State of Smilow Cancer Hospital and Yale Cancer Center 2021

Transcript

• 00:06So good afternoon, everybody.
• 00:08Welcome to the. Grand rounds for.
• 00:11Can't steal Cancer Center in
• 00:13Smilow Cancer Hospital today.
• 00:16As you know, it's really a
• 00:18reflection from the director
• 00:19on the state of the things.
• 00:21Essentially looking back at
• 00:22what we have accomplished,
• 00:24but also looking ahead for the next year.
• 00:28Next slide.
• 00:31OK, I think everybody knows who I am.
• 00:33At this point I've been serving as
• 00:35your interim Cancer Center director
• 00:37since March 1st and really has been a
• 00:40privilege and a pleasure to get to know
• 00:43this wonderful Community in more detail.
• 00:45Over the past few months next.
• 00:49Slide and I think the other point is of
• 00:51course we're in this state of anticipation,
• 00:54but mixed in with a little
• 00:55bit of I would say.
• 00:57Also you know what's coming,
• 00:59and I think everyone seen and met with Eric.
• 01:02And if you haven't,
• 01:03I know you're in for a treat.
• 01:04He was in our network committee meeting
• 01:07this morning and a wonderful human
• 01:09being and just couldn't be more excited
• 01:11that we've been able to recruit Eric,
• 01:13who as you know, is a former Yale alumni
• 01:15and will be joining us February 1st.
• 01:17But as.
• 01:18He has learned has been already a
• 01:20part and parcel of our community.
• 01:23As soon as you sign the job,
• 01:25you start to become involved,
• 01:26so we've been really excited to have
• 01:28Eric be a part of our community.
• 01:31Next slide.
• 01:32OK, so as we talk about sort of
• 01:35our Cancer Center and in Renee,
• 01:37you put the I guess, the.
• 01:40Can be code.
• 01:40I think it's helpful for maybe my
• 01:42perspective and maybe for those
• 01:43of you who are new and some of you
• 01:45may be who've been here for awhile.
• 01:47It's helpful to look at maybe
• 01:50how fast we have grown,
• 01:51and I think sometimes when
• 01:52you're in the midst of it,
• 01:54you forget how much we have done
• 01:57so you know just a little history.
• 01:59Lesson 1974.
• 02:00We started the Yale Cancer Center
• 02:01as a comprehensive Cancer Center.
• 02:03It's 2010 when the Smilow
• 02:05Cancer Hospital was built,
• 02:07and then the network was launched only 2012.
• 02:10So it's really recent.
• 02:12And then if you see the Cancer Biology
• 02:15Institute open on best Campus in 2015
• 02:17or phase one unit in 2016 and then
• 02:21in 2018 as Doctor Fuchs was here,
• 02:25Charlie were here.
• 02:26We went through our renewal and had
• 02:28an outstanding score along with what
• 02:31is fabulous is to see an increase in
• 02:33our research funding and then as you
• 02:35look today in 2021 in between bipan
• 02:37through EMR in the midst of a pandemic.
• 02:40But I think it's.
• 02:41Helpful to look from our perspective
• 02:43of where we are in the red starts.
• 02:45For those of you who are aware or
• 02:48care centers and those are scattered
• 02:50around the state of Connecticut.
• 02:52B are fortunate that we're
• 02:54the only academic institution
• 02:56in the state of Connecticut.
• 02:58And then what many people would be would
• 03:01love to see as a distributed delivery system,
• 03:05which is here.
• 03:06As you can see it exists through
• 03:08Connecticut and also through Rhode Island,
• 03:10as are cited.
• 03:11Best really,
• 03:12this is something that's unique
• 03:14and it's built up very much
• 03:16in the last few years.
• 03:18I think it's growing pains and
• 03:19in some of the stuff that is
• 03:21ongoing now that you feel.
• 03:23But as Eric comes on as Doctor Brian comes
• 03:25on, I hope all of you will think around.
• 03:27How do we connect all of
• 03:29this pieces together?
• 03:30And if you go to the next slide,
• 03:32Renee think the way we think about it is
• 03:34we want to build an academic health system.
• 03:36If you put our. Or signage,
• 03:40whether we call it by nature or Yale
• 03:43or whatever it is, why do we do this?
• 03:45It is to deliver care to our patients
• 03:47and we are in academic system,
• 03:49which means we're teaching organization.
• 03:51It's part of our tripartite mission and that
• 03:53means how to be educate the next generation,
• 03:56whether it's trainees or nursing
• 03:58or the next generation.
• 04:00How do we take resources and
• 04:02improve our patient care?
• 04:03But it can't be done in silo,
• 04:05and especially as we look at the Cancer
• 04:07Center in the distributed nature,
• 04:08not only at the sites.
• 04:10But off the constituencies,
• 04:12how many folks are involved there?
• 04:14Roughly 300 members of the
• 04:16Yale Cancer Center.
• 04:17And then if you look at the number of
• 04:19people we look at our nursing or staff.
• 04:21It's 2000 people, so that's a lot of people,
• 04:23many departments, many sites,
• 04:26and that talks about.
• 04:28It's a great.
• 04:29It's great to see it,
• 04:30but then the day today can
• 04:33sometimes feel sometimes difficult,
• 04:34sometimes fabulous,
• 04:35but it all means that we have
• 04:37to work together.
• 04:38And this is just one quote from Helen Keller.
• 04:41In talking about,
• 04:41it means that we have to learn
• 04:43to work with each other.
• 04:44Think about how we what we do great
• 04:47and where we have opportunities
• 04:48and that I think is probably
• 04:51more telling today as we look in
• 04:5318 months into a pandemic,
• 04:54that some things work wonderfully.
• 04:57But some things we know are health systems
• 04:59could do so much better next slide.
• 05:02So if this is important also in terms of
• 05:05thinking about what we do and why we do it,
• 05:08is this is our vision statement.
• 05:09I think sometimes these
• 05:11are put in on websites,
• 05:13but I want to think about how we deliver.
• 05:16Care is as health care teams.
• 05:19We deliver care one patient at a time,
• 05:22not in the abstract.
• 05:23It's it's one patient at a time.
• 05:25What it and its each and every interaction.
• 05:28So when we talk about the tripartite
• 05:31mission research, education.
• 05:32Clinical innovation and then
• 05:35increasingly at community,
• 05:36it becomes very real in
• 05:38the patient interactions.
• 05:39Whether it happens at best early
• 05:41or enter enter or in New Haven.
• 05:43And how do you conceptualize and
• 05:45deliver all of this transformative
• 05:48transformational care?
• 05:49It's easy to save,
• 05:51and I'm talking about in a PowerPoint.
• 05:53But then it's the teams that put it together,
• 05:55and those teams include our nursing or
• 05:58residents or staff or clinical trial list,
• 06:00our leadership,
• 06:01or administrators.
• 06:01And then I think you get the soup
• 06:04of what we're trying to do.
• 06:05We're trying to make magic
• 06:06each and every day and
• 06:08improve the lives of our patient. Next slide.
• 06:12OK, so when we look at this idea of
• 06:15what does the clinical care and of
• 06:17course we then use our SMILOW standards.
• 06:19The goals we would say is we want to
• 06:22deliver care that's easily accessible.
• 06:24So that means when we want
• 06:26the patient appointment,
• 06:27it's available to us as how you
• 06:29would want your family treated.
• 06:31I think the standards we hold for
• 06:34ourselves is that care is good
• 06:35in that can be defined as that it
• 06:38has good opinions or pathology,
• 06:40radiology, imaging those things.
• 06:42Matter, as it's been shown time
• 06:44and time again also means the clear
• 06:47delivery for a patient standpoint
• 06:48is multidisciplinary that the
• 06:50patient can see all the parts the
• 06:52specialists they need in a more
• 06:54streamlined rate rather than going
• 06:56in serial one after the other.
• 06:58That's not very patient centric,
• 07:00and of course we can use care pathways.
• 07:02We then need to focus about
• 07:03how to be improved care,
• 07:05but I think the other part and I want
• 07:07all of you to sort of take the you
• 07:09know as we think about this clearly,
• 07:11there's what we do today.
• 07:12But part of the mandate for
• 07:14academic health systems is how do
• 07:16we improve the care for tomorrow?
• 07:18And that means how do we take the,
• 07:20you know, the research,
• 07:22the quality to improve care,
• 07:24and I think you've seen that in the
• 07:26town halls that push that all of the
• 07:28teams come together to talk about,
• 07:29learn about each other.
• 07:31Whether it's how do our nursing teams
• 07:33interact and how do we deliver care?
• 07:35Or how is all this basic science
• 07:38related to something very granular?
• 07:40Like how do we deliver care
• 07:41to our patients sitting in?
• 07:42Front office, so this is the hard part,
• 07:45it's it's.
• 07:45It's why we're here,
• 07:47but it's also where we have to flex
• 07:50our muscles and work together next.
• 07:53Now as we look back in the year,
• 07:55it's been probably very much.
• 07:57I think sometimes we need to
• 07:58take a pause and breath and say
• 08:00how much have we done.
• 08:01We've done a lot and the fearless
• 08:03team you see on your left is our
• 08:06two leaders on our day-to-day
• 08:07clinical operations came Slusser,
• 08:10chief nursing Officer and Kevin Billingsley,
• 08:12who is our CMO and both of
• 08:15them have taken us on a lot.
• 08:17Whether it was through the pandemic and
• 08:19all the changes that happened and then
• 08:21how we regrouped and delivered care back.
• 08:24Again,
• 08:24and how we continue to do it.
• 08:26Of course I want to acknowledge
• 08:27that this year we went through
• 08:28magnet and that is really reflects
• 08:30the work of our nursing team and
• 08:32all the great work we do.
• 08:33I think as we look around all the
• 08:35teams and how this has been done,
• 08:38a lot of the stuff beyond re establishing
• 08:40care and I will say it's not all
• 08:43reestablishes where we expected.
• 08:45I think our bar has changed as we
• 08:47come back with all the changes
• 08:49of you know last year we
• 08:51moved from North Pavilion to SRC and
• 08:53clinics moved and then some came back.
• 08:56There's still some disruptions,
• 08:57but in the midst of it, we continue
• 08:59to train our nurses and our teams.
• 09:01We've continued to work on improving things,
• 09:04whether it's through this lean task project,
• 09:07for improving scheduling for infusions,
• 09:10launching patient experience forms,
• 09:12improving residency training,
• 09:14resident centered care,
• 09:15training for our teams,
• 09:17and then at the end of it,
• 09:18I think we have to think about how do
• 09:20we improve the patient experience.
• 09:21As you see this each team,
• 09:23and I'm not going to go through all of this,
• 09:25but each team.
• 09:26Has put in their goals for the next year.
• 09:28It is important for us to look back,
• 09:31acknowledge the hard work
• 09:32of each and every team,
• 09:33but also look ahead and say what do
• 09:35we want to do for the next year.
• 09:37And as you can see,
• 09:39they are obviously focused on many things.
• 09:41Certainly focusing on what
• 09:43is up front and centrals.
• 09:45How do we improve our recruitment
• 09:48and retention strategy?
• 09:49I think this is a nationwide
• 09:51but not phenomenal.
• 09:52It is most acute for health care
• 09:54as we're seeing that our teams
• 09:55that have worked through them.
• 09:57Pandemic we're seeing changes,
• 09:58so we need to think about how
• 10:01do we retain our best people.
• 10:03But there are other things.
• 10:04How do we improve care?
• 10:05How do we look at quality and
• 10:07morbidity and mortality conference?
• 10:09How do we look at our patient
• 10:10experience with our press Gainey,
• 10:11and enhance that and and this team
• 10:14you will see across is how do we
• 10:17think the Black Lives Matter engaged?
• 10:19All of the communities and we have
• 10:21been having a national conversation
• 10:23and that will be seen in the
• 10:25cancer domain so you can see.
• 10:27That they're focusing on culture engagement,
• 10:29and I this is looking inward,
• 10:31but also outward.
• 10:32We're going to have to do both,
• 10:34and this is the part that that this
• 10:37team is also looking next slide.
• 10:39So this just acknowledges,
• 10:41I think,
• 10:41the the all the arrows all it sees
• 10:45is all the stuff you all felt it.
• 10:48It was hard work.
• 10:49I think we can now smile and
• 10:51say it was great.
• 10:53I will still remember when we reopened
• 10:55the inner North pavilion floors
• 10:57and how much excitement there was.
• 10:59Unhappiness with our teams.
• 11:01But this kind of the chaos of this arrows
• 11:04reflect all the hard work you all did.
• 11:07I want to thank you all.
• 11:08I want you to acknowledge.
• 11:10Each and everyone of yourselves
• 11:11and Pat resolve on the back.
• 11:13It was hard work.
• 11:14Perhaps we never felt like we had a pause,
• 11:17because as soon as we moved,
• 11:19the work continued coming
• 11:20and continues coming.
• 11:22We're busier than ever,
• 11:23but I do think it's important
• 11:25for us to say we did it.
• 11:26We have that core and us,
• 11:28and as we look ahead,
• 11:29we have that ability in this next slide.
• 11:34However,
• 11:34things are not pristine and I want to be
• 11:37honest that it's things are still in flux.
• 11:40I've talked about the labor challenges.
• 11:42I think we are busy.
• 11:44If you don't see that, look at RED.
• 11:46It's always busy.
• 11:47Always about 60 to 80 patients
• 11:49waiting to be admitted and that
• 11:51means that are some of her places
• 11:53are not where we expect that.
• 11:55I'm not going to go through and
• 11:56reiterate all of the clinics that
• 11:58are probably still not where you all
• 12:00thought and perhaps some of that will
• 12:02mean that we may change overtime.
• 12:04That's not a good or a bad thing.
• 12:06It's how we look at it.
• 12:07I always see the glass is
• 12:08not half empty or half full.
• 12:10It's waiting for us to be filled
• 12:11with all the colors we want to see
• 12:13and the flavors we want to put.
• 12:15And that's what I want you
• 12:16to think about now.
• 12:17It does mean that spaces get type tight.
• 12:20We have to acknowledge
• 12:21that it's sometimes hard.
• 12:22It means that programmatic growth
• 12:24sometimes doesn't seem obvious
• 12:26or sometimes can be difficult.
• 12:28But I can guarantee you there's
• 12:30ingenuity and creativity in all of you.
• 12:33Whether it's the nursing team.
• 12:35Whether it's the trainees or
• 12:36whether it's the physicians,
• 12:38every one of us has that
• 12:40capacity and that skill set.
• 12:41Next slide.
• 12:44OK,
• 12:44so some of the other stuff besides
• 12:46talking about the pandemic,
• 12:47which I think we've spent a lot of time,
• 12:49is some of the good stuff that
• 12:51happened while we were just so
• 12:53busy catching our breath on doing
• 12:55routine care so often in crisis.
• 12:57Sometimes the best minds and best
• 12:59solutions are born and the hospital
• 13:01program was launched over the past
• 13:03year by Doctor Carrier Edelson along
• 13:05with Doctor Jensen Morris who haven't.
• 13:07If you haven't met,
• 13:08she runs our hospitals program,
• 13:10and although it's only been
• 13:12launched for a few short months,
• 13:13the early signal shows that.
• 13:15Having a dedicated team does
• 13:17improve things like length
• 13:18of stay in early discharge,
• 13:21so again it's a positive signal.
• 13:23It's something will continue to
• 13:24learn from and as Eric comes on
• 13:26this will be something for us to
• 13:28discuss and see how this relates
• 13:30to how we deliver our care,
• 13:31but also think about how does it
• 13:33impact our training experience?
• 13:35Are we thinking about all those facets
• 13:37and training the next generation?
• 13:39But I think early on really remarkable
• 13:42success or working across different
• 13:44programs and across our institution.
• 13:47Next slide.
• 13:48And other things are this
• 13:50next day initiative.
• 13:52I think if it's someone in your family,
• 13:54if you have a cancer diagnosis,
• 13:55we would all say we want to be
• 13:57seen as soon as we hear about it.
• 13:59And that's the right intent.
• 14:00Do you know?
• 14:01We need to think about our patients,
• 14:03how we would want to be treated
• 14:05and they want to be seen next day.
• 14:06So this is an initiative
• 14:08launched by Sarah Mccallion,
• 14:09whose are ambulatory officer on with
• 14:11these Chomsky and the data shows that
• 14:14this has launched in several locations.
• 14:16I'm not going to name them on
• 14:17lot in southern Connecticut.
• 14:19Along with other areas and what has
• 14:21shown is that we are able to do this
• 14:23for things like Breast Cancer Care.
• 14:25About 15% of people are being seen by the
• 14:27next day and also we're seeing about 10%
• 14:30of people being seen in the next day.
• 14:31So there's a huge patient demand for
• 14:34this and offering this is something
• 14:37that we need to start doing,
• 14:39but the dynamics of it become hard
• 14:41because it does mean it puts stressors
• 14:43on the frontlines team to think about
• 14:45how do we work more intelligently
• 14:47around this rather than just making art?
• 14:50Please go longer next slide.
• 14:52And then the patient experience,
• 14:54which is critical around how we
• 14:56think as you know,
• 14:57Terra Sam presents a lot of this and she's
• 14:59helped by her director of patient experience,
• 15:02Michelle Kelby,
• 15:02Albert and some of the experiences
• 15:04that they have really done is
• 15:06the patient experience forums.
• 15:07We've talked about those and
• 15:09then we formed the P fact.
• 15:10These patient and family advisory
• 15:12councils for patients educate us on
• 15:14what are the missing things that we
• 15:16may never hear about or think about.
• 15:18And I think those are important
• 15:21dialogues because partly we live.
• 15:23And then we delivered this
• 15:25tripartite mission.
• 15:25They say we do it in a community.
• 15:27Some of that community is us as human beings,
• 15:30but we live in a community.
• 15:32I'm currently sitting in New Haven.
• 15:33Some of your sitting in Torrington or
• 15:36water for door investor Lior Greenwich.
• 15:38So what does that community think about us?
• 15:40And this is, I think,
• 15:41thinking how?
• 15:42How do we make these abstract notions
• 15:44very much local and important to our
• 15:47patients who live within that community?
• 15:49Next slide.
• 15:51OK, so some more data.
• 15:53In terms of thinking about new
• 15:55patient volumes,
• 15:56this is helpful.
• 15:57We had a lot of growth you can
• 15:59see up till 2017 I think.
• 16:01Think somethings plateaued down
• 16:02and and as we look in twenty 2021
• 16:05I think some things for us to
• 16:07look and pause and say there are
• 16:09areas where we need to focus on.
• 16:11Again,
• 16:12this is just more thinking about
• 16:13and as we think of our strategic
• 16:15framework and I know many of us spend
• 16:17a lot of time thinking about it next
• 16:19slide and then just add more data.
• 16:22And what are the worker views?
• 16:24Associated with their work.
• 16:25That's how one way of how we measure work.
• 16:27There many other ways,
• 16:28but this is how we measure one of our
• 16:30domains of the work and it just shows
• 16:32the data over the past few years.
• 16:34Next slide and then of course,
• 16:36even though we I shared the new patient data,
• 16:38of course,
• 16:39as we all know is you get busy busy
• 16:41people keep getting busier 'cause
• 16:43your patients continue they continue
• 16:45to follow us and you can see that
• 16:48that growth is exponential because
• 16:49those patients stay with us and
• 16:51I think this is an opportunity of working.
• 16:54How do we use telehealth in this population?
• 16:56How do we think as teams
• 16:58around our follow up visits?
• 17:00Is that always done the same way?
• 17:02Are there smarter ways of doing
• 17:04this as we look ahead next slide?
• 17:07And then just I want to make a point.
• 17:09This is a complicated slide.
• 17:11Going this is monthly starting
• 17:12in October on the X axis,
• 17:14going all the way to October 2021,
• 17:16and what you can see is in blue
• 17:19is in in person visits the the
• 17:21light blue color or whatever we
• 17:23call it is video and then that
• 17:25orangish color is telephone visits.
• 17:27We all know that telehealth took
• 17:30off as the pandemic happened.
• 17:32So you can see that although
• 17:34for cancer patients still need
• 17:36their infusion and need to.
• 17:38Visit us so we continue to do
• 17:39a lot of inpatient visit there
• 17:41as you know my other hat is.
• 17:43I'm the head of the Yale
• 17:44medicine practice plan.
• 17:45If you look telehealth across our
• 17:47health system, it was up to 3040%.
• 17:49But here was about 20% back in
• 17:52last year and this is the rest
• 17:54of the trend is not a typical
• 17:56we see that as things opened up,
• 17:58patients wanted to see us more in
• 18:01person and that's what we see here
• 18:03that the telehealth is declining.
• 18:05I think phone as you all know,
• 18:07was not reimbursed.
• 18:08Is is is there's some reimbursement,
• 18:10so we encourage video,
• 18:11but as we look ahead I don't
• 18:13think you should have banned.
• 18:15Until Yelp.
• 18:16I think there are opportunities
• 18:18similar to what I mentioned around.
• 18:21The follow up visits and I'm not.
• 18:23I'm what I mentioned early on as we look
• 18:25at our care centers and they're distributed.
• 18:29And if you're thinking of
• 18:30an academic health system,
• 18:31not everyone has that expertise.
• 18:33We look at, you know,
• 18:34in every domain and how do
• 18:36we bring the specialist?
• 18:38Can we use telehealth as a tactical
• 18:40way rather than everyone going
• 18:42to visit that patient to bring
• 18:44that specialist to remote sites?
• 18:46Again, this is not the answer is not today,
• 18:48but those conversations are happening.
• 18:50But.
• 18:51Delivering that will require
• 18:52some nuances as we pilot them
• 18:54out and think about it.
• 18:56I know certainly in surgery I've seen
• 18:58some nice areas and in Waterbury
• 19:00with thoracic doing this and I think
• 19:03there's opportunity for us to think
• 19:05and use it across as holistically.
• 19:08Next slide.
• 19:09OK, the now,
• 19:11although we are very distributed,
• 19:13there are four divisions that
• 19:14are part of the yield Cancer
• 19:16Center and I think it's important
• 19:17to think about what they do,
• 19:19'cause they're full time
• 19:20in the Cancer Center.
• 19:21So going Herbst runs the
• 19:22division of Medical Oncology,
• 19:24and although it's it's one of our
• 19:26largest division with about 80 people,
• 19:28clearly lot of work and I'm not
• 19:29going to be able to acknowledge it.
• 19:31Some of the key highlights as
• 19:33they have multiple spores.
• 19:34They're also trying to get faculty
• 19:37development and recruitment as
• 19:38we continue to be busy.
• 19:39Lots of drug approvals you can see in head,
• 19:42neck, lung and bladder cancer
• 19:44and I have to say this team has
• 19:46worked really well on faculty,
• 19:47staff and Wellness during the pandemic
• 19:49for next year they continue to.
• 19:51Think about faculty recruitment
• 19:53and development goals.
• 19:54Also, how do we bring that academic
• 19:56piece in the system is fellows come
• 19:58out and they want a much more different
• 20:00practice then perhaps in the past and
• 20:03they're looking at putting in a fourth
• 20:05score application in breast cancer.
• 20:07Next slide.
• 20:09Looking at division of Hematology
• 20:11led by the Stephanie Helene,
• 20:13who as you know took over the
• 20:15division over almost about two years
• 20:18ago and obviously focused on the
• 20:20tripartite mission as I mentioned,
• 20:22but also as I know Stephanie also
• 20:24think about how do we disseminate
• 20:26innovation throughout the world,
• 20:27'cause the research here is phenomenal.
• 20:30Now if you move to the next slide,
• 20:31I think what needs to happen is
• 20:33and what Doctor Helene is very
• 20:35much focused on is how do we bring
• 20:37that depth into all the programs?
• 20:38Because lymphoma is very different
• 20:40from leukemia and that the in
• 20:43especially as we think of the
• 20:45scientific innovations in this.
• 20:46This kind of tells you about
• 20:48how diverse this team is,
• 20:50how large this team is,
• 20:51a couple points to make out point
• 20:54out here the yellow boxes show all
• 20:56the new team members they have and
• 20:59they are some of them are in here.
• 21:01Some of them are in the health system.
• 21:03One point to point out is that
• 21:06the classical theme is an area of.
• 21:08Huge growth and need partly reflects
• 21:11Connecticut as a state with an aging
• 21:14state population that many of our
• 21:16sites are inundated with benign heme,
• 21:19it's either an opportunity or a stressor.
• 21:22It certainly is a lot of demand,
• 21:24but how do we use it for our research,
• 21:26I think those are some things that I know.
• 21:28I know,
• 21:29the heme group is thinking with Bob
• 21:31Boehner and others also want to
• 21:32point out Marcus motion on the left.
• 21:34Some of you may not have met him is
• 21:36he is our inaugural director of CMC.
• 21:39Or central molecular clinical oncology.
• 21:41Dr Mission joined us last summer
• 21:44from City of Hope,
• 21:45accomplished Howard Hughes investigator,
• 21:47whose goal is to bring the physician
• 21:50scientist. How do we train them?
• 21:52And he's he's been able to recruit
• 21:54three people in his group.
• 21:55So really excited about how that
• 21:58comes across and then you can see
• 22:00how Stephanie's thinking about the
• 22:01network and all of the pieces.
• 22:03So I think this group will continue
• 22:04to get bigger over the next year,
• 22:06as Doctor Weiner joins us. Next slide.
• 22:10Neuron colleges led by Antonio Moral.
• 22:13They had the shanavia brain tumor front.
• 22:15You saw the announcement earlier this week.
• 22:18They also had a U 19 grant with
• 22:21Antonio Amaro and Ranchi and drawn
• 22:24launching the therapeutic network.
• 22:26They're continuing to do a lot
• 22:29of clinical trials and
• 22:31then for 2022 for this coming year.
• 22:32Their goals are to kind of optimize
• 22:36their inpatient services as well as
• 22:38launch a PO1 in the future and then.
• 22:40I know that they have also a
• 22:42recruitment needs in this group.
• 22:44Next slide. Alright,
• 22:47so therapeutic radiology or
• 22:49radiation oncology as well is the
• 22:52department led by Doctor Glaser,
• 22:54one of the top five programs in the country.
• 22:57Clearly very much definitely
• 22:59invested in building teams,
• 23:01translational science or what we mean by
• 23:03taking signs from the bench to the bedside.
• 23:05We have to acknowledge that they
• 23:07had the mosaic cyber attack and
• 23:09how this team worked tirelessly
• 23:11to make sure that no one's no
• 23:14patients treatment was interrupted,
• 23:15and I think that's a.
• 23:16Fabulous achievement in addition,
• 23:18Lynn Wilson has now stepped in as
• 23:21our new Deputy CMO for therapeutic
• 23:24radiology is the idea of a Cancer
• 23:27Center and being matrix that we need
• 23:29the connection so really want to
• 23:31welcome Lynn informally and on this in
• 23:34this role and then for the next year.
• 23:37I think all of us have heard the proton
• 23:40center that will be in in the Central
• 23:42Connecticut domain that started construction.
• 23:45They're working on building a spinal.
• 23:46Oncology program with neurosurgery
• 23:48and Woody Mendel.
• 23:49Dr Mendel just joined us and they're also
• 23:52looking at a spore grant in DNA repair.
• 23:54And of course,
• 23:55the team.
• 23:56If you've already heard continued
• 23:57recruitment back to the theme
• 23:59of the academic health System,
• 24:01Surgical services is broad.
• 24:02There are many,
• 24:03many department Dr.
• 24:04Goshen is our deputy CMO for
• 24:06surgical services working across
• 24:08the six Department of Surgery.
• 24:11Again,
• 24:11I'm not going to name the
• 24:13multiple recruitments,
• 24:13but they're here and the health system
• 24:16thing what has happened and this is.
• 24:18It kind of exciting is that we have
• 24:20been able to standardize some of the
• 24:22treatment delivery across the health system,
• 24:24especially in breast and some
• 24:26of the more structural works.
• 24:29I think looking ahead,
• 24:29this is about part of the theme
• 24:31of academic health system.
• 24:33How do we make sure that patients
• 24:36have access to surgical services
• 24:38in the health system?
• 24:39Doesn't make a lot of sense for
• 24:41surgeons to be going to these sites,
• 24:43but how do we think about that?
• 24:44That is an opportunity because
• 24:46when we look at smilow services.
• 24:49We are about 50% of the state,
• 24:51yet we look at surgical services
• 24:53across the six surgical department
• 24:55that's not congruent.
• 24:56We are only about 30% of the state,
• 24:58so there's an opportunity to
• 25:00grow our surgical services.
• 25:01There's a lot of destination programs that
• 25:04are being developed with multiple teams,
• 25:06and you can see all those things.
• 25:08We also need to think about
• 25:09how patients come to us,
• 25:10not only for trials but also
• 25:13novel treatment offerings.
• 25:14We've started the Hipec program
• 25:17with Alina Ratner and then.
• 25:19Our Division I just did a case
• 25:21last week for GI Surgical Oncology.
• 25:24How do we offer more advanced
• 25:25robotic cancer surgery?
• 25:26A lot of patients want to seek
• 25:28that out and
• 25:28so often those are the entries and we
• 25:30need to be really tactical on how we
• 25:32think about that for our patients.
• 25:34So they look here rather than going
• 25:36to New York. The last division is
• 25:38palliative care led by Jeff Capel,
• 25:40and they were able to get two Milbank grants,
• 25:42one to look at providing care,
• 25:44standardized care for palliative
• 25:46care services, and the Cancer Center.
• 25:48Also a dashboard.
• 25:50Development she general so is focused
• 25:52on developing a system right palliative
• 25:54care program and you can see her goals,
• 25:56which is to continue to build the
• 25:58ambulatory network for palliative
• 26:00care services.
• 26:01Because there is a huge need for how
• 26:03we think about that for our patients.
• 26:05Next slide.
• 26:08OK, I think you've heard all enough
• 26:09about this over the last few weeks.
• 26:11If you've been attending all of this,
• 26:13clearly are our clinical trials
• 26:16increased or dramatically?
• 26:18And then with the pandemic we had a.
• 26:21Shut down and now we are enrolling,
• 26:24but slowly as we have seen the
• 26:27labor disruption.
• 26:27This is what I want to stress.
• 26:29Here is what we are feeling is nationwide.
• 26:33If I look at all the Cancer
• 26:35Center director listservs,
• 26:36what we are seeing is every other center.
• 26:38So what I although it doesn't
• 26:41make the hard work easier,
• 26:43it just to recognize that what we
• 26:44are facing is something that the
• 26:46rest of the country is facing.
• 26:48I think part of the pieces that
• 26:50we're also doing in terms of.
• 26:51Thinking about is how do we deliver
• 26:54care in our darts or the Centers
• 26:56for Cancer care or vehicles for
• 26:59taking this tripartite mission and
• 27:01making it one patient at a time?
• 27:04And these are the cares the
• 27:06cancer care teams.
• 27:07Now some of them have been
• 27:09launched next slide formally,
• 27:10into thinking about all of the domains.
• 27:13So now thinking about the clinical teams,
• 27:15the research, the quality,
• 27:18the clinical trials,
• 27:20and this is Roy herbs in the long dream,
• 27:22which you can see it's.
• 27:23Truly multidisciplinary and you
• 27:24can see in the box all the services
• 27:27that go in delivering care services
• 27:29and also all the sites that have
• 27:31to think about it as we now have
• 27:33thoracics services.
• 27:34Cancer services in both Trumbull
• 27:37and Greenwich. Next slide.
• 27:39Similarly,
• 27:40Pam Kunz launched the Center
• 27:42for Gastrointestinal Cancers,
• 27:44and this is a large just in terms
• 27:46of thinking about GI cancers and
• 27:48has matrix with as a relationship
• 27:50with the digestive service line and
• 27:52you can see all the leaders and all
• 27:55the different specialty programs.
• 27:56Huge complex undertaking.
• 27:57I want to congratulate this team
• 28:00and working so inclusively across
• 28:02the entire system. Next slide.
• 28:05And then the breast team just launched.
• 28:07As you know,
• 28:08Doctor Lustberg joined us recently
• 28:10from the Ohio State and has already
• 28:12been busy at work and has been building
• 28:14an inclusive team for breast cancer,
• 28:16which as you know,
• 28:17is distributed throughout our care sites.
• 28:20Next slide.
• 28:22OK,
• 28:22the other one as I mentioned
• 28:24is this genevier
• 28:25fund. As you know we got a $5 million
• 28:28grant gift from Lewis and depression
• 28:30appear earlier in the year and we just
• 28:33announced the three leaders Jennifer
• 28:35Moliterno as a clinical director,
• 28:37Antonio Morrow as a clinical trials and
• 28:39Ranjit Bindra's or scientific director
• 28:41and thinking about destination program.
• 28:44And also as we launch our
• 28:46neurosciences tower at SRC next slide.
• 28:49Now, why you know the how of what
• 28:51we do and what does it result?
• 28:53And if you look at it again,
• 28:54back to this network and how do we make
• 28:56it academic and how do we think about it?
• 28:58It's still relatively young
• 29:00as our integrated system,
• 29:02but we treat roughly 50% of our
• 29:05patients diagnosed in this state,
• 29:06and I think the part which I've
• 29:08mentioned that patients want to be
• 29:10seen especially for you know their
• 29:12day-to-day needs within closer to home.
• 29:14They may want to come for their
• 29:16complicated surgery here,
• 29:17but for the day today.
• 29:19I think thinking from a patient perspective,
• 29:21they want that care closer to home.
• 29:23So the goal is to get that smilow
• 29:25center within 30 minutes,
• 29:26and so they have 16 locations across
• 29:29Connecticut and Rhode Island next slide.
• 29:33So this is a great story.
• 29:34I love stories because I think stories
• 29:36stick with us more than you know,
• 29:37a bunch of factoids and dashboards.
• 29:40So Captain Simon is serves in the
• 29:42in the public health service and
• 29:44was diagnosed with multiple myeloma
• 29:47and was treated by Jason. How this?
• 29:50Atwater Ford and he needed a stem cell
• 29:53transplant and Jason contact it's two
• 29:55seropian who brought him here and he
• 29:58had his transplant and peace and was
• 30:00taken care of by the team and NP7.
• 30:03And then he's gone back to water
• 30:05Ford to get the rest of secure.
• 30:06I mean, that seems that's the kind I mean.
• 30:08We want more of this.
• 30:09It's not easy, but then it happens.
• 30:11It's like the right thing to do
• 30:13because you know, he got the majority
• 30:15of his care closer to home,
• 30:16but when he needed the complicated stuff,
• 30:18he came here to New Haven.
• 30:20Next slide.
• 30:23OK, so the other part of our care
• 30:25centers just some facts which I think
• 30:27it's always are good to know if you
• 30:30think about why NHH and Yale School of
• 30:32Medicine 8% of our people across our
• 30:34School of Medicine and the hospital
• 30:37come for access to clinical trials.
• 30:39That's not just in cancer,
• 30:41but if you look in cancer,
• 30:4325% of patients are in clinical trials.
• 30:45That's a pretty petty in our
• 30:47care sites and then care centers
• 30:49deliver 40% of our cancer care.
• 30:51So I think you get the idea that
• 30:52a lot of patients are patients.
• 30:54Are being treated on these care centers,
• 30:56but how do we improve upon as the
• 30:58next generation is we think about the
• 31:00evolution of the karcist centers that
• 31:02came together by consolidation of a
• 31:04lot of services. I mentioned already.
• 31:06How do we provide advanced services?
• 31:08Whether it's therapeutic radiology,
• 31:10whether it's palliative care
• 31:11or surgical services,
• 31:12how do we use telehealth more strategically?
• 31:15And I think also what we need to
• 31:18do is how do we highlight what is
• 31:21the strength of an academic system?
• 31:23Why is a good pathology?
• 31:26Diagnosis the right diagnosis
• 31:28and right staging important.
• 31:29It has an impact if you don't
• 31:31stage a person right the right time
• 31:33you can't go back and fix it.
• 31:35So I think this is something we need
• 31:37to do when we talk to our patients and
• 31:39our app work to highlight what is the
• 31:42value of an academic health system.
• 31:43Yes, clearly we want to have easy
• 31:46access but also what do we?
• 31:48What do we do?
• 31:49That's a differentiator from,
• 31:50say, the others in the market is
• 31:53something that really needs to
• 31:54be something that our patients.
• 31:56And our referring physicians
• 31:59and teams understand next slide.
• 32:02Right,
• 32:02this is all the recruitments we've
• 32:04seen this over in in Renee's weekly
• 32:07and in my monthly town halls
• 32:09and over the past year.
• 32:11But someone,
• 32:11some folks to point out is Doctor
• 32:14Isaac Kim who just joined us in
• 32:16October as the chair of Urology.
• 32:18Doctor Kim is a physician scientist.
• 32:20He joined us from Rutgers where he led
• 32:23the division of Urology and Clinical.
• 32:25He's an expert and robotic prostate,
• 32:27so bringing that destination,
• 32:28clinical expertise and research he
• 32:31does has been developing treatments.
• 32:33Or press resistant.
• 32:34Treatment resistant prostate cancers
• 32:36using pro tech modality which I
• 32:38know you've heard a lot from Joe
• 32:41Kim and Dan Patrick and Roy and
• 32:43others in the other recruits.
• 32:45Here to point out these continuous
• 32:47Dr Krishnamurthy who also just joined
• 32:49us recently as Chief of Pediatric
• 32:52Oncology from memory and he brings an
• 32:55expert in BMT and really excited to have him.
• 33:00You can see the rest both Tomahawk,
• 33:01the world who has done the world's first.
• 33:04This nation's first face transplant,
• 33:05but it's, uh,
• 33:06his daytime job?
• 33:07Is cancer reconstructive services
• 33:09is also here,
• 33:11from Brigham and I mentioned Dr Mandel,
• 33:14who's here from the Ohio State
• 33:16and leading probably one
• 33:17of the world's or nations,
• 33:18exported spinal oncology and
• 33:20recruited from neurosurgery.
• 33:24OK, so switching gears to
• 33:25some of our research mission.
• 33:27I spent a lot of time on the.
• 33:29Clinical mission on switching gears to
• 33:31our research mission and as we know,
• 33:33we are a comprehensive Cancer Center which
• 33:36means we're supported by a CCSG grant.
• 33:42And we have 300 full-time members of the
• 33:44grant needs a lot of work to manage it,
• 33:47and that work is done by Bob Garofalo,
• 33:49who has been leading the CCSD.
• 33:52Granted all of the administrative
• 33:53workload for us since 2015.
• 33:55He let us through a renewal.
• 33:58Bob is stepping down and add captain,
• 34:00who you all know will be taken over as
• 34:03associate Director for Research Affairs
• 34:05on January 1st for the next year.
• 34:07You can see their goals to
• 34:09continue to improve infrastructure,
• 34:10operational efficiency, and.
• 34:12Help leader re submission next slide.
• 34:16OK, this kind of graph speaks to itself.
• 34:18I think nice steady growth
• 34:20over grant funding.
• 34:22Important point to point out is
• 34:24our NIH NCI funding or cancer
• 34:26specific funding has increased.
• 34:30We also had these research programs.
• 34:32I'm not going to talk about them,
• 34:33but I think just to see out that these
• 34:35six research program represents our
• 34:37efforts for framework for engaging all
• 34:40of our Members in high impact science.
• 34:43So again, it's team work,
• 34:44similar to what we said on the clinical
• 34:46side in each program is often led
• 34:49by either by multiple leaders that
• 34:52bring complementary experience.
• 34:54And also, I think what the goal
• 34:56is to have synergy between them.
• 34:58And then in each of these programs
• 35:00thinks about how do you mentor
• 35:02new investigators and ultimately,
• 35:04how do we improve the number
• 35:06of teen science awards?
• 35:08That are going across our cancer centers.
• 35:12One of the successes is this,
• 35:15which is the the Doral trial?
• 35:18Which was led by Boy Herbs and
• 35:20the correlative work for this
• 35:22by done by Katy Perry.
• 35:23And this is for EGFR mutated
• 35:25non small cell lung cancer.
• 35:27Anything the Kaplan Meier for
• 35:29the folks who could see it is.
• 35:31You can see when you're treated
• 35:32with this new drug was merited,
• 35:34which is an EGFR receptor.
• 35:36You can see the improvement in
• 35:38survival from placebo from 61% to 97%.
• 35:41I think that graph speaks for itself
• 35:43and that this is a great trial in
• 35:46improving outcomes for our stage
• 35:48two and three eight patients.
• 35:50But also says that how I think.
• 35:52What this highlights is how the
• 35:53clinical team and the translational
• 35:55teams and all the teams are working
• 35:57together and how we what we do here,
• 35:59then changes clinical management
• 36:01across the country next slide.
• 36:04Lots and lots of awards.
• 36:06I think we can probably can't cover them all,
• 36:08but some few ones to think about
• 36:11as highlight or obviously.
• 36:13Two people who got inducted into
• 36:15the National Academy of Science,
• 36:16doctor Liping Chen and Scott
• 36:18Miller were inducted,
• 36:19which is one of the highest
• 36:21honors in the country,
• 36:22along with National Academy of
• 36:24Medicine doctor Marcella Nunez Smith.
• 36:26You can see Pankun Scott,
• 36:27woman oncologists at the year and
• 36:29that led to a lot of national
• 36:32excitement over pants.
• 36:35Support on this next slide.
• 36:38OK, so talking about our associate director,
• 36:41Doctor Mark Lemon runs the is the associate
• 36:44director of basic science research.
• 36:47And as as I mentioned,
• 36:50the Cancer Biology Institute
• 36:51is on the West campus.
• 36:53He's been able to recruit six members
• 36:55who were really in fostering research.
• 36:57The goal here is to foster basic science
• 36:59and bring it to a translational end.
• 37:01And you can see the Doctor Lemons goals
• 37:04for the next year to help Foster continued
• 37:07part of this translational research.
• 37:11And how do you work across the other
• 37:13associate directors in data science
• 37:14and which I know is an area that
• 37:17Doctor Lemon is really focused on.
• 37:19Because as we know that genomics is
• 37:21becoming part and parcel of our lights.
• 37:24Next OK, so the next program dot Roy Herbst,
• 37:29also runs the translation
• 37:30and clinical research as the
• 37:32Associate Cancer Center director,
• 37:33and here they focused very successfully.
• 37:36Used the tier team science mechanism
• 37:39and also are fostering this too,
• 37:41for leading to spores NPO ones I know.
• 37:44He would be very excited and as I
• 37:46might to mention that the diversity
• 37:48training both in a T32 program as well
• 37:51as the BMS diversity program which
• 37:53is led by Nabi Fast for next year.
• 37:55Of course I think.
• 37:56We would all agree that improving
• 37:58optimizing the CTO office is critical
• 38:01along with submitting at least
• 38:03one news for grant next slide.
• 38:06These are all the drug approvals
• 38:08that have led from Yale LED studies.
• 38:10Kind of highlighting our continued
• 38:12success in this arena, except.
• 38:15And then for the C2,
• 38:16I think many of you've seen this slide,
• 38:18but as part of improved optimizing and
• 38:21acknowledging our distributed system,
• 38:23we've announced two more medical directors,
• 38:26Stacy Stein and Neil Fishback,
• 38:28along with Stephanie.
• 38:29Hillary, who runs the labs.
• 38:31Alyssa Gateman is our interim director
• 38:33for the C2 office and Margaret Gil
• 38:36Shannon came on full time as part of the
• 38:39Cancer Center as their new deputy director.
• 38:42And then I think you've all heard that
• 38:44urine is helping us to see how do we do?
• 38:46Things more in optimized way without
• 38:48improving our infrastructure excellent.
• 38:51And then these centers,
• 38:52I think,
• 38:53are also important bridges that
• 38:55think about our darks and how do
• 38:57we then continue to engage in this.
• 38:59Once we called matrix and how do we recruit
• 39:02new people and have them be successful?
• 39:04So I mentioned Cancer Biology
• 39:06Institute as one example.
• 39:08We will also mention CMCO
• 39:10Marcus missions program.
• 39:11He just recruited David Braman was
• 39:13going to focus on renal cancers and
• 39:16you can see all the copper program.
• 39:18It's very successful and I want
• 39:20to point out by CIO which.
• 39:22It's launched as a bridge was launched
• 39:24as a bridge program several years ago,
• 39:26and as between the Cancer Center
• 39:29and Immunobiology,
• 39:31and Marcus was appointed as the full
• 39:33time director recently this year.
• 39:34Next slide.
• 39:36So our 84 population and then the sports,
• 39:39which I think you can see the
• 39:41data for itself,
• 39:42how much funding they bring in the
• 39:44leaders of these three scores.
• 39:45And I think you've heard that there's
• 39:47goals to at least put one or two new
• 39:49sports for the upcoming year next week.
• 39:53So Melinda Irvine runs.
• 39:54Are is the associate director
• 39:55for population science and the
• 39:57goal here is how do you improve?
• 39:59Think about our research and
• 40:00focusing on our catchment area and
• 40:02her goals for the next year to see.
• 40:04How do we take our genomic
• 40:06signs and connected.
• 40:07We are all connected by Epic,
• 40:09so how do you use this data science and
• 40:12leverage or electronic health record?
• 40:14With our research to be more sort of,
• 40:18you know cloud would be make call cloud
• 40:20analytics is something that everybody
• 40:21is thinking along with as you saw Mark.
• 40:24Simon is also thinking about that,
• 40:25and then of course,
• 40:28foster collaborations next.
• 40:29And a pet Larussa runs the
• 40:32experimental therapeutics program.
• 40:33Of course,
• 40:34this is focused on how do we take
• 40:37our faculty and position science and
• 40:39do investigator initiated trials?
• 40:41Think things to think about
• 40:42is how do we also increase URM
• 40:44recruitment to set clinical trials?
• 40:46And one of the ways pad is thinking
• 40:48about is decentralizing clinical trials,
• 40:50bringing them closer.
• 40:51Sometimes it's hard to get here,
• 40:53and this is where clinical trials
• 40:55or geography helps us in that those
• 40:58trials are available to our patients.
• 41:00Except.
• 41:02And then if you think about
• 41:04our catchment area,
• 41:04our catchment is the state of
• 41:07Connecticut in 97% of our cases
• 41:09come from the state of Connecticut.
• 41:11Now it's important to note that
• 41:13Connecticut is in the highest
• 41:14second highest quintile in the
• 41:16country for cancer incidence and
• 41:185% higher than the US average,
• 41:20in particular Hispanic or Latino
• 41:21population is a 20% percent higher
• 41:24cancer rate and that gives us,
• 41:27as we think about our different sites.
• 41:29How do we think about our research and and?
• 41:32Will be improved care and then
• 41:34of course in New Haven.
• 41:35We know we have higher rates of
• 41:37smoking and obesity which are also
• 41:40cancer risk factors explained.
• 41:41Now,
• 41:42one of the ways to improve is
• 41:43how do you address the needs.
• 41:45This is one example by Andrea Silber,
• 41:47who has the owner trial,
• 41:48which is goal is to improve minority
• 41:51enrollment in clinical trials.
• 41:52This is and breast cancer.
• 41:54And how do we offer that to our communities?
• 41:56In our local community.
• 41:58In addition,
• 41:59these trials are supported not only
• 42:02by the the CCSG or the NCI grant,
• 42:04but also by foundational funding by BMS,
• 42:07Genentech, etc.
• 42:08In terms of trying to improve
• 42:10care to our communities.
• 42:11Next site,
• 42:12but this is like I love this story.
• 42:14So Maryland Barber was having
• 42:16some symptoms and she kind of
• 42:18went to her primary care even was,
• 42:20you know had her levels checked in,
• 42:22including her CEO on 25 all normal
• 42:24she went to a health fair and you
• 42:26can see some of her team from
• 42:28our health fairs and really had
• 42:30a nagging feeling in in.
• 42:31Really got some information
• 42:32at this health fair.
• 42:33Came to see Alice Andrew Santino
• 42:36actually had ovarian cancer was treated
• 42:39by our team and kind of tells you.
• 42:41That this is these fairs and I also have a
• 42:44teaching responsibility to our community.
• 42:47And this in this case we had,
• 42:50you know, an early patients diagnosis
• 42:52and helped this patient next.
• 42:56OK, and and then this is
• 42:58part of back doors at NCI.
• 43:00Grant that community outreach and engagement
• 43:02is a critical part of our mission.
• 43:05As in as a comprehensive Cancer Center
• 43:08and Marcella Nunez Smith leads this.
• 43:11Our community outreach and engagement
• 43:13program with the goal to reduce or
• 43:16eliminate disparities in our catchment
• 43:18area and the goal here is to use data
• 43:20or dashboards to then understand the
• 43:22burden and then use it to outreach back
• 43:24to the communities to then improve.
• 43:26Here, I think increasingly then,
• 43:28as once you understand what the problems are.
• 43:30Also, how do you ask the right questions?
• 43:32And how do you develop your
• 43:34research around that?
• 43:34Is something that I know more as Marcelo
• 43:37steps away from our White House duties is
• 43:40looking to develop further next slide.
• 43:43And then last but not least,
• 43:45Barbara Burtness was appointed
• 43:46as a new interim.
• 43:4780 for diversity, equity and inclusion.
• 43:49Again, I mentioned this earlier on
• 43:51in our talk that this is going to be
• 43:53an area that's important to us and
• 43:55Barbara is a huge champion of this.
• 43:57Having done this work locally,
• 43:58both in swimming and the Deans
• 44:00committees and nationally for E.
• 44:01COG already since starting,
• 44:02she's been doing a lot of training
• 44:05and implicit bias for trainees.
• 44:07For physicians,
• 44:08a lot of communication initiatives.
• 44:10As you've been seeing that
• 44:12on Smilow Connect and.
• 44:13In future obviously that as you see it,
• 44:16there's a climate survey going on.
• 44:17Then of course we want to eventually get
• 44:20a permanent lady for this role next time.
• 44:22And she's already launched A DE Council.
• 44:25It's obviously highly inclusive and diverse,
• 44:28and this committee I know will
• 44:30continue to look at all of our parts
• 44:32of our functions and to see how can
• 44:35we think about all these issues.
• 44:37And in equity, HealthEquity next slide.
• 44:41And then Harry Cougar runs our
• 44:43education and training.
• 44:44She's the associate director for that.
• 44:47Their program is looking at how
• 44:49do you use metrics to improve and
• 44:52optimize training outcomes and
• 44:53also how do we look at the entire
• 44:55pipeline of students and trainings and
• 44:58optimize their research experience?
• 44:59Because This is why they come to us.
• 45:01Some of the other things to
• 45:03highlight here is the cancer student
• 45:04interest group that has launched,
• 45:06including initiative for MD PHD's.
• 45:09You can see the other training
• 45:10for APR ends for residents,
• 45:12something of pride to us,
• 45:13or 25% of our class is URM this year.
• 45:17And of course,
• 45:18the fellowship will be expanding from 8
• 45:20to 10 trainings which also looking ahead.
• 45:24Next slide,
• 45:25so I want to take a moment.
• 45:26First of all,
• 45:27I want to thank you know I couldn't
• 45:29have done this all of the months,
• 45:31and although I'm going to be your Cancer
• 45:33Center director for the next few months,
• 45:35I may not have many more opportunities
• 45:37with the holiday season.
• 45:38I want to take a moment to acknowledge
• 45:40the people who were silent,
• 45:41but helping me every minute,
• 45:43every hour. Lori Pickens, who as you know,
• 45:46is our Senior VP, is is phenomenal.
• 45:49She has always figured out ways to make.
• 45:51As I ran two departments,
• 45:52my life easier and.
• 45:54Really has never made it that even
• 45:56if I called her on a weekend.
• 45:58Never blinked.
• 45:59Think Dan is de Mayo is one of the
• 46:02most understated and thoughtful people,
• 46:04and I pushed him in so much of the
• 46:07research and helping me in all of
• 46:08this and has been an incredible help
• 46:11as our deputy director Margaret,
• 46:13as I mentioned,
• 46:14just came on and was doing two jobs
• 46:16and then I pushed her for a lot of
• 46:18things and she never let it on even
• 46:20though she was new to our role.
• 46:22Obviously there are many other folks.
• 46:23I can't mention them all.
• 46:24I do.
• 46:25One acknowledge Brian Smith and Tisha
• 46:27Johnson for all the help and the CTO office,
• 46:29what they did and what Nancy and
• 46:31Dan Brown and and Keith Church
• 46:33will have done as we have think,
• 46:35thought about the C2 and all the.
• 46:38Things about what a contemporary
• 46:40clinical trials office looks like.
• 46:43Think I want some of the surgeons
• 46:44may be an unlikely.
• 46:46It's known they're probably all
• 46:47in the operating room,
• 46:48but I also want to acknowledge
• 46:49my department they did lose my
• 46:51attention and that's my faculty.
• 46:53Might chiefs who took on many,
• 46:54many other roles for being
• 46:56wonderful citizens.
• 46:57I do love this Cancer Center bell,
• 46:59so look forward to giving my cheeks
• 47:01and my faculty my time and attention.
• 47:04So I want to thank all of the folks
• 47:06we've been really incredible partners,
• 47:08and then I want to end on a note.
• 47:09As we look ahead next slide, please.
• 47:11Of what you know,
• 47:13as we reflect on pause as Eric comes on,
• 47:16I look forward to working with Eric
• 47:18over the next few months to transition.
• 47:19We've already been working together on
• 47:22recruitments etc, so I think you is.
• 47:25He has a big job but he is obviously
• 47:27very experienced and he has a lot of support,
• 47:29but I want to think come back to how
• 47:31you all can think about what you do
• 47:34and how that helps us eaten every day.
• 47:36We are one academic cancer health
• 47:37system we have to think about.
• 47:39Why do we all come here?
• 47:40Whether it's the nurses,
• 47:42the staff.
• 47:43The environment that everyone
• 47:44comes with a calling.
• 47:46You think this was very clear when
• 47:47I was here during the pandemic and I
• 47:50saw our environmental health services
• 47:52and there was an empty hospital.
• 47:54But nursing working in units,
• 47:56but quiet that everybody has
• 47:58a calling health care is hard,
• 48:00but it comes from the heart and
• 48:02we all want to think about why
• 48:03we came to do this job.
• 48:05It's important to acknowledge that there
• 48:07is a lot of heart in doing this work.
• 48:10It's not just all dashboards
• 48:12and data and planning.
• 48:13I think to do this well,
• 48:14of course we need to have
• 48:16what I call connectivity
• 48:17or collaboration.
• 48:18I gave you some examples,
• 48:20but there are times when it
• 48:21doesn't work right and there are
• 48:23times when it works beautifully.
• 48:24It is something we were going to
• 48:26continue to evolve and learn to
• 48:28work across and how we connect,
• 48:31whether it's in the research arena,
• 48:32in the clinical arena, in quality,
• 48:35safety, whatever we do,
• 48:36but we have to do it more nimbly,
• 48:38so we do not make it so hard
• 48:40for each and everyone of us.
• 48:42And then how does it lead to a community?
• 48:45Some of it is internal to
• 48:46us on how we think about us,
• 48:48because all of these seeds
• 48:50lead to appropriate engagement.
• 48:51Why we are happy at work and not happy haha,
• 48:55but why we feel satisfied with their jobs?
• 48:57So community building is all within us.
• 49:00It has to be local at the end of the
• 49:03day it can't come from 8 zoom meeting.
• 49:06It is sometimes sitting and
• 49:08having lunch together.
• 49:09It's shared in the hallway with a smile.
• 49:12How we greet each other.
• 49:13But that community has to
• 49:15come from all of us,
• 49:16whether I see the DeLuca Awards
• 49:17and I saw all the nursing teams
• 49:19hanging out with each other.
• 49:20That's community.
• 49:21And then we also have to think
• 49:24increasingly as the conversation
• 49:25is happening on and whether
• 49:27receive vaccine rollouts or others.
• 49:29How important health equity is
• 49:31in how outcomes are seen,
• 49:33we may do the best science,
• 49:35but at the end of the day that has
• 49:37to be done in the where we live and
• 49:39that's our patience and they may
• 49:41have social determinants of health that may.
• 49:44Make the best treatments.
• 49:45If they can't access them,
• 49:46it's irrelevant,
• 49:47so that is also a community.
• 49:49I want you to think about.
• 49:51So with the next few months I will be here.
• 49:53I will be engaged and but I will
• 49:56also work with Eric.
• 49:57I look forward to welcoming him
• 49:58and having a smooth transition.
• 50:00I want to thank you all for giving
• 50:02me the privilege of being your leader
• 50:04and with that I hope I leave a few
• 50:07minutes for question and answers.
• 50:08So thank you so much.
• 50:21So we can open for questions and it is zoom.
• 50:25It's not a webinar for once,
• 50:26so it's OK to raise your hand and ask
• 50:28a question or put it in the chat.
• 50:34I'm going to leave leadoff
• 50:37Kevin Billingsley here.
• 50:39Just want to say thank you
• 50:42for your incredible service
• 50:44over these past many months.
• 50:47So I can only imagine what has
• 50:50been involved in running the
• 50:52complexities of the Cancer Center and.
• 50:55And the department,
• 50:56and I think that although we have had,
• 51:00we still have challenges in front of us.
• 51:02I think all of us are really
• 51:04excited for the future,
• 51:06and we see the growth and
• 51:08we see the opportunity.
• 51:09And I think it's it's a very
• 51:12bright time for our organization.
• 51:18Thank you Kevin for highlighting
• 51:20because I think if you didn't
• 51:21sense it from my excitement, I think we are.
• 51:24We have a fabulous institution and the
• 51:26best is yet to come and be a great people.
• 51:30NATO this is Lori.
• 51:32I have to echo Cabman and.
• 51:35Since I got here a little
• 51:36over three years ago,
• 51:37you were one of the first people that
• 51:39I came to see and the collaboration
• 51:42that you have had with with us and
• 51:45cancer from day one has been just.
• 51:48Uh, amazing.
• 51:49It's just been fabulous and
• 51:52there's a part of me that has
• 51:53to apologize a little bit for.
• 51:56Trying to get you over here to
• 51:58serve as our interim 'cause
• 51:59it's a part of me that feels
• 52:00guilty at this point as well,
• 52:02but you have just really stepped
• 52:04into this and just been an
• 52:06incredible partner for all of us,
• 52:08and I probably didn't realize quite
• 52:10how much you would be taking on,
• 52:11but I just want to thank you from
• 52:14the bottom of my heart because your
• 52:16partnership has always been so valuable
• 52:18and having you here over the last.
• 52:20I don't know what 6 to 8
• 52:21months working with us like.
• 52:23This has just come.
• 52:24It's just been terrific and
• 52:26and really thank you for me
• 52:27and thank you from all of us.
• 52:29Thank you, Lori.
• 52:41Quiet group, I'm going to give a minute
• 52:43or so if someone wants to ask a question.
• 52:45It's alright Roy. Go ahead. I knew
• 52:48it so thank you. It's been and will
• 52:51continue to work a lot together.
• 52:53Great working with you and especially
• 52:54as we've had to work through
• 52:56the clinical trials together.
• 52:57It's just been.
• 52:58Your leadership has been just enormous.
• 53:00I'll ask now that you've seen
• 53:02the Cancer Center.
• 53:03And as you go back to be chief of surgery,
• 53:06which it sounds like it's a pretty big job.
• 53:09What have you learned?
• 53:10How can we build better
• 53:11multi modality clinics?
• 53:12So one of the things that we really want,
• 53:14I think to increase our care.
• 53:17Our reputation is to really be seeing
• 53:18patients with tumor boards and
• 53:20multimodality way across the system
• 53:21and is wondering what you've gleaned
• 53:23from this experience that you know
• 53:25could help us as we move forward.
• 53:27You know, really, in good
• 53:29question. I think as.
• 53:33First of all, thank you for
• 53:34all the hard work you've done.
• 53:35I think I put surgeon
• 53:36hours with you every day,
• 53:38so thank you for hand bearing with me.
• 53:41I've had a chance to visit
• 53:42some of the care centers.
• 53:43Unfortunately I didn't have a chance
• 53:45to visit each and everyone of them,
• 53:46but I think what struck me is how
• 53:49connected the patients were for their
• 53:52local community and how incredible the
• 53:55service and and the team work was.
• 53:57Think at least my department wasn't
• 53:59as distributed until we came and
• 54:01then some of the folks like Nina
• 54:04Horowitz and others were incredible
• 54:06champions of taking breast care.
• 54:07But I think there's opportunity
• 54:09for us in even.
• 54:11Sites like water,
• 54:12Ferd and Torrington.
• 54:13I think the part that we have to
• 54:15figure out is how do we make it not so.
• 54:20Difficult because it's not
• 54:21efficient for us to put everybody
• 54:23in the clinic at the same time,
• 54:24so I think some of the pieces will be and
• 54:26I kind of put the telehealth piece to me.
• 54:29That is an opportunity around thinking
• 54:32for the specialty cares for some
• 54:34of the care like breast cancer.
• 54:36We may want to think about
• 54:38should breast cancer.
• 54:39All of the services be
• 54:41available at every site.
• 54:42And again this is work.
• 54:43I know Liz is star Herbert is thinking
• 54:46about with the rest of the teams and
• 54:48the Jeremy and and and others but.
• 54:50This is the pieces that we have
• 54:52to think about on the part.
• 54:54Now there are some challenges
• 54:56of thinking about this.
• 54:57Sometimes our teams are
• 54:59multiple employment models.
• 55:01It doesn't mean it's good or bad,
• 55:03we just have to think tactically around.
• 55:05If imaging is not yield
• 55:07medicine but someone else,
• 55:08how do we make sure we're still working
• 55:10as a team and thinking on these systems?
• 55:14The last piece I'm going to
• 55:15tell in this is an opinion,
• 55:16so please,
• 55:17but I do think.
• 55:20That there's still a lot of education
• 55:22that's needed on the importance
• 55:24of multidisciplinary management,
• 55:26not into our patients who are.
• 55:29Ultimately it's their health and not
• 55:32to the physicians, but to our patients.
• 55:35And our primary care doctors,
• 55:36especially in southern Connecticut,
• 55:38where there's a lot of people whose
• 55:40first thought is to go to New York,
• 55:42and in my mind that should never happen.
• 55:45If you were a patient in Connecticut,
• 55:47and you have Yale Cancer Center
• 55:49in your background.
• 55:50They should know all of us,
• 55:52but I can tell you there are many
• 55:54times they don't know all of us
• 55:55and they call me and I answered
• 55:57these phones and I'm like.
• 55:58Well, here's the world's best expert in XYZ,
• 56:02but they are not aware so that
• 56:04education is upon all of us.
• 56:06Every interaction is an educational
• 56:09opportunity and that is what we have
• 56:12to do to educate our communities
• 56:14on what we bring in language
• 56:16that they can understand.
• 56:19And it's easy to explain.
• 56:20So again,
• 56:21that's what I mean by a distributed health
• 56:24system to explain what is whether
• 56:26it's therapeutic importance of giving
• 56:28I MRT radiation, or whether it's
• 56:31proton or whether it's complicated
• 56:33clinical trials or complicated surgery.
• 56:36But there's a huge opportunity and and
• 56:39obviously we will be working with your
• 56:41teams to sort of make that happen.
• 56:44Alright, it's 1258.
• 56:44I want to give people two minutes back.
• 56:47I hope everyone had lunch, but thank you all.
• 56:49You are an amazing group.
• 56:51We are very large.
• 56:52We are strong and I want you to
• 56:55acknowledge yourself and I want to thank
• 56:57each and everyone of you for making this.
• 57:00You know for coming through the
• 57:02pandemic and containing growth.
• 57:03Thank you everybody.
• 57:04Have a great rest of the day.