Adult Echocardiography Lab
• July 2018 – Cindy Devine, senior staff coordinator, College of Medicine Office of Faculty Affairs
• August 2018 – Renee Miller, respiratory therapist, Respiratory Care
• September 2018 – Carol Fees, administrative associate, Clinical Engineering
• October 2018 – Amy Schwalm, data management specialist, Stroke Program
• November 2018 – Darlene Miller-Cooley, chaplain, Pastoral Services
• December 2018 – Erica Brenner, Informatics Distribution associate, Pharmacy
• January 2019 – Robert Basehore, Environmental Health, Hope Drive outpatient clinics
• February 2019 – Jamie Agnew-Gruber, administrative associate, Emergency Medicine
• March 2019 – Denise Newhard, social worker, Pediatric Bone and Joint Institute
• April 2019 – Amy Dailey, radiation therapist, Radiation Oncology

Employee of the Year

• Cindy Devine, senior staff coordinator, College of Medicine Office of Faculty Affairs

Steve and Sharon Baron Leadership Awards

• Nonsupervisory staff – Bill Krenz, administrative associate for Community Health, Department of Nursing
• Manager/supervisor – the Rev. David Simmons, director of Pastoral Services
• Faculty – Dr. Charles M. Davis, III, division chief, Hip and Knee Arthroplasty Service, Penn State Bone and Joint Institute

The Michael B. Bongiovanni, MD, Patient Experience Awards

• Individual Award – Allison Irvin, Perinatal Center coordinator
• Team Award – Life Lion EMS Community Paramedicine: Jason Druschel, Miranda Grimm and Loren Miller

Patient Satisfaction Awards

Patient Experience Peak Performer Award

This award is presented to the department, unit or clinic with the highest overall rating on its respective patient experience survey:

• Adult Inpatient – Penn State Heart and Vascular Progressive Care Unit
• Pediatric Inpatient – Pediatric Intensive Care Unit
• Medical Group Practice Site – Penn State Health Breast Center

Patient Experience Dean’s List Award

This award is presented to individual providers scoring in the 99th to 100th percentile rank for overall rating on the Medical Group Practice Site Patient Experience survey:

• Ann Bogdan ― Family and Community Medicine
• Jennifer Hosband ― physician assistant, Penn State Health Sports Medicine and Physical Therapy, State College
• Raymond Reichwein, neurologist, Penn State Neuroscience Institute
• Ashley Snyder, assistant professor, Department of Medicine, Division of General Internal Medicine

Community Awards

Community Benefit Inventory for Social Accountability (CBISA) Reporter of the Year

The following three individuals have gone above and beyond in their roles to consistently gather and enter community benefit data into CBISA, and share events and reminders with their departments:

• Emmy Sasala, Pediatric Trauma and Injury Prevention
• Julie Chudnofsky, Tobacco Cessation Programs
• Julie Groh, Nursing Community Outreach

      Community Relations Start-up Grant

• Aditi Sharma ― graduate assistant, doctor of public health program, Penn State College of Medicine
• Megan Mendez Miller ― Family and Community Medicine

Community Innovation

• Brandon Wattai ― Life Lion EMS Community Paramedicine

Community Leader

• Kimie Cimarelli ― director, Pharmacy Inpatient Services

Penn State Health Milton S. Hershey Medical Center has once again earned the highest grade on The Leapfrog Group’s latest safety ranking report card. The Medical Center achieved an A on the Fall 2019 Leapfrog Hospital Safety Grade.

This represents the seventh consecutive A grade for Hershey Medical Center.

Leapfrog assigns grades of A, B, C, D or F to hospitals across the nation based on their performance in preventing medical errors, infections and other harms among patients in their care.

Leapfrog’s Hospital Safety Grade uses 28 measures of publicly available hospital safety data to assign grades to more than 2,600 U.S. hospitals.

More information is available at www.hospitalsafetygrade.org.

Researchers at Penn State College of Medicine have developed a new method to model how genes interact with each other – and it may someday contribute to the development of personalized treatments for patients.

According to the researchers, the new model is able to construct personalized networks for an individual patient that can show complex gene interactions in multiple directions and predict how those interactions may change over time.

Genes encoded in human DNA determine physical characteristics like hair color or body shape. Historically, it was believed that a single gene influenced a single trait. Modern scientists understand that genes influence each other in a complex web of connections called gene regulatory networks.

Rongling Wu, PhD, distinguished professor of public health sciences and statistics, led a team of researchers at Penn State and several other universities in developing a model that can construct gene regulatory networks for individual patients. He said that the model could help enhance the field of personalized medicine.

“This model may allow us to study why patients receiving the same treatment may have different results,” said Wu, who is also a member of the Penn State Cancer Institute. “If we can identify the unique genetic processes underlying the different physical outcomes, we may be able to develop personalized treatments.”

Wu described the creation and characteristics of the new model — called an idopNetwork (informative, dynamic, omnidirectional and personalized networks) — in the Oct. 11 issue of Nature Partner Journals’ Systems Biology and Applications.

idopNetworks are constructed using data obtained from genetic experiments and tests. When the genetic data are processed using differential equations, the result is a model that informs how genes relate to each other. According to the researchers, these gene relationships may differ from person to person.

“There are tens of thousands of genes in human beings,” said Wu. “idopNetworks give us the ability to reconstruct a network that paints a personal, intricate picture of the relationship between all these genes for each person.”

According to Wu, groups of genes that influence each other can be organized into clusters called modules. For example, a module may show how gene A can influence gene B – whether one promotes or prevents the activity of another. It might also show how genes C, D and E influence the activity of A while genes F and G may affect the activity of gene B. Relationships between genes organized into modules can also be illustrated to show a bigger picture of gene activity in a cell, tissue or organism.

“In one patient, one gene’s activity may influence a second gene’s activity,” Wu said. “It is possible that in a second patient the second gene’s activity actually influences the first gene’s activity. It is essential that we identify and understand these differences when developing personalized medicine approaches.”

Wu said previous mathematical methods for constructing dynamic gene regulatory networks are limited by their necessity to collect genetic data at multiple time points. By integrating the strengths of other disciplines, such as ecology and game theory, into mathematical equations, idopNetworks do not need to rely on data from multiple time points. They can monitor the snapshots of biological processes and dynamically predict how gene networks vary in response to changes in time and environment.

“Traditional approaches involved reconstructing networks at one time point from data collected at multiple time points,” said Ming Wang, MS, PhD, co-author and associate professor of public health sciences at the College of Medicine. “Our approach is statistically innovative in that it allows us to use data from one time point to reconstruct a network that is dynamic and can predict changes based on time and environment.”

Wu and collaborators studied genetic data collected at the University of Florida from patients who had undergone a surgical intervention for a circulatory disease in a separate study. Of the 48 participants, 35 had successful outcomes. They used the data to construct idopNetworks of 1,870 genes for each individual – and found that the people with successful outcomes had more connections within their networks. They also found that one gene played a critical role in regulating many of the genes within each person’s network.

According to the researchers, once a critical gene within a network is identified, further studies can be initiated to find out how many other genes it regulates and through what methods. This data may help in designing therapeutic interventions for patients with certain conditions. It may also help scientists investigate how changes in genes contribute to human disease.

“idopNetworks are flexible and may help us build tissue-specific gene regulatory networks using Genotype-Tissue Expression Project data,” said Chixiang Chen, first author and Biostatistics PhD candidate at the College of Medicine. “That data comes from a long-term project supported by the National Institutes of Health that aims to build a comprehensive public resource containing information on gene expression in specific tissues.”

Chen says idopNetworks constructed from this data set may help investigators determine what normal activity looks like in healthy tissues. It may also help them identify differences between the gene regulatory networks of healthy tissues and diseased tissues – which may help lead to the development therapeutic interventions for diseases like cancer.

Biyi Shen, a Biostatistics PhD student at the College of Medicine, and Zhenqiu Liu, PhD, associate professor of public health sciences at the College of Medicine, contributed to this study.

Also contributing to this research were Libo Jiang, Beijing Forestry University; Guifang Fu, SUNY Binghamton University; Yaqun Wang, Rutgers School of Public Health; Zuoheng Wang, Yale School of Public Health; Wei Hou, Stony Brook School of Medicine; and Scott Berceli, University of Florida.

This study was supported by Fundamental Research Funds for the Central Universities (Jiang) and grants from the National Institutes of Health (Wu and Berceli).

The authors declare no conflict of interest.

Weekly Quick Hits recaps announcements and events from The Daily Brief email. Check your email inbox for more.

Have an item to be featured in Quick Hits? Email news@pennstatehealth.psu.edu

PEOPLE

O’Donnell’s Cycling Raises $13,486

Tiffany O’Donnell, a medical office assistant in the Penn State Health Breast Center, raised $13,486 in the Tour de Pink, a cycling charity event. O’Donnell, who is a breast cancer survivor and was diagnosed in June with metastatic breast cancer, rode 111 miles over three days. The event raised more than $360,000 to help young women with breast cancer.

Braund Wins Alumni Fellow Award

The Penn State Alumni Association honored Penn State College of Medicine alumna Dr. Wendy Braund on Oct. 23 with the Alumni Fellow Award, the Alumni Association’s highest award. Braund, who graduated from the College of Medicine in 2001, is considered a national leader in public health practice. Read more.

ANNOUNCEMENTS

Hand Hygiene at St. Joseph

Penn State Health St. Joseph places a high priority on safe patient care. Knowing that the Centers for Disease Control estimates that one in 30 patients will acquire a hospital-onset infection, they have made good hand hygiene a top safety priority. What started as a 2018 campaign, in which staff pledged to wash in and out of patient rooms, continues with regular education. Today, secret shoppers provide a non-biased method for monitoring compliance at St. Joseph Medical Center. Providers see good hand hygiene as second nature. While the most recent review indicates compliance has increased to the low 80s, St. Joseph Medical Center continues to pursue its goal of 100% compliance.

Hershey Earns Highest Grade on Leapfrog Group Ranking

Hershey Medical Center has once again earned the highest grade on The Leapfrog Group’s latest safety ranking report card. The Medical Center achieved an A on the Fall 2019 Leapfrog Hospital Safety Grade. This represents the seventh consecutive A grade for Hershey Medical Center. Read more.

Compliance: Hotline Available

The toll-free Compliance hotline, 800-560-1637, is your connection for reporting any illegal or unethical conduct. Manned 24 hours a day, the hotline should be used to report issues such as patient rights violations, fraud, integrity issues, sexual harassment, confidentiality issues and more. Anyone who makes a report can do so anonymously or directly and will be protected from retaliation.

Compliance: Review the Code

Financial losses, security breaches, poor patient care, license revocations and a damaged reputation are just a few potential consequences of health care noncompliance. That’s why Penn State Health developed its Compliance Code of Conduct so employees understand the complex laws and perform their jobs honestly. It also empowers you to recognize ethical dilemmas you may encounter and know when and how to report them. Review the Code of Conduct here.

Compliance: Patient Safety

Compliance takes many forms in health care, but it’s especially important as it relates to patient safety. Our Compliance team conducts monthly checks to ensure that all active employees and vendors have not engaged in fraud or abuse and are authorized to participate in federal and state health care programs, such as Medicare and Medicaid. To learn more, review our Excluded Parties Verification policy.

UPCOMING EVENTS

Charity Ball

Penn State Health St. Joseph will host the 2019 Jardin du Chateau charity ball on Saturday, Nov. 9, from 7 to 11 p.m., at the Crowne Plaza, 1741 Papermill Road, Reading. The charity ball has been one of Berks County’s premier philanthropic events since 1927. Over the years, millions of dollars have been raised for St. Joseph Medical Center. Tickets are $200 per person. Contact Ann Marie Haus, development services coordinator, at 610.378.2477 or ahaus@pennstatehealth.psu.edu.

“Engineering Orthopaedic Surgery”

Gregory Lewis, assistant professor in the Department of Orthopaedics and Rehabilitation, will present “Engineering Orthopaedic Surgery: The Cutting Edge” on Wednesday, Nov. 20 at noon in Junker Auditorium, HG316, or via Zoom. The lecture is part of the Research Quality Assurance Lunchtime Lecture series. Register by Friday, Nov. 15. Food will be provided to those who RSVP by the deadline.

“Rethinking General Anesthesia”

Dr. Emery N. Brown, Warren M. Zapol Professor of Anesthesia at Harvard Medical School, will present “Rethinking General Anesthesia” on Thursday, Nov. 21, noon to 1 p.m. at the College of Medicine, Junker Auditorium. Lunch will be provided. Continuing Medical Education credit will be provided to those who attend in person. The lecture will be livestreamed and available for viewing afterward.

“Of Thee I Sing”

Save the date: Tuesday, Nov. 26 at 5 p.m. for Dr. David Goldenberg’s inaugural lecture as chair of the Department of Otolaryngology – Head and Neck Surgery. The lecture, entitled “Of Thee I Sing: The Anatomy, Physiology and Health Benefits of Song,” will take place in Penn State College of Medicine’s Junker Auditorium and be livestreamed at med.psu.edu/oto-chair.

Mindfulness-Based Stress Reduction

Penn State Health will offer two new sessions of Mindfulness-Based Stress Reduction – one class on Monday evenings at the University Fitness Center and another class on Wednesday evenings at Penn State Cancer Institute, starting this January. The eight-week course teaches participants effective ways to deal with stress and the demands of daily life. The program features body awareness exercises, meditation, gentle yoga and guided discussion. Orientations are scheduled on Monday, Jan. 6, and Wednesday, Jan. 8. Tuition is $500 for most participants. Some scholarships are available. Register at ufc.pennstatehealth.org. Learn more about the program on abc27.

Highmark Blue Shield has granted $10,000 to Penn State Health in support of a community health initiative to cover standard vision assessments and the cost of eye glasses for students in need in the Lebanon and Steelton-Highspire school districts.

In 2018, Penn State Health partnered with the Lebanon County Career and Technology Center to provide required health assessments for height, weight, vision, hearing and scoliosis for students in kindergarten through 12^th grade in Lebanon and Steelton-Highspire. More than 5,500 students were assessed, and over 18 percent of the students in the two districts were determined to need vision follow-up for glasses or other eye concerns.

This year, in partnership with the Lebanon Free Clinic and Penn State Health’s Department of Ophthalmology, the community health team offered three clinics in Lebanon and Steelton to provide health assessments and follow-up care referrals. Highmark Blue Shield’s 2019 vision grant will provide free glasses for more than 100 students who need them.

“It has been estimated that 80 percent of children’s learning is obtained through vision,” said Judy Dillon, community health director at Penn State Health. “When children can see well, they can be more successful in school. By providing glasses for kids in need, Highmark is giving these students greater opportunity to succeed in school and in life.”

“When we are able to impact so many children with this kind of gift, it is really wonderful. Think about the return on the investment of having a role in helping a child learn better; that is something they will use for years and years,” said Kathy McKenzie, vice president of community affairs for Highmark Health. “This continues to be an impactful partnership with Penn State Health and this is another really good example.”

Steelton-Highspire School District in Dauphin County and Lebanon School District in Lebanon County were selected for this initiative based on their community needs index (CNI) score from Penn State Health’s 2018 Community Health Needs Assessment, which indicated that both school districts had a high percentage of children in need of additional resources and services.

Penn State Health Center for Women’s Health Research will host the sixth Women’s Health Research Day on Thursday, April 16, 2020, at University Conference Center in Hershey.

The event will feature research from across the academic community related to women’s health and sex/gender differences, including oral research presentations, research posters and a keynote address on women and substance abuse delivered by Dr. Jane Liebschutz of the University of Pittsburgh Medical Center.

To attend, register online here

Faculty, students and trainees are also encouraged to submit research abstracts, which are due by 11:59 a.m. Dec. 13, 2019. See abstract submission details below.

As part its continuing commitment to diversity and inclusion, Penn State Health is hosting a Diverse Business Enterprise (DBE) Contractor Outreach Event for diverse contractors on Tuesday, Nov. 19, from 4 to 6 p.m. at Spooky Nook Sports, 75 Champ Blvd., Manheim.

Diverse business owners and contractors will learn about our DBE labor, vendor and service needs for the new Lancaster Medical Center. Penn State Health is working with Barton Malow Alexander, general contractor for the new medical center, to use diverse business enterprises in its construction projects.

“We recognize that our partnerships with diverse contractors support the overall economic growth of the communities in which we provide quality patient care and provide our organization with a competitive financial advantage through increased competition and innovative approaches to business,” said Lynette Chappell-Williams, chief diversity officer for Penn State Health.

Penn State Health’s commitment to supplier diversity includes not only vendors, but also construction contractors who are doing renovations or building our medical centers. Diverse suppliers are businesses that are at least 51% owned by a designated diverse background. For Penn State Health, that means owned by women, racial/ethnic minority populations, veterans or a member of the LGBTQ communities.

Diverse contractors are encouraged to attend and should reserve their seat by Friday, Nov. 15.

In the patients who walk through the doors of Penn State Health Medical Group – Cornerstone in Lititz, Dr. Scott Osborn sees the same sense of community and connection to a greater purpose that he saw as a chief medical officer in the U.S. Army.

“It’s that same ‘salt of the earth’ kind of people, and I feel honored to help meet their needs just as I helped meet needs in Afghanistan,” said Osborn, who was in the U.S. Army Reserve from 2003 to 2007 while he was in medical school and on active duty from 2007 to 2014.

Carrying on a family tradition of military service – both grandfathers served in World War II – Osborn completed a three-year family medicine residency at Fort Benning in Georgia, got orders for service with the 173^rd Airborne Brigade in Vicenza, Italy, and eventually shipped out for Afghanistan.

There, he attended to trauma cases as the senior medical official on the ground and helped train U.S. and Afghan medics. Later, he cared for soldiers and their families at the U.S. Army Health Center Vicenza. He completed his service at Fort Bliss in El Paso, Texas, where he was the director of a clinic for retired military personnel and their dependents.

“My military experience helps me better serve veterans in our community because I can speak their language – it’s a connection, especially in family medicine,” Osborn said.

The deep agricultural roots in Lancaster County’s makeup provide a very stable population that is enhanced by many people moving into the area, creating a diversity that Osborn says he is fortunate to serve.

“I felt very proud to do my service for our country, and I feel proud to continue to care for patients right here in Lancaster County,” he said.

Penn State Health recognizes the value of a diverse workforce in advancing innovation and excellence – and employees who are veterans and military service personnel are an aspect of that commitment to diversity, said Lynette Chappell-Williams, chief diversity officer at Penn State Health.

“They epitomize our values and advance our need for employees with exceptional leadership, teamwork and adaptability skills,” she said.

Kat Schoenknecht, a registered nurse and oncology financial counselor at Penn State Health Lime Spring Outpatient Center, sees her current job as a natural extension of service she felt proud to give while serving as a U.S. Army medic at William Beaumont Army Medical Center in El Paso, Texas, from 1984 to 1987.

“I got my passion for nursing from being exposed to some very strong nurses there,” said Schoenknecht, who worked in the emergency room, adult and pediatric clinic and surgical floor.

When she returned home, she remained on inactive duty until 1990 and earned her bachelor of science in nursing in 2000.

Her personal journey with breast cancer led her to specialize in oncology, where she says her clinical knowledge helps her better advocate for patients in need of financial resources and services.

“The people that walked me through that journey were a huge influence, and it’s an honor to help the next person along on that journey,” she said. “I know what they are going through. I know I’m right where I’m supposed to be.”

Penn State Health today celebrated the ‘topping off’ of Penn State Health Hampden Medical Center, the future 300,000-square-foot, three-story acute care hospital in Cumberland County.

The topping off ceremony included speakers from Penn State Health, Highmark Health and members of the Pennsylvania Legislature. Construction workers used a crane to hoist the final beam of the structure and guide it into place. A ‘topping off’ ceremony is a long-standing tradition of builders to commemorate the completion of a building’s structure. Many topping off ceremonies include a tree, said to be due to the Native American belief that no building should be taller than a tree. The final beam for Hampden Medical Center included a pine tree, two Penn State Health banners signed by patients, staff, students, volunteers and community members and the U.S. flag donated by VFW District 18.

“Hampden Medical Center is one way we are delivering on the promise we made together with Highmark Health: Patients across the central Pennsylvania region will be within 10 minutes of Penn State Health primary care providers, 20 minutes of our specialty services and 30 minutes of a Penn State Health acute care hospital,” said Steve Massini, CEO of Penn State Health. “We are committed to developing a regional health network that will offer a full complement of primary and specialty care services closer to where the patients we serve live and work.”

The new $200 million facility will feature 108 inpatient beds, an emergency department, physician offices, various specialty inpatient services, image and lab services and complete medical and surgical capabilities. It will feature an open medical staff, with a plan to develop collaborative programs between Penn State Health physicians and private community providers. Hampden Medical Center will include an attached outpatient medical office building.

“In less than two years, Highmark and Penn State Health have made significant progress in creating a world-class, community-based network of health care in central Pennsylvania,” says Deb Rice-Johnson, president of Highmark Inc. “From providing grants to advance cancer research, to partnering with leading independent physicians, to establishing new facilities including Hampden Medical Center, we are committed to improving quality, access and convenience across the region. We will continue to invest in the health and well-being of our members, patients and neighbors in the years to come.”

The project will bring hundreds of well-paying jobs to the area, both during construction and for hospital operations. The construction process is expected to bring about 600 jobs; and once operational, the hospital will initially employ 650, with a planned increase over the first three years to about 1,000 employees.

A national search is underway for a president of Hampden Medical Center, with an appointment anticipated for early 2020.

Penn State Health is partnering with Cannon Design and Barton Malow Alexander on this project, which is expected to be complete in summer 2021.

Penn State Clinical and Translational Science Institute generates innovative health research ideas and promotes collaboration through its Bridges to Translation pilot grant program, which seeks to link researchers not traditionally in health research with those who can help mold a new idea.

The institute recently funded seven diverse projects in Bridges to Translation V. These grants allow researchers to explore new ideas and gather information in preparation for more substantial grant opportunities from outside organizations.

Researchers are invited to submit letters of intent for the institute’s next funding opportunity, Bridges to Translation VI. The institute will award grants up to $50,000 each. It gives special consideration for projects that relate to rural and other vulnerable populations who experience health disparities, specifically projects that explore social and environmental determinants; study of or interventions focused on those diseases identified by Case and Deaton; new methodologies including telemedicine, community-engaged research and big data modeling in research of the determinants of health; and population health and patient-centered outcome research. Letters of intent are due by Dec. 2.

After a competitive process, Bridges to Translation V grants were awarded to principal investigators Winnie Adebayo and Cara Exten; Amy Arnold; Nikolay Dokholyan; Michael Hayes and Susan Veldheer; Charleen Hsuan; Dahlia Mukherjee; and Jane Schubart and Rebecca Bascom. The projects are:

Barriers to health care in rural transgender adults

Winnie Adebayo and Cara Exten are studying the barriers to health care and the unmet health needs of rural transgender adults.

“The overall goal of this research is to identify the barriers transgender individuals are experiencing to seeking and receiving health care,” Exten said. “Results from this study will allow us to identify critical points of intervention. We plan to disseminate results to health care providers, clinics and trainers of health care providers to inform and educate about the barriers. We intend to use these results to aid in the development of intervention programming to reduce health care barriers affecting this vulnerable population.”

Collaboration is vital for the project, Adebayo said.

“We will be working closely with co-investigators Carly Smith and Katharine Dalke from the College of Medicine, and Julie Barroso, a mixed-methods expert from the Medical University of South Carolina,” Adebayo said. “We will also collaborate with Penn State Center for Sexual and Gender Diversity and clinics and community-based organizations that serve transgender populations across the state of Pennsylvania.”

Adebayo and Exten are both assistant professors of nursing.

Understanding ‘brain fog’ in postural tachycardia syndrome

Amy Arnold is studying the disabling disorder postural tachycardia syndrome. The disease causes an excessive increase in heart rate upon standing that is accompanied by symptoms such as dizziness and fatigue.

“One of the most underappreciated and bothersome symptoms of this syndrome is impaired cognition or ‘brain fog,’ which occurs to a level that interferes with daily activities such as work and education,” Arnold said. “However, the reasons why patients have problems with cognition are not well understood. This project will determine if brain activity in response to mental tasks is different in postural tachycardia syndrome patients compared with healthy subjects when at rest and during a physical challenge that mimics standing.”

A better understanding of the causes of this “brain fog” can lead to new treatments to improve symptoms. The findings from this project may also have broader importance to improve understanding of brain mechanisms involved in standing in healthy individuals and patients with other cardiovascular disorders.

This study will collaborate with four College of Medicine departments, including experts in cardiology, cardiovascular autonomic disorders including postural tachycardia syndrome, brain imaging modalities, cognitive neuroscience and neuropsychological testing.

Arnold is an assistant professor of neural and behavioral sciences.

Speeding up drug discovery

Nikolay Dokholyan is studying the use of software algorithms to speed up drug discovery.

“Drug discovery is a costly and long process: a drug discovery process can take over a decade and cost several billion dollars,” Dokholyan said. “One of the primary time and money consuming steps is the identification of potential lead compounds that would be further tested in animals and clinic.”

Dokholyan and his collaborators created software called MedusaDock, which helps screen potential compounds by taking into account the complex physical and chemical interactions between small molecules and proteins. Many drugs are small molecules. This process can be slow, even using computer software.

Dokholyan teamed up with Mahmut Kandemir and Kamesh Madduri, both from the School of Electrical Engineering and Computer Science, graduate student Mengran Fan and postdoctoral fellow Jian Wang to accelerate the algorithms.

“We came up with the plan to port our software to graphical processor units – also called GPUs – which would allow calculations to be massively parallel,” Dokholyan said. “GPUs are now in high demand for their ability to process a large number of simple mathematical operations and have been the centerpiece for mining bitcoins. We plan to utilize GPUs to increase the speed and processing power of MedusaDock. This proposal is a harmony of very distinct but complementary expertise. Neither of the sides would have been able to achieve the goals without working together.”

To further improve the speed, the team also decided to first predict potential binding sites before performing more expensive simulations. Dokholyan believes that through these efforts, time for each attempt will decrease from up to eight minutes to less than a minute.

Dokholyan is G. Thomas Passananti Professor and vice chair for research in the Department of Pharmacology and a professor of biochemistry and molecular biology.

Barriers to sharing social influence information

Michael Hayes and Susan Veldheer are studying what gets in the way of patients and their care providers sharing information about social influences that affect health.

“Some evidence suggests as much as 40 percent of health outcomes are determined by social influences, such as the conditions in the places where people live, learn, work and play,” Hayes said. “With safe, acceptable and effective ways to use information about social influences, patients will receive better care and achieve greater health.”

The project will provide essential data to identify barriers to and solutions that enable the routine collection of such information as the standard of patient care.

“Collaboration is critically important and lies at the heart of our pilot project,” Veldheer said. “We will do this through a series of Clinical and Translational Science Institute-conducted Community Engagement Studios and research-team led focus group meetings. There will also be ongoing collaboration among the pilot’s team of investigators and a related project led by Dr. Hayes and Dr. Andrea Hobkirk – a Penn State Cancer Institute Catchment Area Award that also aims to investigate social influences on health.”

Hayes is an assistant professor of psychiatry and Veldheer is an assistant professor of family and community medicine.

Laws regulating inter-hospital transfers

Charleen Hsuan will examine state laws regulating inter-hospital transfers, disparities in quality of emergency department transfers, and the association of one state law on transfers.

“The Emergency Medical Treatment and Labor Act requires Medicare-participating hospitals to provide emergency care to all patients, regardless of insurance status, race or ethnicity, and permits transfers of unstable patients with emergency medical conditions only under specified conditions,” Hsuan said. “This law enshrines the belief, recommended by the Institute of Medicine, that improving health care quality requires that care be equitable. However, hospitals continue to violate the law, including the transfer provision. This leaves a large potential for state laws to decrease disparities in hospital transfers.”

This project also serves as a pilot project for the institute’s policy impact core. The core’s work is related to T3, translation to practice, and T4, translation to population health, in the phases of translational science.

“Evidence-based policies such as transfer guidelines for hospitalized patients have the potential to affect public health, but only to the extent that they are used,” Hsuan said. “Laws are an important mediator of the relationship between the research that creates the guidelines and their public health effects, as they influence what providers do and thus what care patients receive.”

The project has collaborators from Health Policy and Administration and College of Health and Human Development at University Park and Public Health Sciences and Emergency Medicine at the College of Medicine.

Hsuan is an assistant professor of health policy and administration.

Study of major depressive disorder

Dahlia Mukherjee is studying the loss of interest or pleasure in activities that a person usually enjoys when they have major depressive disorder. This loss is called anhedonia and is linked to a responding poorly to treatment or having thoughts to self-harm.

“Current treatments for depression primarily focus on treating depressed mood and not anhedonia,” Mukherjee said. “Part of the reason why anhedonia is not addressed in treatment is that it is not well understood.”

Mukherjee’s project will look at changes in brain activation and inflammation levels in depressed people reporting high anhedonia. Understanding these biological changes can lead to better treatment options.

Mukherjee is collaborating with Charles Geier, who will analyze the brain imaging results;

Brandon Auer and Christopher Engeland, who will process and analyze samples; and Erika Saunders, who will help with patient recruitment and medication management of patients.

“I am very excited to be working with such an accomplished and talented group of people,” Mukherjee said. “Hopefully, with the support of this pilot grant, my colleagues and I will be able to determine clues to a better understanding of anhedonia.”

Mukherjee is an assistant professor of psychiatry.

Educating primary care doctors to help patients with a rare disease

Jane Schubart and Rebecca Bascom are studying Ehlers-Danlos Syndromes, a set of rare heritable disorders of connective tissue.

They will study the effectiveness of using Project ECHO for Ehlers-Danlos Syndromes. Project ECHO at Penn State College of Medicine offers a unique learning experience and support network. ECHO, which stands for Extension for Community Healthcare Outcomes, gives primary care physicians the tools they need and a professional network to treat patients in regions with little or no access to specialists. It links expert specialist teams at an academic ‘hub’ with primary care clinicians in local communities – the ‘spokes’ of the model. Together, they participate in weekly virtual clinics, combined with mentoring and patient case presentations.

“People with Ehlers-Danlos Syndromes are a vulnerable group who are falling through the cracks in our health care system,” Schubart said. “Primary care physicians with expertise in treating Ehlers-Danlos Syndromes are difficult to find and specialists have waiting lists of two-to-three years.”

Researchers will evaluate both the program implementation and its performance to determine whether the program will increase quality and access to Ehlers-Danlos Syndromes specialty care.

“The support of the Clinical and Translational Science Institute has been essential and has made possible our growing portfolio of collaborative research,” Schubart said

Schubart is an associate professor of surgery, medicine and public health sciences and Bascom is a professor of medicine.

Penn State Health’s Life Lion Emergency Medical Services received the Pennsylvania CARES Award.

CARES stands for Cardiac Arrest Registry to Enhance Survival. The award, given in October in observance of Sudden Cardiac Arrest Awareness Month, acknowledges Life Lion’s dedication to collecting out-of-hospital cardiac arrest data for quality improvement purposes.

Life Lion EMS’s dedication to collecting the data has helped strengthen the collaboration between 911 centers, first responders, EMS agencies and hospitals, with the ultimate goal to improve survival rates for out-of-hospital cardiac arrests.

Penn State Health and Highmark Health have entered into a multi-year sponsorship agreement with the Reading Public Museum to serve as title sponsors of an annual exhibition from 2020 through 2022.

The agreement is the broadest in scope in the museum’s history, supporting various educational and cultural programming, including Reading Public Museum’s premiere exhibitions over each of the next three years, as well as scholastic programs at its Neag Planetarium.

“Penn State Health and Highmark recognize the significant benefit and increasing scarcity of programs like those offered by the Reading Public Museum,” said Steve Massini, chief executive officer, Penn State Health. “This commitment is an important investment in the cultural enrichment and educational interests of our community. Penn State Health is proud to support the museum’s varied and vital contributions to the Greater Berks region.”

“When we partnered with Penn State Health, we said the partnership would benefit the community,” said Kathleen McKenzie, vice president, Highmark Health. “Those benefits go beyond providing access to high-quality, affordable care close to home. We also want to invest in making our communities a better place to live, and supporting the Reading Public Museum is a great way to do that.”

As part of the sponsorship, Penn State Health and Highmark will serve as title sponsors for premiere exhibitions in the museum’s main Second Floor Galleries over the next three years. These include “Mazes & Brain Games” in 2020, “Courting Style: Women’s Tennis Fashion” in 2021 and “Real Bodies” in 2022.

“This investment by Penn State Health and Highmark Health demonstrates a tremendous commitment to the museum’s educational programming and to the varied communities we serve,” said John Graydon Smith, Reading Public Museum director and chief executive officer.

The Reading Public Museum sees nearly 3,000 visitors weekly. Attendance topped 125,000 visitors for the first time ever in 2018. School tour visits from every district in Berks County are now an annual tradition and include field trips by schools across central and eastern Pennsylvania.

Penn State Health CEO Steve Massini and Penn State College of Medicine interim dean Dr. Kevin Black sent a Veterans Day message to employees, faculty and students:

Dear colleagues,

Today is Veterans Day, when we pause to honor and thank the extraordinary individuals who have chosen to serve our country and protect our freedom.

Nearly 400 Penn State Health and Penn State College of Medicine faculty, staff, residents, students and volunteers have served, or are still serving, in the U.S. Armed Forces. Many others among us grew up in military families, or have loved ones in uniform.

To each of you, we say thank you. We are grateful you are a part of our organization. Your perspective helps us to provide better care to our 19,000 patients who share your military experiences.

We invite you to read two stories about remarkable veterans in our community. The first story features some of our own veterans and how they continue their tradition of service with our patients. The second one – from our This is Penn State Health campaign – tells the story of a young Marine named Paul Brennan who came to us for care while home for Christmas in 2013 and ended up undergoing a liver transplant.

Penn State Health and College of Medicine are developing an organization-wide military/veterans affinity resource network group for faculty and employees who have served or are still serving, and the college also has a military medicine interest group for students. Those with military service or an interest in supporting colleagues with military service are invited to become affiliated with these groups by emailing our Office for Diversity, Equity and Inclusion at diversity@pennstatehealth.psu.edu to get connected. Veterans are also invited to request a pin that identifies your military service.

To our veterans who have served, and to our future veterans who are still serving – thank you. Happy Veterans Day.

Steve Massini                                                  Kevin Black, MD
CEO                                                                   Interim Dean
Penn State Health                                          Penn State College of Medicine

The 13^th annual People’s Pay 4 Play on WQXA-FM 105.7 The X on Nov. 7 and 8 raised a record-breaking $359,410 for Children’s Miracle Network at Penn State Children’s Hospital — a 36% percent increase over last year.

The 2019 show brings the event’s 13-year fundraising tally to $2,080,303.

Jen Shade, Nipsey and Earl David Reed from The People’s Morning Show hosted the 28-hour event. Listeners made a donation for a song request.

“Wow! We are blown away by the growing support of Pay 4 Play,” said Danielle Sunday, director of Children’s Miracle Network. “We send our sincere thanks to WQXA-FM and their listeners who have turned a 28-hour event into a year-long fundraising effort to save kids’ lives.” Sunday also credited the event’s sponsors, local businesses, volunteers and patients and patients’ families for the windfall.

Donations will support lifesaving equipment, family-centered programs and innovative research at Penn State Children’s Hospital. Learn more at CMNHershey.org

Parents spend hours planning to talk with their children about the “birds and bees.” But moms and dads often ignore an equally important conversation—discussing their family’s overall health history.

That’s why, in 2004, the U.S. Surgeon General declared Thanksgiving Day as National Family History Day.

“The more parents know and share about their family’s health history, the better they can help their children prevent health problems later in life,” said Dr. Mack Ruffin, chair of the Department of Family and Community Medicine at Penn State Health.

Many health conditions carry a genetic link that will be seen in your family. These include diabetes, hypertension, heart disease and cancers of the breast, colon, pancreas and prostate. So too do many behavioral health conditions. People in certain ethnic groups also may be at higher risk for certain conditions.

When starting the family health history discussion, parents should make the conversation age appropriate. “For younger children, talk about it in general terms, the way a 9 or 10-year-old might understand it,” Ruffin said.

Get more detailed when talking to teenagers. If a history of addiction runs in the family, begin conversations about avoiding alcohol, tobacco and recreational drugs in the early teen years. “All children should know their full family health history by the time they start making their own health care decisions,” Ruffin said.

Some tips to help parents shape the conversation:

Gather pertinent information. Write down the names of blood relatives—parents, siblings, grandparents, aunts, uncles, nieces and nephews. Talk to them about the health conditions they have or had, and when they were first diagnosed. What about stepparents? “While they can help lead the conversation, a stepparent’s family history will not affect their stepchild’s health because they aren’t blood relatives,” Ruffin said.

Get details. Knowing that “Grandpa died of cancer” won’t give a physician enough facts to help children potentially avoid cancer in the future. So, give children as much information as possible. “Knowing that Grandma had breast cancer before age 50, Uncle Dave had colon cancer in his 70s or that all men in the family had prostate cancer by age 60 gives us useful clues,” Ruffin said.

Discuss lifestyle factors. Just because a health condition runs in the family doesn’t mean it’s genetic. “If grandma and great-grandma died of lung cancer but both smoked two packs of cigarettes a day, children might reduce or eliminate their risk by simply not smoking,” Ruffin said.

Review family photo albums. Notes scribbled in the margins may provide information about a blood relative’s health. Also check the family bible.

Write it down. Keep a record of the discussion in a familiar location so children can access it at any time. Write it, type it, or use a free online tool like the Surgeon General’s My Family Health Portrait.

Provide action steps. For younger children, having an awareness of family health history is enough. For younger teens or older children, ask them to talk with their health care providers about their family history and steps they can take to prevent disease.

Rinse and repeat. Discussing family health history annually keeps it top of mind for everyone.

While some people give the gift of DNA genetic test kits for the holidays, the family health history discussion should come first. “That way a doctor can help properly interpret any genetic testing results,” Ruffin said. Ruffin does recommend adults with no biological family information consider DNA genetic testing.

The Medical Minute is a weekly health news feature produced by Penn State Health. Articles feature the expertise of faculty, physicians and staff, and are designed to offer timely, relevant health information of interest to a broad audience.

Related content:

• The Surgeon General’s Family Health History Initiative
• The Medical Minute: Understanding family health history for a healthier you
• The Medical Minute: Four reasons to focus on family health and history

Longtime Penn State philanthropists Dallas and Diane Krapf have committed $1 million—their largest single contribution to the University to date—to build a new interfaith chapel on the campus of Penn State Health Milton S. Hershey Medical Center.

The Krapf family is already the strongest individual supporter of Pastoral Services at the Milton S. Hershey Medical Center, having established the Krapf Family Endowed Fund to support the program in 1998. “After my dad’s accident in 1992, my family wanted to give back to the hospital to express our gratitude and make sure other patients and families could receive the same kind of care we did,” said Dallas Krapf.

Krapf’s father, George, was transferred to Hershey from a hospital in Canada following a life-threatening snowmobile accident. He spent more than 80 days at Hershey Medical Center, and the family credits the medical team for saving his life and restoring his health. For almost three months, the Medical Center became a second home to the Krapf family, who relied on their faith to carry them through and offer hope.

“My mom was a very devout Methodist,” Krapf recalled. “When she wasn’t by my dad’s side, she spent time in the prayer chapel, and we all deeply appreciated the visits we received from the pastoral care staff.”

For more than 20 years, family and friends have continued to support the Krapf Family Endowed Fund in Pastoral Services. When Dallas’ sister, Millie Krapf Fails—an alumna of Penn State—passed away in 2006, memorial contributions were also directed to the fund, which has now grown to more than $300,000.

The Krapfs’ gift to build the new interfaith chapel further exemplifies their family’s longstanding support for pastoral services at the Medical Center. “It was important to us to honor my parents’ memory and express our gratitude in a tangible way that will benefit many others for years to come,” Krapf said. “We’re proud that our family name will permanently be connected to the chapel and the spiritual care that was so meaningful to us.”

The current chapel, located behind the main surgical waiting area on the first floor of the hospital, serves as a place where patients, families, students and staff of all faiths can seek respite, participate in weekly religious services, celebrate joyous occasions or memorialize loved ones who have died in the hospital. Over the years, the chapel has also served as the site of special events like weddings, baptisms, Blessing of the Hands services, Ash Wednesday blessings, recognition and retirement ceremonies, and military commissioning and promotions. It is open at all times, and chaplains are available 24 hours a day, seven days a week to provide spiritual, emotional and sacramental support.

“Although our pastoral services team provides thousands of hours of patient and staff support each year in clinics, patient rooms and departments throughout the hospital, the chapel stands as the central place for prayer and meditation and the visible home for our team’s spiritual care,” said David Simmons, director of pastoral services.

A need to expand clinical services on the first floor of the hospital, coupled with a desire to enhance the current footprint and accessibility of the chapel, made building a new facility a priority project for Hershey Medical Center. The new chapel will be prominently located in the courtyard just off the main entrance of the hospital, providing greater and more convenient access for all guests, faculty and staff.

“We are deeply grateful to Dallas and Di Krapf for their extraordinary generosity to build this new interfaith chapel, which is such an integral part of the care we provide,” said Deborah Berini, president of Hershey Medical Center. “The prominent location of the new building signifies the priority we place on providing care.”

The chapel is also an important place for physicians, nurses, residents, students and other caregivers. “In a profession like healthcare that has high stress and burnout rates, the chapel is often the first stop for many of our employees to center themselves at the beginning of a shift or before leaving work,” noted Simmons.

In addition to their support for Pastoral Services and the new chapel building, the Krapf family previously donated a stained glass piece depicting Mount Nittany, in memory of their parents and grandparents, Eleanor and George Krapf, Jr. The art is part of the Medical Center’s permanent collection and provides a peaceful backdrop for visitors in the main hospital waiting area on the first floor.

The Krapf family has a long history of family members attending and graduating from Penn State, including the late Millie Krapf Fails ’60 Edu; Marcia Krapf McQueen ’64 Edu; Tim Bryant ’82 Bus; Todd McQueen ’91 Bus; Tara McQueen Sandora ’98 MEd Edu; Joel Krapf ’11 Bus and Alison Cumens Sload ’13 Com.

Building a Legacy of Generosity

While the Krapfs’ leadership commitment to build the Di and Dallas Krapf Interfaith Chapel at Hershey Medical Center was inspired by their personal experience at the hospital, their loyalty to Penn State predates Dallas’ father’s accident in 1992. In fact, the family says their love of Penn State and trust in the institution helped them make the difficult decision to have George transferred to Hershey in the first place.

Besides the fact that two of Dallas’ sisters graduated from Penn State, the Chester County native has also been a Nittany Lion football fan since he began attending games with his brother in the early 1970s. Dallas has held football season tickets since 1972, and he and his wife also have season tickets for wrestling, basketball and hockey. The couple has supported the Lasch Building, home of the football program, and Penn State baseball’s Medlar Field at Lubrano Park.

Beyond Hershey Medical Center and athletics, the Krapfs have long supported Penn State Great Valley, the campus closest to their home, including gifts to name the alumni building on campus, support scholarships and dedicate a piano in memory of Dallas’ sister, Millie, among other contributions.

They’ve given to the libraries and Special Olympics, in honor of Sue and Joe Paterno. And in 2016, the Krapfs acted on their passion for education and the military by making a commitment to establish the Dallas and Diane Krapf ROTC Outstanding Leadership and Service Scholarship. Dallas is a veteran of the United States Army. This scholarship will support undergraduate students who have demonstrated excellent academics and leadership potential through community involvement and are enrolled, or plan to enroll, in any of the Reserve Officers’ Training Corps (ROTC) programs at Penn State.

“Although Dallas never completed a college degree following his military service, he and Di clearly bleed blue and white,” said Kelly Altland, associate vice president for development and chief development officer at the Medical Center and College of Medicine. “It’s safe to say they are among the most loyal and generous Penn Staters.”

This latest gift from Dallas and Di Krapf to build the interfaith chapel will advance “A Greater Penn State for 21st Century Excellence,” a focused campaign that seeks to elevate Penn State’s position as a leading public university in a world defined by rapid change and global connections. To learn more about the campaign, visit greaterpennstate.psu.edu.

When the wife of a patient at Penn State Health Milton S. Hershey Medical Center’s Heart and Vascular Institute (HVI) took a turn for the worse at a nearby hospital earlier this month, staff rallied to make sure he could visit her before she died.

On Oct. 7, cardiologist John Boehmer got a call from UPMC Pinnacle Community Osteopathic Hospital, where the patient’s wife was battling end-stage cancer. They believed she was nearing death.

Boehmer and his team discussed whether they could discharge the patient so he could spend time with his wife before she died.

Unfortunately, the man had just gotten a left ventricular assist (LVAD) device implanted. He was in the intensive care unit and had not yet been taught how to manage his LVAD, so it was too risky to discharge him.

The patient and his family were not happy about that and wanted him to be able to leave right away.

Vikki Cicchillo, a clinical practice nurse leader for the HVI Critical Care Unit, said a social worker suggested a special type of order that would allow the man to leave the hospital briefly, as long as he had someone to monitor him and provide care until his return.

“A lot of people worked very hard to make this happen,” said Scott Buchle, Life Lion Emergency Medical Services (EMS) manager.

The initial effort started with the nurses and doctors, then social workers and care coordinators got involved. Risk Management, the Legal Department and Patient Safety all had to clear the plan, as well as the hospital administrator on duty.

Wendell Hess, HVI Critical Care Unit nurse manager, said because the visit was so important to the patient and his family, hospital staff wanted to find a way to do it, while ensuring he remained safe and that his insurance would still cover his stay.

“Sometimes insurance companies aren’t able to pay for the whole stay if a patient leaves the hospital,” he said. “They will question why we didn’t just discharge him.”

Once that was accomplished, the HVI staff called Life Lion EMS to request a transport team.

Life Lion EMS paramedics Steve Wukovitz and Tom Alleman responded with Life Lion emergency medical technician Tyler Nelson. Accompanied by Cicchillo, they drove the patient to Community Osteopathic.

Surrounded by their family, the man and his wife were able to spend about one hour together before he returned to the Milton S. Hershey Medical Center.

The following day, HVI staff completed the patient’s LVAD education and discharged him. His wife died two days later.

“This is a whole-institution story because we had everyone weigh in, and nowhere along the way did anyone say no,” Buchle summed up.

An online guidebook detailing the clinical research process and available support resources at Penn State is now available. It is based on a guidebook released last year specifically for Penn State College of Medicine. It is a collaborative effort of Penn State Clinical and Translational Science Institute, Penn State Social Science Research Institute and the Office of the Senior Vice President for Research.

“The amount of clinical research happening outside the College of Medicine is growing quickly,” said Justin Snyder, quality management coordinator, Office for Research Protections. “The Office of Research Protections has been working with the Clinical and Translational Science Institute to make sure that investigators have the support for clinical trials they need. The guidebook is an important part of that.”

With the broadened definition of clinical trials from the National Institutes of Health, the number of investigators who need this support is increasing.

The guidebook includes sections on several aspects of the research process, including resources and training, study development and feasibility, financial consideration, compliance and protected health information. It guides an investigator through necessary first steps, such as training resources and trial development, obtaining required approvals and maintenance of a trial through closure stages. Links provide direct access to additional information for each topic.

“Some investigators conducting clinical research at University Park and the Commonwealth campuses have a background in basic science so that they may be unfamiliar with the special rules, regulations and best practices for clinical research,” Snyder said. “The guidebook acts as a digital concierge for anyone at Penn State conducting clinical research, but especially those outside the College of Medicine.”

The guidebook is an example of collaboration within the Clinical and Translational Science Award program. University of California Davis Clinical and Translational Science Institute shared its guidebook, including editable files, with Penn State to use as a foundation. Dee Bagshaw, Penn State Clinical and Translational Science Institute program manager, worked with Snyder to collect information and assemble the University Park guidebook.

“The mission of Penn State Clinical and Translational Science Institute is to accelerate discoveries to benefit human health, including by helping our researchers move their research more efficiently and effectively out of their laboratories and into use by the people who need it,” said Susan McHale, institute associate director and director of Penn State Social Science Research Institute. “The guidebook at the College of Medicine has been well received as a valuable resource. We believe that researchers at University Park and our Commonwealth campuses will benefit as well from this comprehensive resource.”

The guidebook is hosted on the Social Science Research Institute website and will be regularly updated. It is part of Penn State Clinical and Translational Science Institute’s initiatives around clinical research, through its Hub Capacity Core, and workforce development.

The University Park guidebook is here and the College of Medicine guidebook is here.

To request a consultation with Penn State Clinical and Translational Science Institute, complete a service request form.