Smilow Town Hall | May 6, 2021

Transcript

• 00:00Of the town Hall, and for those of you
• 00:03who have been met, I'd like to say,
• 00:05say hello and it's my pleasure to be the
• 00:08interim director and position in Chief.
• 00:11The goal of this town Hall is
• 00:13for us to share information.
• 00:15If he say that you know one of our
• 00:18aspirations is to be an academic cancer
• 00:20system in an academic health system,
• 00:23and what we hope,
• 00:24and I hope you'll see that today,
• 00:26is that the town halls brings together
• 00:29all facets of our combined universe,
• 00:31including our clinical entity
• 00:32and our educational forum,
• 00:34as well as a research and these town
• 00:36halls will be monthly moving forward
• 00:39on the 1st Thursday of the month.
• 00:41At 5:00 PM.
• 00:46Next
• 00:49so just so you know,
• 00:51if you have have missed this,
• 00:53I'm just going to remind you,
• 00:56this month is Oncology Nursing Month and we
• 00:58have been having celebration all months.
• 01:01Yesterday we had the nursing award ceremony
• 01:03and today's national nurses state so
• 01:06please wish all your favorite nurses.
• 01:08All the nurses around us,
• 01:09Happy Nurses Day and I specially would
• 01:12like to thank the more than 400 plus
• 01:15nurses who deliver exceptional patient
• 01:17care at Smilow Cancer Hospital in.
• 01:19All of our 15.
• 01:22Ambulatory care sites in Connecticut
• 01:23and Investory Rhode Island.
• 01:24Thank you for all that you do.
• 01:27Each and every day for for
• 01:29all of our patients,
• 01:30I think many of us call you are,
• 01:33you know, depend on you.
• 01:35All of our patients depend on you,
• 01:37so thank you for all your hard
• 01:39work and truly appreciate it.
• 01:41I think it also would be remiss
• 01:43not to call out a special call
• 01:46out to our Chief Nursing Officer.
• 01:48Our very own Kim Slusser for
• 01:50her inspired leadership.
• 01:51She's been here since mid 2019 and
• 01:53what a journey it's been through.
• 01:55Covid and Kim has really empowered our
• 01:58nursing leadership team at Smilow and.
• 02:00Support Ferguson step so thank you to
• 02:02all of you and thank you for helping us
• 02:04provide care to all of her patients,
• 02:07not only during kovit,
• 02:08but as we are now dealing with the
• 02:11transformation efforts beyond coding.
• 02:12OK agenda for today next slide.
• 02:15Today we have a busy agenda with
• 02:17clinical updates by cabin Billings
• 02:20Doctor Kevin Billingsley and Kim
• 02:22Slusser to give you an idea of
• 02:24what where things are including
• 02:26what is happening in North Haven
• 02:28with Kathleen Moseman.
• 02:29Karen Edelson will provide a brief
• 02:31update on the hospitalist program,
• 02:33which I know very,
• 02:35very excited about and then Doctor
• 02:37Peter Glaser and Lynn Wilson will
• 02:40provide updates on radiation oncology.
• 02:42We have our very own Doctor Rob
• 02:44Fogarty who will give us an update on
• 02:47the bed stacking which has affected
• 02:49a lot of as we've dealt with covid
• 02:51that the changes all of us have seen
• 02:53in Smilow and then Doctor Demaio is
• 02:56going to give us research updates
• 02:58as and he's our Deputy Director
• 03:00for the Yale Cancer Center.
• 03:01With that I'm going to turn it
• 03:03over to Doctor Kevin Billingsley,
• 03:05Doctor Billingslea.
• 03:07Thank you Doctor Ahuja before we launch
• 03:09into the more formal program today.
• 03:12I have the pleasure, an honor of of
• 03:16recognizing a member of our community.
• 03:20We do a series of awards and recognitions
• 03:23at the Smilow Conclave on an annual basis.
• 03:26But every so often there is an
• 03:29individual whose contributions and
• 03:31service have risen to a level that
• 03:33they need to be recognized in an
• 03:36off cycle or in spontaneous way.
• 03:38And we have one of those individuals
• 03:41with us in this town Hall this evening.
• 03:44One of the things that I think we
• 03:47have all realized over the past 15
• 03:49months of this pandemic that we
• 03:52have managed to weather together is
• 03:55that the communication links of our
• 03:57organization have played a central
• 03:59role in maintaining our response,
• 04:01our community, our well being,
• 04:03and keeping and keeping us in touch
• 04:06with our patients and our family
• 04:10and their families.
• 04:11For her key role in keeping us all
• 04:14integrated as a community and managing
• 04:17these critical communication links,
• 04:20it's my pleasure to recognize Renee Gaudet.
• 04:23Our communications director with
• 04:25an out of the Blue Award.
• 04:30Renee, thank you for everything
• 04:32you do for all of us,
• 04:34our patients and families every day.
• 04:37I think everyone recognizes that
• 04:39you worked tirelessly 24/7 just
• 04:42last week you had time off and
• 04:45you were answering calls, emails,
• 04:47drafting communications and your personal
• 04:49time off to keep our community and
• 04:52patients informed critical changes in
• 04:55their radiation therapy treatments.
• 04:57The work you do has been a source of comfort,
• 05:00security and reassurance for our patients.
• 05:02During this really difficult
• 05:03time and all of us are extremely
• 05:06grateful and we can't thank you.
• 05:08Enough Flowers will be coming your direction.
• 05:12Thank
• 05:12you very much, appreciate it.
• 05:15So Kim, I think I'm going to
• 05:18turn it right over to you. He
• 05:21thank you Kevin.
• 05:22We have some just great topics to
• 05:25discuss tonight so I will be very brief.
• 05:28Anita kind of stole my Thunder
• 05:30but I also want to just recognize
• 05:32all of our smilow nurses and wish
• 05:35them a happy nurses week and a
• 05:38wonderful oncology nursing month.
• 05:39The theme for Oncology Nursing Month
• 05:41this year is inspiring an ovation and
• 05:44inspiring care and I just see examples
• 05:47of that every single day and I just
• 05:50feel honored to be your colleague so.
• 05:52Thank you to our entire Smilow clinical
• 05:55team and thank you to our oncology
• 05:57nurses an with that I think we will
• 05:59just turn it over because there are
• 06:01some very important clinical updates
• 06:03that our colleagues are going to
• 06:05share and that first update is around
• 06:07the consolidation of our infusion in
• 06:09North Haven and we have two of our
• 06:12patient service managers for smilow.
• 06:13We have Kathleen Moseman and Paula Pike
• 06:16who are going to provide that update.
• 06:18So thank you for being here this evening.
• 06:23Hi good afternoon thank you Kim.
• 06:25My name is Kathleen Moseman and I'm a
• 06:28patient services manager for Smilo's
• 06:30ambulatory solid tumor oncology
• 06:31services at the York Street campus.
• 06:34I'm here with Paula Pike,
• 06:36the clinical program manager of the
• 06:38Smilow North Haven Care Center,
• 06:40to talk briefly about the recent
• 06:42consolidation of infusion services
• 06:44at the North Haven Medical Center.
• 06:46As some of you may know,
• 06:48some of the ambulatory solid
• 06:50tumor disease teams,
• 06:51including medical oncology infusion,
• 06:53remain displaced from their pre covid
• 06:55location on the main campus and have
• 06:57been seeing patients in the North Haven
• 07:00Medical Center since March of 2020.
• 07:02Over the past year,
• 07:03these solid tumor patients
• 07:04have received their oncology
• 07:06infusions in the Endoscopy suite,
• 07:07sharing the space with the digestive
• 07:10health team and their patient population.
• 07:12We are administering oncology infusions
• 07:14to patients in recovery room bays and
• 07:17enlarge oor procedure rooms that were
• 07:19converted to hold infusion chairs
• 07:21and while the endoscopy team was more
• 07:23than collaborative and welcoming,
• 07:24it felt awkward and it wasn't consistent
• 07:27with our onkologie significant care.
• 07:29So we partnered with the existing Smilow
• 07:32Care Center in the North Haven Building,
• 07:34which occupies the 4th floor.
• 07:36Identify how we can optimize
• 07:38patient care for oncology patients.
• 07:41Paula and her team were eager to help
• 07:43and were able to provide some resources
• 07:45for the solid tumor patients to use.
• 07:49Thanks Kathleen for providing that
• 07:51background and setting us up.
• 07:52Let me just say that it's
• 07:56lawn mowing season and.
• 07:58Milo is able to turn on a dime.
• 08:00We can pivot and we are
• 08:02a zero turn lawn mower.
• 08:04An ivory respect 'cause we've
• 08:05been through lots of relocations,
• 08:07but we make it happen.
• 08:11So I wanted to just share a couple of slides.
• 08:18The first really is that relocation timeline.
• 08:21And like I said, we we turn on a dime.
• 08:25We started talking about it.
• 08:27Maybe we might have some relocation
• 08:29going on mid March the 30th of March.
• 08:32We had our first introductory meeting
• 08:34with stakeholders by April 9th and 10
• 08:37days later we are moving equipment,
• 08:40moving people upstairs,
• 08:41moving people downstairs with the Go
• 08:44live date on Monday morning at oh 700,
• 08:46which is phenomenal.
• 08:48I want to say, you know, for me,
• 08:52the relocation of Kathleen's team
• 08:54and the SMILOW patients to the 4th
• 08:56floor was a little bit different
• 08:59from what we had experienced in 2020,
• 09:02where other teams did come to the buildings
• 09:05in which smilow care centers were occupied,
• 09:08but never really integrating them into one.
• 09:11And I think that this is really significant
• 09:14and really makes a difference in how
• 09:16we're going to move the future forward.
• 09:19You know,
• 09:20we moved two teams of two separate
• 09:22identities and we County Moseman team Pike.
• 09:25We put him together in this funnel.
• 09:27They got all shaken up and they came out
• 09:30and the end result is we're smilow nurses
• 09:33treating smilow patients in a common
• 09:35location and we're erasing those identities.
• 09:37And yet we have departments
• 09:39that we belong to.
• 09:40But really.
• 09:42It's all about being smilow.
• 09:45So I know that you know our nurses
• 09:47had a little bit of anxiety.
• 09:49I think Kathleen and I had a little
• 09:51bit of an anxiety about how we
• 09:53were going to make this all work,
• 09:55because if you ask the 4th floor team,
• 09:57we have no space. But you know what?
• 10:00If you really think about it in the end,
• 10:02there's always room for one more,
• 10:04and to me it's like hosting
• 10:06Thanksgiving dinner, right?
• 10:07Yes,
• 10:07set out the plates and you've invited all
• 10:09the teams and you get a knock on the door.
• 10:12You open it up and there's aren't Lucy,
• 10:14but she's got five more people
• 10:16with her that you didn't expect.
• 10:18But you have enough food and you get enough
• 10:21chairs and in the end it all works out.
• 10:24And that's exactly what we did here.
• 10:26Kathleen put together a great
• 10:28scheduling team we work together.
• 10:29We figured it out.
• 10:31Six chairs were assigned integrated
• 10:32into the entire 4th floor and putting
• 10:34together that plan and working
• 10:36with Kathleen was phenomenal and
• 10:38I think it helped our teams feel
• 10:40better about what was happening
• 10:42for our patients for the good of
• 10:44our patients at the end of the day,
• 10:46and less than four weeks.
• 10:49Because of what we have done,
• 10:51Kathleen and I working together,
• 10:53we have treated 196 patients in
• 10:55less than four weeks that we would
• 10:57not have treated on the 4th floor.
• 11:00Incorporating them into one Smilo
• 11:01team and one Smiler location.
• 11:07Thank you.
• 11:09Thank you. Ola in Kathleen.
• 11:11I think all of us are just
• 11:14wowed by the work that the two of you have
• 11:19led and the flexibility and resilience
• 11:22of your teams and Paula watch out.
• 11:26Don't open your door on Thanksgiving,
• 11:28so maybe there.
• 11:30I'd like to turn next to a program
• 11:33that I think we are all enormously proud of.
• 11:37That is rolling out and introduce
• 11:40Doctor Karen Adelson.
• 11:42Add after Liz Pristiq and Doctor Tim.
• 11:45Opera Bay and Doctor Jensen Morris,
• 11:48who will update us on our new oncology
• 11:52inpatient hospitalist program.
• 12:02Sorry I was
• 12:03muted. So Renee. Are you
• 12:04sharing or am I sharing?
• 12:10OK, alright so I think somebody else is
• 12:13sharing the slides so I'm so excited
• 12:16to tell you about this program.
• 12:18Gensa and I are going to
• 12:21be going over the slides,
• 12:23but everybody needs to know what
• 12:26an incredible team effort this
• 12:28has been from workgroups with
• 12:30representation from every different
• 12:32group of workers at smilow and every
• 12:35different group of clinicians and
• 12:37the leadership of Liz Persich,
• 12:39Tom, Opera Bay and Genset together
• 12:42has really LED us to where we.
• 12:45We are now and currently our education
• 12:47firm Chiefs Polydor and Nicolai Padal
• 12:50stuff are getting us on the track
• 12:52to make sure that this new model
• 12:55maintains and improves the highest
• 12:57quality of education for our trainees.
• 13:01Slide.
• 13:05Am I am I at this answer OK?
• 13:09So the goals of this Co
• 13:11management service were many.
• 13:13The most important was to provide
• 13:15the highest quality of care to our
• 13:18patients and improve the efficiency.
• 13:21Shorten length of stay and make
• 13:23the patient experience better.
• 13:25We also wanted to make sure that the.
• 13:29Patients were receiving the
• 13:31highest level of expertise,
• 13:33which meant that their care would
• 13:36be Co managed by a hospitalist who
• 13:39was an expert in internal medicine,
• 13:43an inpatient medicine,
• 13:44and their hematology or
• 13:46oncology specialist clinician.
• 13:47We wanted to emphasize a multi
• 13:50disciplinary team based care
• 13:52model and to reduce the burden
• 13:55of attending on service on the
• 13:58hematology and oncology faculty.
• 14:00Who have very busy clinic San.
• 14:03Lots of other responsibilities
• 14:04and whom only spend four years
• 14:07on the acute inpatient service.
• 14:09An really sometimes have a hard time
• 14:12navigating the demands of impatient
• 14:15work over the years in patient has
• 14:17medicine has become increasingly
• 14:19complex and there is a reason that
• 14:22a field of hospitalists have grown
• 14:25up and Yale has one of the wonder
• 14:28most established an excellent
• 14:30hospitalist programs in the country.
• 14:32And it made sense for us to
• 14:35tap into this deep expertise.
• 14:37We also would optimize the ability of
• 14:40the oncologist to work in their clinics.
• 14:43That research environment and
• 14:44have time to actually teach an we
• 14:47we wanted to reduce hematology,
• 14:49oncology burnout at a time when our
• 14:52burnout levels were extremely high.
• 14:54Next slide.
• 14:56I wanna say how lucky we were to have
• 14:58been able to recruit Jensen Morris
• 15:01to lead our program as the Director
• 15:04of the Smilow hospitalist Service.
• 15:06I think you start to know that you
• 15:09have been successful in building a
• 15:12program when you start to feel that
• 15:15you are unnecessary and that is how
• 15:18I'm feeling because I am watching these
• 15:21incredible partnerships between gensa,
• 15:22an lizanne genset in Toma grow as we are.
• 15:26Rolling out this service so
• 15:27just a little bit about gensa,
• 15:29and then I'm actually going to tell
• 15:31you a little bit of a physician story
• 15:33about some text that I got today.
• 15:35I have to make sure my phone is ready is
• 15:39on and ready to read these text to you.
• 15:43So Jensen has been a hospitalist at Yale,
• 15:46New Haven since 2002 and was
• 15:48the medical director for the
• 15:50Center of Musculoskeletal Care.
• 15:52She really developed what it meant
• 15:54to have a Co management program
• 15:57in her work with orthopedics in
• 16:00developing care for medically complex
• 16:02in developing a model for caring
• 16:04for medically complex patients,
• 16:06including geriatric hip fractures,
• 16:08high risk spine and sickle cell patients.
• 16:12She is a top ten hospitalists in
• 16:15the American College of Physicians.
• 16:17She had national recognition As for
• 16:19excellence in hospitalist medicine.
• 16:20There's ten physicians chosen annually,
• 16:22and has been recognized as a Yale
• 16:25New Haven hospital hero for as serve
• 16:28it with a Service Excellence Award,
• 16:30and she has lectured extensively
• 16:32on medical comanagement consulte
• 16:34tive care in internal medicine
• 16:36and pre operative care.
• 16:37So Gensa officially joined us three days ago,
• 16:40but has been working tirelessly
• 16:42to build this program.
• 16:43While attending on the covid units for
• 16:46the last couple months and has had
• 16:48now three days working on the service,
• 16:51and I got a text today.
• 16:53I have to edit a little 'cause
• 16:56there's names in there,
• 16:57but this came from one of our
• 17:00lead advanced practice nurses
• 17:01and she wrote me to tell me that
• 17:04Doctor Morris is just amazing.
• 17:06I have to tell you she just corralled.
• 17:09A series of doctors in the span
• 17:11of two hours to get everyone on
• 17:13the same page for this patient.
• 17:15This would have taken a week
• 17:17to do previously,
• 17:18and then she goes on to say it
• 17:20is so motivating to me to see her
• 17:23practice at such a high level.
• 17:25What a wonderful example for us all.
• 17:28So we're just getting started,
• 17:29but I think we're really getting
• 17:31started on the right note.
• 17:35Advance to the next slide. OK.
• 17:39So we launched this with Workgroups
• 17:42to really identify the cultural
• 17:45barriers that would get in the
• 17:48way of success of this program.
• 17:51I deliberately took a backseat and
• 17:54let Tomas Lizanne gensa really work
• 17:56together with an incredible group of
• 17:59stakeholders in very structured series
• 18:01of meetings that would identify the
• 18:04roles and responsibilities and the
• 18:06workflow for this new service so that it
• 18:10would be well established when we started,
• 18:13they finished the work in the last couple
• 18:16weeks and have now handed offthe new
• 18:19guidelines to the Education Committee.
• 18:22Who are figuring out how to use this
• 18:25new structure to optimize teaching?
• 18:28And so now we are getting into the education
• 18:31work group meetings with Paul Nikolai,
• 18:34Leah Burke,
• 18:35and Gensa so incredibly exciting
• 18:38work that has been done an.
• 18:41Now Jensen is going to take over an Liz.
• 18:43You're on this call and if if you want to
• 18:46think about a few words to say at the end,
• 18:49we'd love to have you contribute as well.
• 18:52So here we go.
• 18:53So as Karen said,
• 18:56the hematology and solid tumor work
• 19:00groups have completed their work and.
• 19:04The hematology consensus was
• 19:06that we would divide the massive
• 19:09Duffy service into two services,
• 19:11so you would have we will have the Duffy
• 19:15teaching service led by the hematologist,
• 19:18just as it was before staffed by housestaff.
• 19:22Taking care of the most complex
• 19:25inpatient hematology patients,
• 19:26there would be a second.
• 19:28There will be a second service led by
• 19:32a hospitalist and staffed by an APP.
• 19:35That will take care of the lower
• 19:37acuity hematology patients and the
• 19:39Duffy hematologist will serve as
• 19:40as a consultant on those patients.
• 19:43Anna mentor to the hospital list
• 19:45on the solid tumor service.
• 19:46It will look a little different.
• 19:48We're going to embed a hospitalist into
• 19:51the teaching service and the hospitalist,
• 19:53and the oncologist will work hand in
• 19:55hand to take care of those patients,
• 19:58run the service, and teach the residents.
• 20:00The hospitals will be the attending
• 20:02of record. The oncologist will have.
• 20:05Greater focus on teaching and really
• 20:07the specialty care on the service.
• 20:09This is a true multidisciplinary
• 20:11model and then as Karen said,
• 20:13the education group is working now to
• 20:16do a full assessment of the educational
• 20:19needs of the trainees and the new
• 20:21hospitalists and developing clear curriculum.
• 20:27We thought it was important to
• 20:30define the unit leadership and
• 20:32the structure of the Hut smile.
• 20:34Hospice care management service
• 20:35and really emphasize that
• 20:37this is a triad with equal
• 20:40leadership among the hospitalist.
• 20:41Attending the hematology, oncology,
• 20:43attending, and the nursing staff.
• 20:46Like to introduce our new
• 20:49smile hospitals for July 2021.
• 20:52Doctor Nathaniel Parker Dr Erin Gumbos,
• 20:54doctor Orce Webert and
• 20:56Doctor Matthew Carter thera.
• 21:00We intend to expand this program over
• 21:02the next three years.
• 21:04Expansion of the program
• 21:05depends on meeting our goals,
• 21:07our clinical care goals,
• 21:08and our financial goals.
• 21:10Year one. We have a Hospice
• 21:12director and for hospitalists,
• 21:13we hope to add 5 new Hospice on
• 21:16in year two and an additional
• 21:182.5 hospitals in year three.
• 21:20Of course,
• 21:21I have big plans beyond year three,
• 21:23but this is where we're starting and we're
• 21:26happy to entertain any questions Liz.
• 21:28Is there anything you'd like to add?
• 21:31I just wanted to highlight
• 21:33the gratitude I have for Smilow leadership
• 21:35and making this longtime dream or
• 21:37reality for the inpatient services
• 21:39and recognize the enormous support of
• 21:41all years for it to come to fruition.
• 21:43This past year has been quite chaotic,
• 21:46and we recognize that it's a true
• 21:48investment and sign of trust and
• 21:50commitment in the work that we plan to do.
• 21:53And I feel confident that will be
• 21:55able to improve care not just for
• 21:57our in patients and their families,
• 21:59who are oftentimes going through.
• 22:02Enormous challenges that they have not
• 22:04faced before in their cancer journey,
• 22:06but also for the physicians and
• 22:08staff and providers,
• 22:09and nurses that are caring for them.
• 22:11So just grateful for the opportunity
• 22:13to launch this program
• 22:14this summer and
• 22:15for the team we have.
• 22:18You know Doctor Persich stepped into her job.
• 22:20I think 2 weeks before Covid hit
• 22:23and we moved all of our oncology
• 22:25services across town to Saint Rafe.
• 22:27So what was supposed to be a small
• 22:30job has become a huge job as soon as
• 22:34basically as soon as we got back to the
• 22:37to the main campus she was thrown into
• 22:40working to plan this hospitals program.
• 22:42So it has been a very very active first
• 22:45year for for Liz as a firm chief so.
• 22:48Thank you Liz. Incredible work.
• 22:52Karen Gensa Liz.
• 22:53This is an incredible step
• 22:55forward for our patients.
• 22:57For our teams. Very exciting.
• 22:58Thank you for everything you're doing
• 23:01and I know we're all looking forward
• 23:04to seeing how the program develops
• 23:06in the coming months and years.
• 23:08Without any further ado,
• 23:10it's a real privilege for me to to
• 23:13hand off to our leadership team and the
• 23:15Department of Therapeutic Radiology,
• 23:18who have also been very busy in recent weeks.
• 23:21Caring for patient sing and
• 23:23managing a number of challenges
• 23:25in their division or Department
• 23:27that they will share with us.
• 23:30So, Doctor Glaser, Doctor Wilson,
• 23:32and Doctor you.
• 23:33Yeah thanks thanks Kevin.
• 23:36I think most of you know actually
• 23:39thanks to the excellent communications
• 23:42work by Renee that our Department
• 23:46was impacted by a cyberattack
• 23:49on the software vendor Electa.
• 23:51That provides the software that runs
• 23:54our linear accelerators and this
• 23:57impacted our ability to deliver
• 23:59our treatments in a normal way.
• 24:02And like Paula,
• 24:03used the analogy of a lawnmower
• 24:06pivoting we had to pivot on a dime to
• 24:10develop a whole entire new workflow
• 24:13that was highly manual and depended
• 24:16on creativity of our physicists and
• 24:19the dedication of our physicians.
• 24:21Dosimetrists and.
• 24:22Therapist to implement in a way
• 24:25that minimize the interruption
• 24:27of treatment to our patients.
• 24:30And I want to recognize our leadership team,
• 24:33Lynn Wilson James you,
• 24:34Frank Claudio, Brian Wang,
• 24:36Ina Sala and and others who
• 24:38played a major role in helping
• 24:40to lead us through this process,
• 24:43which is still under way.
• 24:45We're not totally out of the Woods yet,
• 24:48but we have the light at the
• 24:50end of the tunnel.
• 24:52And, you know,
• 24:53we're in much better shape right now.
• 24:56But it is a wake up call, I think.
• 24:59Not just to us,
• 25:01but to all of you know,
• 25:03our medical infrastructure,
• 25:04not only young haven health
• 25:07system but in our country of
• 25:09the risk of this sort of thing.
• 25:11So I think I'll hand it off to
• 25:13Lynn and James to give a little bit
• 25:16more detail about where we are.
• 25:22Thanks Peter. So the first
• 25:25indication that there was a problem
• 25:28was actually back on April 6th.
• 25:32That afternoon our systems went
• 25:36down and it became apparent to us,
• 25:39through communications and a
• 25:41memoranda that we received from
• 25:44Elekta that there had been some
• 25:47sort of cyber malicious activity
• 25:49impacting one of their cloud systems,
• 25:52of which all of our data and
• 25:55treatment mechanisms resided upon.
• 25:59This also impacted over 40 other
• 26:02department's internationally,
• 26:03so we were not the only ones they had
• 26:07Fireeye involved, who is one of the
• 26:10world's leading cybersecurity firms,
• 26:12and we were given good assurance by
• 26:15Electa that over the next 24 hours,
• 26:18things were actually contained an fine.
• 26:21So at that point our downtime was minimal.
• 26:25We only lost one treatment day.
• 26:29Which old physicians felt that we
• 26:32could tolerate for our patients?
• 26:34So we were underway again?
• 26:37Two weeks later, on April 20th,
• 26:40we ran into trouble again.
• 26:43Systems went down and we quickly,
• 26:46unfortunately,
• 26:47learned that there had been
• 26:50another attack on their systems.
• 26:53Fire I advised them to shut
• 26:55everything down and it became clear.
• 26:58Over the ensuing hours that evening
• 27:00that this was not going to be.
• 27:03Like it was two weeks prior where
• 27:05we might be able to be back on
• 27:08our feet within a day or so.
• 27:10At that point,
• 27:11we obviously had lots of emergent meetings,
• 27:14lots of folks involved started to
• 27:16have conversations with parents,
• 27:18patients, and tried to figure
• 27:20out what we were going to do.
• 27:24Fortunately,
• 27:24we are.
• 27:25Physicist did develop an alternative
• 27:27treatment mode called file mode,
• 27:28which was developed in the event that
• 27:31we were having a software upgrade,
• 27:33which usually happens over the weekend
• 27:36when we're not treating patients.
• 27:38But we do treat emergencies over the weekend,
• 27:41so we needed a system in place
• 27:43to be able to treat a patient
• 27:46who required emergent care.
• 27:47If we were doing a planned
• 27:51voluntary software upgrade.
• 27:52We enlisted that mode.
• 27:55We had never used it before,
• 27:57although it does require much more
• 27:59manual input and closer supervision
• 28:01than the standard treatment delivery,
• 28:04which is basically run by computer systems.
• 28:06Although we did deem this safe of course,
• 28:09to treat patients,
• 28:10and it was our emergency backup
• 28:13plan that we had developed to treat
• 28:16patients on a weekend in an emergency
• 28:19which predated this catastrophe.
• 28:21We initiated that mode for
• 28:23patients very slowly at first.
• 28:26To get experience.
• 28:27We also had the advantage of Griffin
• 28:30Hospital is staffed by Yale University,
• 28:33radiation oncologists.
• 28:34Although they're not obviously in the
• 28:37system as part of the Yale Health system,
• 28:40their machine linear accelerator
• 28:42there and they also have elected
• 28:45software is quite similar in what
• 28:48we call closely be matched to
• 28:50three of our linear accelerator.
• 28:53For elector one, it's Milo,
• 28:54one in Hamden and one in Guilford.
• 28:57So patients from Guilford in Hamden
• 28:59were quickly triaged to Griffin
• 29:01and physicians from those centers.
• 29:03Also of course,
• 29:04were involved in the care of
• 29:06those patients at Griffin,
• 29:08so that was very helpful to us.
• 29:11The remainder of the patients
• 29:13needed to be treated in filed mode,
• 29:15and they were brought on all of these
• 29:18patients I'm talking about were
• 29:20brought back online within several days some.
• 29:23More quickly than others,
• 29:25depending on their clinical situation,
• 29:27how far along they were in their treatment,
• 29:30and what sort of mitigating
• 29:32circumstances we could consider on
• 29:34a case by case basis is a patient getting
• 29:37active in treatment after a tumor's
• 29:40been completely removed compared to,
• 29:42say, a head neck patient with large
• 29:45tumor obstructing their airway.
• 29:47Obviously very different case
• 29:48priorities and complexities.
• 29:49The other thing you should know
• 29:52about the mosaic. Software.
• 29:56Many departments around the world
• 29:58use this elect as one of the two
• 30:02large vendors internationally.
• 30:03This was an international incident.
• 30:05Fortunately, none of our equipment or
• 30:08software in House or any of our Yale systems
• 30:12was infiltrated in any way by this attack.
• 30:15So that's the silver lining.
• 30:17This software system also serves as
• 30:19our medical record for these patients,
• 30:22so we had a lot of challenges
• 30:25when this happened.
• 30:27We literally had no record of what
• 30:29had happened to anybody other than
• 30:31their clinical epic appointments,
• 30:33which was extremely helpful.
• 30:35Are our physicians notes and you know our
• 30:38recollection from physicians and our staff,
• 30:40because obviously it was important
• 30:42to identify how many treatments
• 30:45each of these patients that had,
• 30:47especially since we were moving them around.
• 30:51Outside of what we're used to doing.
• 30:53So. At this point, we continue to.
• 31:00We are coming.
• 31:02We've come back online significantly.
• 31:04Those three elected machines
• 31:06are now operational.
• 31:08Are Yale,
• 31:09IT team and physics and everybody
• 31:12involved in our Department has literally
• 31:15been working around the Clock since
• 31:19the 20th to rebuild the system.
• 31:21But on premises as opposed to seeking
• 31:25this information from the cloud.
• 31:27And that's not unusual.
• 31:29And many departments around the
• 31:32world don't interact with the cloud.
• 31:35Many do. It's you can do it either way.
• 31:39So now we've got our own mosaic system
• 31:42on premises. It is up and running.
• 31:45New patients are being integrated
• 31:47through that system,
• 31:48and we're basically in terms of patient care.
• 31:52Things are very,
• 31:53very seamless at this point,
• 31:55no new patients who were on
• 31:57our schedules or plan to start
• 32:00treatment have had any significant.
• 32:02Interruption in their care and
• 32:04things are still very hectic but
• 32:06running relatively smoothly.
• 32:08We're still using paper charts for
• 32:10those who are in the file mode,
• 32:13and we expect to, probably,
• 32:15hopefully by the end of next week,
• 32:17or into the beginning of the following week.
• 32:20Get to a point where we have
• 32:23everybody back online in a way
• 32:25that we can care for our patients
• 32:28in the very traditional sense,
• 32:30and we can move away from all the paper.
• 32:34Paper documentation and get back
• 32:36to where we're used to operating,
• 32:39but this has been a whole Erica Hercule
• 32:43Ian effort from many of our staff.
• 32:46As you can imagine, Yale.
• 32:49New Haven Hospital IT matza.
• 32:52Wallach and his team have been phenomenal.
• 32:55This type of on Prem system is
• 32:58something that we have thought about
• 33:01before and talked about just to give
• 33:04it perspective under normal operating
• 33:07circumstances it is at least a two
• 33:11month project pushing three months.
• 33:13This team has accomplished this literally
• 33:16in five days which has been incredible.
• 33:20So I'll stop there and ask James
• 33:22if he would like to add any
• 33:25additional comments at this point.
• 33:30No, I think you guys covered it.
• 33:33I just want to say, you know,
• 33:35in the Department where we're making our
• 33:38way back we continue to face challenges,
• 33:41but we appreciate truly the
• 33:43outpouring of support from all of
• 33:45our colleagues throughout Smilow
• 33:47and just a couple more names.
• 33:49Jay Chena physics Denise Allen,
• 33:51Sarah Lombardi and is similar in our therapy
• 33:54managers Christina Solano Metabolic.
• 33:56We truly took a village to get us back.
• 34:00And they were absolutely terrific,
• 34:02and the future is bright for us. We are
• 34:04going to move forward with
• 34:06two more with some new
• 34:07technology coming up, so stay tuned.
• 34:09This won't be the last you hear Atlas.
• 34:15Gentlemen, thank you.
• 34:16I know that we're all incredibly
• 34:19grateful for your leadership.
• 34:21The on the fly innovation that
• 34:23you and your teams have done
• 34:26over the past several weeks.
• 34:28And please take our debt of gratitude
• 34:31back to the really literal army of
• 34:34Unsung heroes in your Department,
• 34:37many of whom were mentioned by name,
• 34:40some of whom were not.
• 34:42But we know that the physicist,
• 34:44dosimetrist, therapists,
• 34:45nurses all contributed mightily
• 34:47to this effort, so thank you.
• 34:52So moving on with our agenda,
• 34:54it is always a pleasure for me to.
• 34:58Welcome Doctor Rob Fogarty to our gathering.
• 35:03Speaking of Heroes sung or unsung,
• 35:06Rob has been.
• 35:08Kind of the stalwart behind our covid
• 35:12response efforts as we have kind of had to.
• 35:17Sometimes pivot like lawnmowers
• 35:18sometimes turn like the Titanic.
• 35:21All of our efforts is a health system to
• 35:25navigate our response to the covid crisis.
• 35:28Over the past 15 months.
• 35:32And hopefully we are entering maybe not
• 35:34the end game, but the fourth quarter.
• 35:37And we did ask Rob to join
• 35:40us today to bring us up.
• 35:43To speed on bed stacking from
• 35:45a health system perspective,
• 35:46thanks Rob.
• 35:47Thank you.
• 35:48So
• 35:48I'm gonna take just a minute because I am
• 35:50a hospitalist much like Doctor Morris.
• 35:53And for those of you who haven't met her,
• 35:56she is the hospitalist that
• 35:58we all aspire to be like.
• 36:00But realized we will never get there.
• 36:03She is a. The type of doctor that a
• 36:08lot of us wish we had the ability so.
• 36:11You did good. And we'll just.
• 36:14We'll leave it at that.
• 36:16So I do have some slides that
• 36:19I'll pull up here.
• 36:20And I'm going to start with
• 36:22where we have been, where we are,
• 36:25and then hopefully where we're going.
• 36:27But I want to take it just a second
• 36:30and say that I need to crowd source
• 36:33all sorts of ideas so my inbox is
• 36:36always open and I'm more than willing
• 36:39to listen to any idea because it's a
• 36:41challenge and I will never turn away.
• 36:44Good idea,
• 36:45regardless of where it comes from.
• 36:48So this is some mortality data for
• 36:50inpatient covid disease specifically,
• 36:51and this comes from the CCA,
• 36:54which is the organization that also
• 36:56reports out to the feds and is usually
• 36:59what is used for the popular press.
• 37:01And this is this is inpatient mortality
• 37:04from covid in Connecticut for the entire
• 37:07pandemic and in the middle you can
• 37:10see that the mortality rate is 13.2%.
• 37:13Well, no,
• 37:13cancer is the 2nd leading cause of
• 37:15death in Covid was number 3 this year,
• 37:18so that number probably is not
• 37:19much of a surprise.
• 37:21Nationally,
• 37:21it's about 11 to 11 1/2% and if
• 37:23you look circled there, you'll do.
• 37:25Haven Health System is 9.2%, well below I.
• 37:27I understand this is all wrong
• 37:29mortality data.
• 37:30I didn't do statistical testing
• 37:31and all of that,
• 37:32but it certainly passes the eyeball test
• 37:35and if you look at the rest of the state.
• 37:38Draw your attention to Trinity.
• 37:39Trinity is a big healthcare system.
• 37:41They have a big hospital.
• 37:42They have a giant national network
• 37:45and our mortality rate was left
• 37:47at less than half of theirs.
• 37:48And that's something that the health
• 37:51system should be very proud of.
• 37:53We we we you all of us.
• 37:57Presented with truly unprecedented challenge
• 37:59and the data I think speaks for itself.
• 38:01If we're going to get New Haven centric,
• 38:04we can do that.
• 38:06There are two big health
• 38:07systems in Connecticut.
• 38:09There are two, but are largely
• 38:11considered to be referral centers.
• 38:13There is able to have in hospital,
• 38:15which you can see it only
• 38:18gets better 8.7% mortality.
• 38:19At which is remarkable,
• 38:21really, if you think about it,
• 38:23unbelievable.
• 38:23And if you compare that to what
• 38:25is the other referral center?
• 38:27Other hospitals specially unaffiliated
• 38:29hospitals will play a game where
• 38:31they will try to transfer patients to
• 38:33both hospitals because they know that
• 38:35those are the two hospitals that can receive.
• 38:38Referrals hard for hospitals
• 38:40down here in orange.
• 38:41In the mortality rate for 16%.
• 38:45And they do good things up there.
• 38:47I'm not here to throw stones,
• 38:48I'll point out that Windham had the
• 38:51lowest mortality rate in state 7%.
• 38:53But I want to just take a second and
• 38:55say that this would not have happened
• 38:58without everybody's contribution
• 38:59and all of you everyone smile.
• 39:01Oh, it doesn't matter if you saw covid
• 39:03patient in clinic or you rounded on a covic,
• 39:06it doesn't matter.
• 39:07Everybody picked up a bucket and
• 39:08put out the fire and we don't.
• 39:10We don't get to celebrate a lot for the
• 39:12past couple of months past year really.
• 39:15So so if I may take a minute and
• 39:17realize that when the story is
• 39:19written about covid this is one of
• 39:22the successes that Yale New Haven
• 39:23Hospital stood up and we were here for
• 39:26our community when they needed us.
• 39:28And you all absolutely more critical in that.
• 39:30So for what it's worth,
• 39:32I know I'm kind of a nobody,
• 39:34but from where I sit looking at the
• 39:36health system in the hospital as a whole.
• 39:38And what we were confronted with,
• 39:40you will always have my.
• 39:42My thanks for what that's worth.
• 39:45So that's where we were.
• 39:47Now let's look at where we are.
• 39:49This is the daily version of the CCA.
• 39:51Report out then I slide is from the 27th.
• 39:54Just because I I'm trying to tell
• 39:56the same story to different folks as
• 39:57I as they invite me to these things.
• 40:00But there's a couple things I want
• 40:02to point out. The slides very busy.
• 40:04For the past two or three months,
• 40:07you may have experienced some
• 40:08cognitive dissonance.
• 40:09The states opening up things
• 40:10are getting better.
• 40:11You know the WTNH was throwing parties,
• 40:13and yet our census was getting worse.
• 40:15Our covid stress was getting worse,
• 40:17and it's true.
• 40:18New Haven County detached itself
• 40:19from the rest of the state,
• 40:21and we were really the only part of
• 40:23the stage was experiencing this surge
• 40:25over the past two or three months.
• 40:27It was real and we felt it,
• 40:29and you felt it,
• 40:31and it was hard because the rest of
• 40:33the state maybe wasn't feeling it.
• 40:35And on this particular day,
• 40:37all of Hartford County,
• 40:39entire County of Hartford had
• 40:4183 covid inpatients and Yale.
• 40:43New Haven Hospital had 88.
• 40:47There are 2500 hospital beds in
• 40:48Hartford County and it has more
• 40:50people than all of New Haven County
• 40:52and yet our hospital with our
• 40:54fraction to catchment area still
• 40:56had more covid inpatients so.
• 40:58It's been a punch in the face.
• 41:01Then it got punching and whatever
• 41:03other cliche you want to use,
• 41:05but it was real.
• 41:06New Haven County in specially Young
• 41:07Hospital has had a disproportionate disease
• 41:09burden through this most recent wave,
• 41:11and it's unfair,
• 41:12but it is what it is and we have
• 41:16to play the hand that we're dealt.
• 41:19To Kevin's point to doctor Billingsley point.
• 41:21Potentially,
• 41:21there's a little bit of encouraging
• 41:23news recently. Let's hope it continues.
• 41:24I don't want to.
• 41:25I want to say more than that.
• 41:27I am a superstitious person.
• 41:29So how do we continue?
• 41:30How do we continue to dismount?
• 41:32So we're kind of flying the plane is
• 41:35we're building it to borrow a cliche.
• 41:37And there are two things that we think
• 41:39about when we're trying to do bed planning.
• 41:41One of them is the volume of patients
• 41:43and the second one are there.
• 41:45To be to be glib about it,
• 41:47the restrictions in their care,
• 41:49whether their isolation needs,
• 41:50what are the gown needs,
• 41:52can maybe Co forwarded with other people.
• 41:54What are the airflow requirements
• 41:55and the volume is either lower height
• 41:57or somewhere in the middle and then
• 41:59the restrictions are either low or
• 42:01high or somewhere in the middle.
• 42:03And we don't know where this
• 42:05is going to end up.
• 42:06We don't know what our long term
• 42:08covid run rates are going to be.
• 42:10We don't know eventually with the
• 42:12science is going to tell us about
• 42:14how best we can covert these folks.
• 42:16We've learned a lot and work very
• 42:18closely with infection prevention.
• 42:19We do what the science tells us.
• 42:22We talked to other health systems.
• 42:23We're all learning through this together,
• 42:25but we don't really know where
• 42:27we're going to end up.
• 42:28If we end up with two or three
• 42:31covid inpatients, that's easy.
• 42:32If we end up with. 40 or 50?
• 42:35That's not so easy.
• 42:36The one thing that everyone agrees is cope.
• 42:38It's not going away,
• 42:39so we have to plan for it in some some way,
• 42:42shape or form.
• 42:44So the approach that we're taking,
• 42:46I call him Lego blocks,
• 42:47but it's really to be precise
• 42:49about it's a modular tools and Lego
• 42:51blocks come in different sizes,
• 42:53shapes, and colors,
• 42:54so we're trying out and we're
• 42:56learning how to do all of these
• 42:58five different techniques,
• 42:59and eventually,
• 43:00wherever we are on this curve,
• 43:02we can take these pieces and put
• 43:04them together and right size it.
• 43:06And the reason we want to right size
• 43:07it is because the disruption that
• 43:10you're feeling and the disruption,
• 43:12the signature of care, the way that we.
• 43:14Wanna provide care for all of our
• 43:16patients regardless of their disease state?
• 43:18It's not where we want it to be,
• 43:20and we need to keep moving forward.
• 43:22You need to keep pushing the
• 43:24envelope so that things can can
• 43:25return so that every day we're
• 43:27coming in and not only that,
• 43:29the medicines and procedures
• 43:30that we're doing,
• 43:31but the way that it's being the way
• 43:33that is being delivered to the patient,
• 43:35the experience of the patient.
• 43:36At this critical,
• 43:37we need to get back to that.
• 43:40So those are the those are the tools
• 43:42that we're using two special points
• 43:44just to point out for transparency.
• 43:46Covid is a medicine disease.
• 43:48We all realize that if it was normal,
• 43:50coronavirus would go to the
• 43:51medicine footprint.
• 43:52Medicine footprint is predominantly
• 43:53doubles and triples,
• 43:54so if you were going to XYZ a
• 43:56disease that exploited a weakness
• 43:58in our medicine bed stack,
• 43:59covid does that pretty well.
• 44:01And then the ICU piece.
• 44:02Just want to point out that that's
• 44:04that's debilitating to the institution.
• 44:06We have a group and some of the folks
• 44:08on the collar on it, and we meet.
• 44:11Every day to try to figure out how to
• 44:13move the pieces to keep all the patients
• 44:16moving through the through the ICU.
• 44:18And it's a challenge.
• 44:20And the last thing I'll say is that.
• 44:25I mentioned earlier a lot of folks
• 44:27call me to come to things like this
• 44:29and I'm always happy if anybody wants
• 44:31to talk about any of these in detail.
• 44:33Send me email. I'm more than happy.
• 44:35Transparency is critical.
• 44:38And not only are you not alone when
• 44:40when people are having a rough day
• 44:42and I share with them some of the
• 44:45stories of what your team has done,
• 44:47I tell them about how disruptive
• 44:49and we want this bin.
• 44:50I tell them about when I was rounding
• 44:52in the first piece on MPA and how
• 44:55critical that was to keeping patients
• 44:57who didn't have covid as their primary
• 44:59disease getting their lifesaving care.
• 45:01I talked to them about operating on
• 45:03one campus and using an ambulance
• 45:05in the postoperative state.
• 45:06I share all of those stories.
• 45:09So so,
• 45:09so you're heard your valued and and again,
• 45:12I'll just end by saying I I cannot
• 45:15thank you enough because the success
• 45:18story of our covid response is in no
• 45:21small part due to your efforts and
• 45:24your flexibility. That's all I have to.
• 45:30Rob, thank you.
• 45:33You know your overall perspective
• 45:35really helps frame the work that that
• 45:38the entire organization has done,
• 45:40but also the importance of the
• 45:43contribution that that our teams have made.
• 45:47And I do think that that's helpful
• 45:50and affirming and hopefully
• 45:51will have a few moments for Q&A.
• 45:54At the end there.
• 45:56There may be some questions,
• 45:58but just your presence and.
• 46:01Your perspective is is enormously helpful.
• 46:06I think in our closing interval here
• 46:11will shift to our research world and.
• 46:16Doctor Dimaio can I ask you to?
• 46:19Take it from here.
• 46:36Did Dan are you muted?
• 46:45There you go, thank you.
• 46:48So can you see
• 46:50my slides? We lost your slides, Dan.
• 46:54Try again.
• 47:04How is that?
• 47:05It's coming up there.
• 47:06We are firm business. OK, I'm going
• 47:08to open him up.
• 47:13OK, perfect, so we need to ask me a
• 47:15couple of weeks ago or told me that
• 47:18she wanted to combine the smile of town
• 47:21Hall with the Cancer Center meeting.
• 47:23Thought that was a terrific idea 'cause
• 47:26we really need to work together and
• 47:28it struck me that for the El Cancer
• 47:30Center in the Spinal Cancer hospital
• 47:33truly attains extraordinary potential.
• 47:34The research and clinical arms really need
• 47:37to work together seamlessly and support
• 47:39each other so the research benefits from
• 47:42access to patients and patient samples.
• 47:44And the patients will benefit for the
• 47:47wonderful scientific discoveries that
• 47:48we make here in the Cancer Center.
• 47:50So I thought this was a terrific idea.
• 47:53We have a major event coming forward
• 47:55in the next couple of years and that
• 47:58is we have to renew our Cancer Center
• 48:01support grant we call our CCSG at.
• 48:03The grant is not due until.
• 48:07At the end of 2022,
• 48:09that's more than a year from now,
• 48:11but we're already beginning,
• 48:12and as you can see,
• 48:14the first drafts are due in a
• 48:16couple of months.
• 48:17So many of you may be asked for help
• 48:19writing sections of the grant or
• 48:21providing data to put into these sections,
• 48:24but this is a long process.
• 48:26Very important.
• 48:27This is a multiyear multimillion
• 48:28dollar grant that supports much of
• 48:30the administrative infrastructure
• 48:31at the at the Cancer Center,
• 48:33as well as many other activities
• 48:35including pilot grants.
• 48:37It also allows us to maintain our
• 48:39designation as an NCI comprehensive
• 48:41Cancer Center.
• 48:42This is this is very important.
• 48:45We have had one major structural
• 48:47change we have used to have 7
• 48:50research programs and we disbanded
• 48:52one of them this year.
• 48:53The Cancer microbiology program
• 48:56and we dissolved it because.
• 48:58We had trouble convincing the NCI
• 49:00that it had sufficient cancer focus.
• 49:02We disagreed with them, but.
• 49:05Instead,
• 49:06I will continuously has told the
• 49:08SAT and we decided that we wouldn't
• 49:10fight that battle anymore.
• 49:12There are 33 members of this program
• 49:14that have been moving to the
• 49:16remaining 6 Cancer Center programs,
• 49:18and I want to reassure them and
• 49:20everyone else in the Cancer Center
• 49:22that the topics studied by cancer
• 49:24microbiology are of crucial importance.
• 49:26Tumor viruses HIV bacteria in the microbiome.
• 49:28These studies will flourish and that
• 49:30will strengthen our remaining programs.
• 49:32About 20% of all cancers are called by my.
• 49:36Caused by microorganisms.
• 49:36This is very important to our Cancer
• 49:39Center and we will continue to support it.
• 49:43I do want to highlight some special
• 49:45awards and recognition that
• 49:47members have received just last week.
• 49:50Liping Chen was elected to
• 49:52National Academy of Sciences,
• 49:53one of the highest honors our faculty
• 49:56can receive in honor of discovery
• 49:58of some of the first checkpoint
• 50:00can controls for immunotherapy.
• 50:02In fact, email therapy in large part
• 50:05derived from some of his early research,
• 50:08which just highlights how important basic
• 50:11research is for improved cancer treatment.
• 50:14Two other members run breaker and hit.
• 50:16It was Saki, where electricity members of
• 50:18the American Academy of Arts and Sciences.
• 50:20They both actually we're already
• 50:22members of the National Academy,
• 50:23so this is another nice recognition for
• 50:26them for Ron studies on RNA in the pico
• 50:28studies on viral and cellular immunology.
• 50:31Our strengths aren't restricted
• 50:33to the to the laboratory.
• 50:35We have a number of people have received
• 50:38very nice clinical words recently.
• 50:40Joe Lacey and and this check park have
• 50:42been named Fellows of the American
• 50:45Society of Clinical Psychology,
• 50:47ASCO and then Jen Capo.
• 50:49You see,
• 50:49the President's award for the Connecticut
• 50:52Coalition to improve care end of life care.
• 50:55So it's terrific.
• 50:56This really spans the entire spectrum of
• 50:58clinical care, medical oncology, surgery and.
• 51:01Pillars of care.
• 51:03In addition,
• 51:04a number of people receive very nice
• 51:06grants that are that are listed here from
• 51:09DoD from Alliance American Cancer Society,
• 51:11the Yale Cancer Center has more research
• 51:14money now than we ever have to study cancer.
• 51:17It is a tremendous accomplishment
• 51:19approaching $100 million in direct costs.
• 51:21And finally,
• 51:22I just wanted to point out
• 51:24a few of the new members.
• 51:26I'm sure this is not a complete list that you
• 51:29can see here that are enriching our program.
• 51:32Some have already been here and
• 51:33I've just joined the Cancer Center.
• 51:35Others are new recruits TL and I
• 51:38will help highlight two of them.
• 51:39Marcus Motion is come here to lead the new
• 51:42Center for Molecular and Cellular Oncology.
• 51:44Wanted to recruit a bunch of new
• 51:46physician scientists that will help
• 51:48against ban help bridge the gap between
• 51:50basic research and clinical care.
• 51:52And Michaela Dynon,
• 51:53who is from Duke, who is our new.
• 51:58Out of our new leaders for the cancer
• 52:00prevention and control programs,
• 52:02and so both of them,
• 52:03and particularly Michaela,
• 52:04will be very busy in the coming months.
• 52:06Writing up her program
• 52:07for Cancer Center renewal.
• 52:09So that's why I want to say,
• 52:11and I'm I'm happy to transit podium backed,
• 52:13Anita, thank you.
• 52:16Thank you Dan and thank you
• 52:18to all of our panelists.
• 52:20I have to say, if you know the past few
• 52:22weeks as I've gotten to know everyone,
• 52:25I am so impressed by the amount of
• 52:27clinical activity research activity
• 52:29in our trainees, what they're doing,
• 52:31and I hope that you all get to see that.
• 52:34I think sometimes when we run
• 52:35around in our daily actions,
• 52:37we forget what an incredible space we occupy.
• 52:40And you know that as Doctor Fogarty
• 52:42shared all that data around the state.
• 52:44I think we have to sort
• 52:46of all give ourselves.
• 52:47A silent Pat on our own backs
• 52:50in that everybody participated
• 52:52during Kovit in in various ways.
• 52:55Cancer Center Smilow Hospital
• 52:56probably took a big brunt as
• 52:58the shift she places shifted.
• 53:00I know that Fogarty's hardness
• 53:02we are looking at solutions,
• 53:03but I think we also need to acknowledge
• 53:06what a wonderful you know job everyone
• 53:08has done and and I have to say that you
• 53:11know as Dan was sharing all the people,
• 53:14Akiko Wisocki was known on.
• 53:15If you go on Twitter as doctor viral
• 53:18immunity and she taught probably most
• 53:20of the world about covid and and the impact.
• 53:22So we are blessed to have such
• 53:25amazing people around us and.
• 53:27I hope that as we use this town Hall,
• 53:29we get to know each other because.
• 53:32Patients fundamentally benefit when
• 53:33science and great clinical care and
• 53:35quality and everything comes together.
• 53:38So the more we can intersect
• 53:40all of these pieces,
• 53:42the better our patient care delivery becomes.
• 53:44I'm not seeing questions,
• 53:46so either you everyone's being really
• 53:49shy or I'm missing the raised hands
• 53:51when they please keep me honest.
• 53:54If I have someone's raising hands,
• 53:56I try to be good about it.
• 54:00I'm going to give us a minute or two
• 54:02for folks to sort of raise their
• 54:04at least be anonymously asked me.
• 54:06I think the whole point of this is
• 54:09that we start sharing the things we
• 54:12want to hear about this Cancer Center.
• 54:15Doctor Billingsley Kim Saucer
• 54:17anything else you'd like to?
• 54:20Oh,
• 54:21there you go.
• 54:21Roy hurts way to go.
• 54:23When will we get the ECC back?
• 54:26Hey, this is Kim. I can take that one so.
• 54:31Boy will ask you. There we go.
• 54:33So we are currently exploring the
• 54:36ability to move back the ECC to MP
• 54:3912 or I do not have a timeline,
• 54:41but we are actively looking at it
• 54:44and evaluating if it's a possibility
• 54:46because we do know that that is
• 54:49important to do on so many levels.
• 54:51So so more to come.
• 54:53Hopefully you know we'll have more
• 54:55to share at the next town Hall,
• 54:57which is just four weeks away and it might.
• 55:01Communication might be even sooner,
• 55:03so we will keep you posted.
• 55:05But after
• 55:0640 you may get away.
• 55:07I told you where there's going
• 55:09to be a lot of questions and
• 55:11no ones asking the questions,
• 55:12so I don't know either.
• 55:14Kevin kind of did such a great
• 55:15job of sort of introducing you
• 55:17or not getting all of this.
• 55:20Offense in their room,
• 55:21but I I first of all Rob
• 55:23said that he he kind of minimized his
• 55:26role but he is the bed sore and you
• 55:29know units were flipping nonstop and I
• 55:31felt like we were in very able hands
• 55:34throughout this very chaotic time and
• 55:36so just to recognize his efforts there
• 55:38and always with a smile and always
• 55:40very competently and calmly somehow.
• 55:42But, you know, smile has made
• 55:44significant sacrifices and it's been
• 55:45a huge challenge operationally in
• 55:47clinically not just for the outpatient
• 55:49space for the impatient space, but.
• 55:51We will always ask at every
• 55:52meeting with Rob Fogarty.
• 55:54If and when will get NP15 back.
• 55:58Short, so you should ask,
• 56:00and that's right, absolutely,
• 56:02and I'll tell you that I don't know I
• 56:07that I think I mentioned our daily ICU.
• 56:11Meeting and I don't want to waste
• 56:13the whole time, but we we thought
• 56:15we were going to lose a significant
• 56:16portion of the overflow medical ICU.
• 56:19And we test drove what it would look like,
• 56:22not even to close. MP 15.
• 56:25But just to take about 1/3 of that
• 56:27ICU census and find other places
• 56:29to provide ICU level care to those
• 56:31folks and to say it was grim,
• 56:33understates it so it actually got
• 56:35to the point where not only could
• 56:37we not get all the patients out,
• 56:38but we would take every single adult
• 56:40ICU bed at the York Street campus,
• 56:42which means no one can go to the
• 56:45ICU for the OR no one can go to
• 56:47the ICU from any of the floors.
• 56:49No one can go to the ICU from the Ed,
• 56:52and that's just that.
• 56:53If we're going to be Frank about it,
• 56:55that's not.
• 56:56Not really palatable, but it's it.
• 56:58Believe me, I don't. I don't.
• 57:01I was up there last week.
• 57:05And I walked in and the first
• 57:07room on the left.
• 57:08Now that there's the glass windows,
• 57:10there was a young woman who's
• 57:12insulated and it really every time
• 57:14I go up there it rips my heart
• 57:16out that we're providing ICU level
• 57:18care in what was basically a A.
• 57:22A floor.
• 57:23And I long for the day when we
• 57:25don't have to do that anymore.
• 57:27But I would say keep asking me,
• 57:29keep poking me,
• 57:30I promise you Doctor Billingsley
• 57:32and Kim and everyone else they are
• 57:34involved in the conversations.
• 57:35And like I said my inbox is open.
• 57:38If someone has a creative solution.
• 57:41Let's explore it.
• 57:43Thank you for your continued efforts
• 57:45in the New World doing our best.
• 57:47It's it's still tough.
• 57:48Thank you Rob. There's a question for
• 57:50I think either Kathleen or Paula.
• 57:52If you have, I think we're at
• 57:54the top of the hour. Can I ask?
• 57:56Kathleen, can you reach out to Doctor
• 57:58Kunz and ask some of the stressors of
• 58:00North Haven that perhaps so you know?
• 58:03I don't want to sort of take up 'cause
• 58:05I want to end at the top of the hour.
• 58:08Renee, do you want to share
• 58:10the last slide of just the.
• 58:12Because I think the other piece is,
• 58:15it will be helpful to hear what you
• 58:17all want to see on these town halls,
• 58:19so you can just email cancer answers
• 58:21at yale.edu with all your sort of
• 58:23things you want to see discussed
• 58:25and I can guarantee you that Rob
• 58:27Fogarty will be back for another
• 58:29appearance in in in a few weeks.
• 58:31I imagine this will be a agenda when is in.
• 58:34When are we getting in P50 mag?
• 58:36Ann Dr.
• 58:37Kunz.
• 58:37I know that Kathleen will reach out to you
• 58:40right away and give you sort of at least.
• 58:42I'm not sure there's a perfect answer,
• 58:43but we want you to sort of be part of that.
• 58:47Piece of making things better
• 58:48for all of our teams of GI and
• 58:51thoracic oncology so it's 6:00 PM.
• 58:53I know it's I I hate sort of late sort
• 58:56of meeting. So thank you everybody.
• 58:58This is our first of many more.
• 59:00These monthly sessions, again,
• 59:01first Thursdays each month at 5:00 PM.
• 59:03Thank you all. Have a great evening.