Smilow Cancer Hospital Town Hall | March 27, 2024

March 28, 2024

Hosted by: Dr. Kevin Billingsley

Topics include: New Clinical Announcements, Workplace Safety, and a presentation on Harnessing the Power of Cellular Therapies.

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00:00Hi folks. I am coming to you
00:03live from just getting off I-95,
00:06so if I seem a little distracted,
00:09please give me your forbearance.
00:13We have a great agenda this evening.
00:16Tracy and I will be giving
00:18our usual clinical updates.
00:20We have a terrific and timely
00:23presentation on Workplace safety
00:25and we will be hearing from our
00:29multidisciplinary team who will be
00:31sharing details about our rapidly
00:34developing multidisciplinary
00:36cellular therapy program.
00:38I'm going to jump right into the
00:41the clinical updates and details and
00:43I'm going to say one of the things
00:47that I am I enjoy most and is most
00:50gratifying is welcoming new faculty
00:53and experts to the Cancer Center.
00:56And I am particularly excited to share
00:59news of the arrival of Doctor Tracy
01:02Battaglia to Smilo and the Cancer Center.
01:08And I can't tell since I'm
01:10driving if Tracy's picture is up,
01:14but I hope that slides up.
01:16Tracy is a is a internist by clinical
01:22background, but she is also a
01:27a cancer care equity expert and
01:30researcher and an expert in
01:33clinical cancer care navigation.
01:36She comes to us from Boston University
01:39and Boston Medical Center where she
01:42was the Director of the Women's Health
01:44Initiative and also the Director of
01:47the Avon Breast Cancer Initiative.
01:50And I think Tracy's arrival is
01:53particularly timely as we have
01:56learned that CMS and major payers
01:59will be supporting reimbursement for
02:03cancer care navigation services.
02:06So I think her leadership and
02:08expertise combined with these
02:10additional resources will be a
02:12unique opportunity for us to augment
02:15these services for our patients.
02:18So I I think all of you will
02:20probably have a chance to meet Doctor
02:23Battaglia as she makes her rounds
02:25and the organization and please
02:28join me in in welcoming her.
02:33The next slide that I can't see
02:36but I think is probably up is
02:40our update on clinical trials.
02:42I think it is a good point in our
02:45history to show that we've really come
02:48through a very significant downturn
02:50in our clinical trials accrual and
02:54we are now on a significant upswing.
02:58And I'd like to give a big shout
03:00out and word of gratitude to Dr.
03:02Ian Crop, Alyssa Gateman and
03:05Adam Roschka who've LED A-Team,
03:08an expanding team of of the clinical
03:12trials staff as well as all of our
03:15investigators and division chiefs who
03:18have deployed A robust portfolio of
03:21trials and we're really putting patients on.
03:25So I think it's something we could
03:27all celebrate and be proud of.
03:32The other thing that I want to take a
03:34minute to, to call out and ask people
03:36to do if they have not already is to
03:40get on Toximity and vote of course for
03:44Smilo and Yale Cancer Center as the
03:47premier cancer treatment center on U.S.
03:50news and world reports.
03:52The Doximity voting is closing very soon.
03:55So I think that window of
03:58opportunity is rapidly closing.
04:00So please take the opportunity.
04:05So with that,
04:06I think I'll pass it over to you, Tracy.
04:11Thank you. So we just wanted
04:13to mention that on March 19th,
04:15we celebrated our certified nurses.
04:17It's it's a national day to celebrate
04:19certified nurses through the
04:21American Nurses Credentialing Center.
04:23And so we have over 200 certified
04:26registered nurses in our Smilo sites
04:29and organization and we have over 30
04:32AP PS with specialty certification.
04:36So those are really great numbers and we
04:38have continued to increase those each year.
04:41So thank you to all the nurses for
04:43all they do and the professionalism
04:46they bring with their certification.
04:48We also just want to mention that and
04:52thank the the cancer registry team.
04:54National Cancer Cancer Registrar
04:57Week is April 8th through the 12th
05:01and this is the team pictured here.
05:04The the registry team really plays
05:08a vital role in the fight against
05:10cancer and their work really helps
05:12to continuously improve the quality
05:13of care we provide to our patients
05:16across the organization.
05:17The cancer data that they collect
05:19helps provide valuable insights
05:21to understand our cancer outcomes
05:24and they play important roles,
05:27sometimes unseen and collecting data
05:29that will impact Cancer Research and
05:31treatment programs for future generations.
05:33So great shout out to the team and if
05:35you see any of them during this week,
05:38please make sure you thank them
05:39for all that they're doing.
05:44We are now gonna turn it over to
05:47Nick Proto and Stephanie McGuire.
05:50We, as in we in Smilo as well
05:53as the organization had a lot
05:56of feedback and comments through
05:58the Glint survey about concerns
06:00related to personal safety,
06:02security and you know,
06:04there's been a number,
06:05there's a lot of events going on
06:07and so the organization is taking
06:09a lot of action in relation to
06:11the concerns with employee safety.
06:13And so thank you Nick and Stephanie
06:15for joining tonight to share some
06:17of the work that you're doing
06:18in this forum.
06:20Thank you, Tracy.
06:21So I'm gonna be speaking on
06:23behalf of myself and Tom Mendillo,
06:25who's the operations Manager who is
06:27tied up at another meeting right now.
06:29I'll be doing the presentation on
06:31security and safety initiatives
06:33that we are currently doing at
06:35Yellow Haven Hospital and has been
06:37ongoing initiatives every year.
06:39And Stephanie's gonna talk about the
06:42electronic physical security infrastructure.
06:43She manages the infrastructure from infant
06:46security to all the cameras and carriers.
06:49Anything that's not people,
06:51Stephanie manages from a security standpoint,
06:54very well versed and educated in
06:57electronic physical technology and is
07:00always looking at bigger and better
07:03ways to secure our institutions.
07:06So if you could progress the
07:07slide for me Stephanie,
07:09so I want to talk to you about
07:11communication and collaboration.
07:13You know,
07:14aside from our patients and visitors
07:17arriving with a high level of anxiety,
07:20there are considerable increases in
07:22behavioral health and substance abuse
07:24patients arriving in our facility.
07:26And they're not just showing
07:27up at our Salem Tunnel,
07:28one floors in Salem Tunnel 5 and Yale
07:31physician Yale's Saint Ganswick Hospital.
07:32They're showing up on all
07:34the patient care units.
07:35They're coming in with medical issues
07:37and then it's escalation and our staff
07:39are getting injured or getting assaulted.
07:42And, you know,
07:42aside from the high level of anxiety,
07:44there are also societal issues
07:45that are going on.
07:47There's the political climate.
07:48There's St.
07:48violence, COVID, the cost of living,
07:51the wars in Gaza, in Ukraine, you know,
07:54mass shootings around the country.
07:56There are a lot of things happening in our
07:58society that are affecting our patients,
08:00our employees and visitors
08:02who are coming in there.
08:03We're seeing a spike in a lot of crime
08:05and we're seeing a spike in a lot of
08:09things that are going on in
08:11and around the hospital.
08:12I want to talk to you about some of
08:13the initiatives that we're doing
08:14and some of the things that we could
08:16all do to keep the institution safe.
08:18I want to talk about rounding,
08:19Tricare system and educational
08:21safety huddles.
08:23We have a we require our officers
08:26to round 6500 rounds per month
08:28on every patient care unit.
08:29That's a documented tract performance
08:32improvement initiative that we require
08:35officers to do every single month.
08:37That gives us an opportunity to
08:39communicate with clinical staff and team
08:41up at our off shift clinical leaders
08:43on the off shift and on weekends.
08:45In addition to that we do the
08:47three tiers of rounding.
08:48The first one is we call direct,
08:50the 2nd is intuitive and the
08:52third is indirect.
08:53The direct rounding deals directly with BRA,
08:55said Rossitool.
08:56If you don't know what it is,
08:58it's those patients who have a
09:00propensity for escalation of violence.
09:03We get a list of those patients twice a day,
09:069:00 in the morning and 9:00 at night.
09:08And those officers who are on
09:10patrol go up to those units and
09:12talk to clinical staff to see
09:14what the patients are doing,
09:15making sure there's no escalation.
09:17And try to be proactive before the
09:20patient does escalate or get violent.
09:22There's the intuitive rounding
09:24and the intuitive rounding
09:25is our victims of violence.
09:27We have numerous victims of violence
09:29here on any given day and it's
09:32community violence with shooting
09:33victims and stabbing victims.
09:35The we have numerous victims of
09:37domestic violence and we also have
09:39issues on our maternity floors
09:41where their risk of injury of a,
09:43I'm sorry, risk of a patient being,
09:45you know,
09:46taken out against the Guardian's best wishes.
09:49And it's usually some kind of
09:52domestic distribute between two
09:53parties responsible for that child.
09:56So the risks are very high in some
09:58of these areas and we make sure
10:00that the indirect rounding and the
10:02intuitive rounding goes up on all
10:04those patient care units every day,
10:06numerous times a day on every shift.
10:09We also do safety huddle talks.
10:11It's a an abbreviated version
10:12of what I'm giving you today.
10:14We go on the patient care units
10:16and we talk to patient to our
10:18employees and clinical staff and we
10:20talk about situational awareness.
10:23We talk about St.
10:24awareness and things that are happening
10:25around the hospital and what we could
10:27do together and want to keep them safe,
10:29to keep our patients safe and to
10:31work with security for reporting
10:33whether they see something that
10:34may be a potential risk for the
10:37hospital or somebody's safety.
10:38The next thing I want to talk about is St.
10:40Outreach,
10:40the Hospital Violence Intervention Program.
10:42These are people in the community
10:44who did not have great pasts with
10:47the law but have done their time and
10:49are now working with the community,
10:51with the police,
10:52with Hospital Protective Services,
10:54with Yale University Police
10:56Department to turn the lives of
10:58children and kids and teenagers
11:00in our communities around and not
11:03have the recidivism of shootings
11:05and victims of violence etcetera.
11:07So when we get victims of violence,
11:09they show up at our emergency
11:11departments and they work with my
11:13team and tell us is it gang related,
11:16is it gang, is it drug related,
11:19is it random act of violence,
11:20is it domestic violence?
11:23So we end up getting the information
11:25and that's important to our emergency
11:27departments so they could provide the
11:30care to that patient without being
11:32hindered by risk of retaliation.
11:35And it also follows up to the
11:37patient care unit where we house or
11:39we treat the patients of violence.
11:41And we have to lock down the patient
11:44care units to make sure staff
11:46are safe and that victim is safe.
11:49The COMSTAT participation in
11:50New Haven Police Department.
11:51I work with the Chief of Police myself,
11:53Tom and Steph.
11:54We meet with the chief every other
11:56Thursday at a COMSTAT meeting.
11:58We also meet with the Yale University
12:00Chief of Police Anthony Campbell
12:02and Bonnar Cease on a regular basis.
12:04Anything that goes on here,
12:06we have open communication.
12:07We're a phone call away and
12:09we talk very frequently.
12:11I want to talk about a workplace
12:12violence tracker in it,
12:13but before I talk about the tractor,
12:14I wanna the tracker.
12:16I wanna tell you about what
12:17actually initiated us to do this.
12:19A number of years ago we had an an employee,
12:22a nurse who was assaulted and
12:26the we took a report,
12:29patient assaulted the nurse.
12:30We took the report.
12:31We called the New Haven Police
12:32Department and the New Haven Police
12:34Department showed up and took the
12:35report and then asked the nurse for her
12:38home address and her home phone number.
12:40And the nurse said I'm not gonna give you
12:42my home address and home phone number.
12:43I'm gonna give you my work
12:44address and work phone number.
12:45And the police said no,
12:47if you don't give me your home
12:48address and home phone number,
12:49we're not documenting it and
12:50we're not gonna affect an arrest.
12:52So they walked away and I came in
12:54the next day and I found out about
12:55it and I called the district manager
12:57and I said what is happening?
12:59Why did this happen?
13:00And he said Nick, it doesn't come from us,
13:02it comes from the chief of police.
13:04So I called the chief and I said
13:06why is this happening?
13:07And he said, Nick, it doesn't come from me,
13:09It's an order from the state's
13:11attorney's office.
13:11So I called the state's attorney and
13:13I asked to meet with him, which I did.
13:15And I said,
13:16why are you making this rule that
13:18people get assaulted in the hospital,
13:20are not being their their,
13:23their crimes are not being recorded and
13:26there's no consequences for the offender.
13:28And he said,
13:28because if they don't give their
13:30home address and home phone number
13:32when the court appearance comes
13:33on and we're looking for that person to
13:35give a statement as to what happened,
13:37we can't reach them because it's occurring
13:39on evenings and nights and the courts
13:41aren't open on evenings and nights.
13:42And this is causing a backlog
13:45in our judicial system.
13:47And I said, well, this is not fair.
13:48I said you gotta overturn that.
13:50And he said absolutely not.
13:52I'm not gonna overturn it.
13:54So I have a friend of mine
13:55who's a judge in Hartford,
13:57from the judge.
13:58And I was talking to him about it and
14:00he connected me with the judge in New Haven.
14:03And I spoke to the judge in his chambers.
14:04And I said when I was a police officer for
14:0720 years in New Haven and I was assaulted,
14:09I never had to give my home address and home
14:11phone number with the risk of retaliation.
14:13I never required firefighters to give it
14:15and neither did I require AMR to give it.
14:18Why are we allowing this for healthcare
14:21workers who work in a world class
14:25hospital giving world class care to
14:27give their home address and home phone
14:29numbers and put their lives at risk?
14:31And he said you make a good point.
14:33I'll let you know in two days.
14:35I'll render a decision.
14:36I'll let you know in two days.
14:38He called me in 2 1/2 hours and overturned
14:40the state's attorney's decision.
14:42And now the police are coming here.
14:44Now when I talk about the collaboration
14:46with the judicial system,
14:47that's what I'm talking about.
14:48And this prompted Tom Mondillo and
14:50myself and Stephanie to put together
14:52something called the Violence Tracker.
14:54And quite simply,
14:55it's a four pronged effect.
14:56It's confidence that our staff
14:58are going to report.
14:59We go up to 100 different patient care
15:03units a couple times a year and we give
15:06safety talks and we encourage our staff.
15:09If you feel threatened,
15:10if you come to work and you feel
15:12threatened if you are assaulted,
15:14if you are groped,
15:15if you're sexually assaulted,
15:17we want to know about it.
15:18You have to call us.
15:19We want to be the conduit
15:21to local law enforcement.
15:22We'll document it and we will be the
15:24conduit to local for law enforcement.
15:26It's accountability for the police
15:28and the judicial system to follow
15:30through with these types of complaints.
15:32It's consequences for the
15:33offender and most importantly,
15:35it's closure for the victimized employee.
15:37We have lieutenants who work every shift.
15:39They find out the status
15:40and disposition of the case.
15:42They meet with our employees and
15:43they let them know what the status
15:45and disposition of the case is.
15:47I tell our employees the
15:48morning safety huddles.
15:49If you go to Home Depot tonight and they
15:51don't have a part to your house and you
15:53kick the person who is not helping you,
15:55chances are you're not leaving Home Depot,
15:57not in handcuffs.
15:58If you go to a restaurant tonight and
16:00they don't give you your meal on time and
16:02you slap the waiter or the waitress,
16:04you're not leaving the restaurant,
16:06not in handcuffs.
16:06So why do you think you could come to
16:09a medical facility and and and slap,
16:11abuse, threaten and assault our staff
16:13and not be held accountable for it?
16:16So we drew a line in the sand
16:18with this violence tracker.
16:19Again, it's the confidence,
16:21the accountability of the consequences
16:23and the closure for each event and
16:26everything is documented and tracked.
16:29I also serve on the Workplace Balance
16:31Risk Assessment Committee and we have
16:33a Joint Commission standard which
16:35we go up and do risk assessments
16:37on every patient care unit and
16:39look at gaps and opportunities.
16:41And Department of Homeland Security,
16:43which is DHS and the FBI are
16:46very close to us.
16:48Department of Homeland Security comes
16:49here every five years and they do a risk
16:52assessment on the entire institution.
16:54They come with a team of people and
16:55they look at gaps and opportunities
16:57and we take that and we make the
16:59department work with Stephanie
17:00McGuire and her team to make the
17:02department more secure and safer.
17:04The FBI is in the city of New Haven,
17:06so it's good to have open
17:08collaboration with them.
17:09They work with us.
17:10We've had we had a bomb threat
17:12going back about 14 months ago where
17:15somebody called them for bomb threats
17:16over a or over a 12 hour period.
17:20We called the Joint Terrorist Task Force.
17:22They sent somebody up here and they
17:26investigated and four weeks ago
17:28that person got 7 years in prison.
17:30We recently had another bomb threat
17:33that happened 3 weeks ago and they're
17:36investigating that right now.
17:37But somebody had called in that
17:39there was a ammonium nitrate bomb
17:41around Yellow Haven Hospital.
17:44And that the person who made the call,
17:47actually,
17:47he actually sent an e-mail to the
17:49mayor of the city of New Haven saying
17:51that he's gonna find me on New Haven
17:53Hospital and that he was going to
17:54shoot at doctors who were leaving the
17:57facility because they killed his daughter.
17:59So we have the FBI working on this and we're
18:02actually tracking this through the dark web.
18:04So more to come on that,
18:06but those are,
18:07those are that's the
18:08collaboration that we have.
18:09This is a communication we have with staff.
18:12This is the ongoing communication
18:13we have with the community,
18:14with local law enforcement,
18:16with projects that are going on
18:18within the hospital which includes
18:20risk assessments and being part of
18:22workplace violence committee on a
18:24hospital and a health care setting.
18:27Next slide please Stephanie.
18:30So this gives you a an idea of the
18:33breadth and scope of what we do.
18:35We are at at we currently have
18:38presence at 10 offsite locations.
18:41However we're we're with the technology
18:44that the security technology
18:47Stephanie currently operates at
18:49over 104 offsite locations for
18:51approximately 10.8 million square feet,
18:53thousands of people into
18:55our facilities every day.
18:56We have numerous victims of violence.
18:59Stephanie, I don't know if you want to
19:00talk about the electronic infrastructure
19:02at these locations and what we have
19:04here and what we're trying to do to
19:06make this the institution safer.
19:07If you want to talk about the
19:09technology now and then I'll get
19:10into the last part of the slides.
19:13Sure. Thanks, Nick.
19:14And apologies for not being on camera.
19:16I'm not feeling my best.
19:17I'm like minutes, hours,
19:19days away from giving birth so
19:22I am home resting and again just
19:25not feeling or looking my best.
19:26So apologies for not being on camera.
19:29But again Nick,
19:30thanks for for kicking this over.
19:32As he said,
19:33we have a very robust physical
19:36security security technology system
19:39that's not only located
19:41within the four walls of each campus,
19:43but we have a heavy presence
19:45in our ambulatory sites too.
19:46So for those of you that frequent
19:49the off site Smilo centers,
19:52you know that we have panic
19:54devices and we have cameras and we
19:56have card readers to keep those
19:58satellite locations safe as well.
20:00So we have over 1700 cameras,
20:04we have over 2800 card readers we have.
20:08Over 2500 links, panic devices,
20:10which are the panic devices that
20:11are located on your keyboards.
20:13As Nick mentioned before,
20:15we have a very robust infant security
20:17system which we actually just
20:19transitioned over as I'm noticing
20:21we're we're looking at the PowerPoint.
20:23We have transitioned from a Stanley
20:26product which was formerly called Hugs
20:28to a new program by Guard RFID called
20:31Top Guard that was completed about
20:33two weeks ago because we do have,
20:36you know,
20:36that's one of our most precious
20:38populations with over 6000 babies birthed
20:42annually at the York Street campus.
20:45We have over 100 emergency blue
20:47phones which I'll get into talking
20:49about some initiatives regarding blue
20:51phones on the exterior in a moment.
20:53We have close to 3000 alerts users,
20:58which we will also talk about
21:00in a future slide,
21:01which is the mobile panic device system.
21:04And dispatch receives or can receive
21:07up to 10,000 alarms that are monitored.
21:13So between panic alarms,
21:16between fire alarms,
21:18environmental alarms,
21:19pharmacy alarms,
21:19there's quite a bit of action that comes
21:22in through both of our dispatch centers.
21:27Thank you, Steph.
21:27If you go to the next slide, please?
21:30Sure. So I'd like to give you the
21:34breadth and scope of what we do.
21:35This is sort of like an eye
21:37chart and I you know it.
21:38You know we monitor,
21:39we have performance improvement initiatives
21:41that we monitor on a daily basis,
21:43almost on an hourly basis and
21:45we calculate them by the year.
21:47The the calls between here and St.
21:49Rayfield Campus, we average about
21:51150,000 calls for service a year.
21:54I talked about the building checks that
21:56we do, the rounding up on the floors.
21:58We average anywhere between 6000
22:01and 7500 rounds pounds per month,
22:03which is required as performance
22:05improvement initiative.
22:06I want to take your line,
22:07your eyes to line number four.
22:10It says number of patient interactions.
22:12Those aren't. Those aren't patient problems.
22:14Those are interactions.
22:15Those are.
22:16They gives us an opportunity to make
22:20that right when we approach a patient
22:23and they're highly escalated or highly,
22:25you know,
22:26they're 1° above boiling point.
22:28It's up to us to deescalate that or
22:31redirect that patient to comply with the
22:34medical care that they're going to receive.
22:37We do about of the redirects we
22:42we interact with about 32,500 /
22:45a thirteen month period.
22:46If you look at line number six,
22:48look at the number of those patients
22:50that end up in restraints 19101,
22:53that's less than 5% of the patients that
22:57we interact with that end up in clinical
22:59restraints at the request of a physician.
23:02So we hire retired police officers to patrol
23:05and to respond to these types of calls.
23:08They bring a skill set,
23:10they bring a discipline and they bring
23:12a certain level of communication,
23:14problem solving and critical thinking
23:17to every patient interaction.
23:18Most of our patient interactions are in
23:21the adult emergency departments and our
23:23behavioral health and our YPH buildings.
23:25They know us by name and there
23:27are many patients who call us on
23:29a first name basis and we have
23:31a good rapport with them.
23:32We also have opportunities to
23:34empower clinical staff and they
23:36have opportunities to empower us to
23:38sometimes step back from a patient
23:40'cause they may be escalating
23:42and we tell them the same thing.
23:44You may wanna step back.
23:45This is gonna escalate.
23:46We don't want you to get hurt.
23:47So these are the types.
23:48We put a lot of emphasis on the number
23:50of patient interactions and the number
23:52of patient restraints to show our successes.
23:55But look in line #7 where it has
23:57patient number of patient safety checks.
23:59You know how difficult it is to
24:01put your hands on a patient who
24:03has a mental illness or behavior,
24:05health issue or substance abuse issue
24:07or may have Alzheimer's or the onset
24:10of of dementia to put your hands on
24:12them to check for weapons or drugs.
24:14We do that 16,000 times over the course
24:18of a year and very rarely does that escalate.
24:22So you have to have really
24:23good communication skills and
24:25problem solving techniques in order
24:26to put your hands on somebody,
24:28search them and get them to comply
24:30so the clinical staff could do the
24:32care that is provided they they
24:34need to provide for that staff.
24:36So these are some of the things that
24:37we do and these are the numbers.
24:38Again, it's just an eye chart,
24:39but it's something that we track and
24:41we report out on a monthly basis and
24:43something that we hold and as a P I,
24:45I and hold all our officers accountable for.
24:48Next slide please, Steph.
24:54So New Haven crime statistics, again,
24:57you know, why is this important to us?
24:59You know, I get emails from the chief
25:02almost on a daily basis from the Yale
25:04University and Yale New even hospital.
25:06While things that are
25:07going on around the city,
25:08there are a lot of protests based on the
25:10wars that are going on around the country.
25:13You know, for or against certain countries.
25:15There are a lot of protests
25:17on the New Haven Green,
25:18not a concern to Yellow Haven Hospital.
25:21We are not the focal point.
25:22However, we can become the focal point.
25:25If somebody gets hurt at once,
25:27there's any kind of a risk involved.
25:30Once there's an assault,
25:32once there's somebody that at that
25:34location that needs medical attention,
25:36that shows up at our front door and
25:38our emergency department and that will
25:40bring family and friends and protesters
25:43to the front doors of our institution.
25:45It will also bring media
25:46and a police presence.
25:48So although I'm not concerned about
25:50the protests that are going on,
25:52you know,
25:53anything that has a potential for violence
25:55that may show up at our front doors.
25:56It's important that we're in close
25:58communication with the chief at both
26:00the hospital and the university.
26:02I wanna know about the about the confirmed
26:04shots that are fired every day or every year.
26:07I wanna get the rolling numbers.
26:09I wanna know about the aggravated assaults,
26:11the assault with the firearm,
26:12the the robberies,
26:14the murder victims.
26:15These patients show up at our front doors.
26:18They bring friends and sometimes
26:20they bring foes who come in here
26:22and want to try to do harm to
26:24that patient or patient's family.
26:27I know a big thing on the glint
26:29was the thefts from or of autos.
26:31This is something that's been
26:33going on nationwide.
26:34We've seen an increase and thefts from
26:38autos from our parking lots and garages.
26:40We're not exempt from any other
26:42city or town or any other parking
26:44lot or garage in the city.
26:45New Haven.
26:45I know everyone's seen an uptick in this.
26:47It's sort of started levelling out
26:50but we have put New Haven police,
26:53New Haven Parking Authority because
26:55Yale New Haven Hospital does not
26:56own any of our lots and garages.
26:58So we encourage the parking authority to
27:00round and put personnel in these areas
27:02and we also encourage our officers to
27:04go there especially during peak times
27:06to show a presence in the lots and
27:08garages to make sure that our staff,
27:11our patients and visitors
27:12are safe on the lot.
27:14They are some of these
27:15are opportunistic crimes.
27:16We just arrested 214 year old kids
27:19today in our two house street garage.
27:21Were checking door handles of cars
27:24walking around and they're also
27:26involved in other things that
27:28they admitted to today as well.
27:29But just so you know,
27:30do not leave anything of value in your car.
27:33We are in a high end call for
27:35police service
27:35area. We are, we are in a great community.
27:38I got to tell you, I work in the
27:40streets in New Haven for 20 years.
27:4295% of this community are great people
27:45but we have 5% are out for all the wrong
27:47things and all the wrong reasons and that's
27:49the reason why we got to lock the doors.
27:50Be careful walking to
27:51and from from your cars.
27:53Take advantage of shuttles of
27:55security escorts of police escorts
27:57from Yale University.
27:59Take advantage if you're going to walk.
28:00It's getting lighter later now,
28:02so take advantage.
28:02If you're going to walk to your vehicle,
28:04walk in groups, safety and numbers.
28:07I know, I know Yale University
28:09has an app for your phone.
28:11We also have one for Yale New
28:13Haven Hospital for our employees.
28:14It's called Alert CC app.
28:17That's definitely talking about in a minute,
28:19but you need to take precautions.
28:21You can be viewed as a target,
28:23but you do not have to be a victim,
28:25so take precaution.
28:26We need the eyes and ears of
28:28every one of our employees to
28:29keep our institutions safe.
28:31There was an incident about about two
28:34months ago where one where one of our
28:36employees parked their vehicle at a
28:37lot on the office in Rayfield Campus
28:39and as she was exiting her vehicle
28:41she was approached by a homeless woman
28:43who asked for her the keys for her car.
28:46When she refused to give the keys over to
28:49this woman they engaged in a struggle.
28:51The woman while the woman felt she
28:55was losing the struggle she reached in
28:56her pocket and she pulled out a knife.
28:58Our employees started to run away from
29:00the woman and the woman threw the knife
29:03that the employee thankfully missed her.
29:04But please think about this.
29:06Do not take any unnecessary if somebody
29:09asks for your purse or somebody asks
29:11for your computer keys to your car,
29:13please give them up.
29:15Your life is not worth a setting your
29:17your set of keys is not worth your life.
29:19So please turn them over.
29:21It's not worth it.
29:22They're desperate people out
29:24there taking desperate measures.
29:25And you know, we don't want to see,
29:27you know,
29:28one of the unthinkables happen to any
29:30of our employees from the the hospital
29:32or university or anybody for that matter.
29:34So please,
29:35if they're if you're asked to give something
29:37starting over and it could save your life,
29:39relinquish whatever you have and and please,
29:42it's not worth your life.
29:44Give it up and and and move on.
29:46Call the police and chances are very
29:48good it's on a camera somewhere.
29:50We'll be able to capture that.
29:52Next slide, please.
29:55So Stephanie,
29:55you want to talk about the alerts and links?
29:59Sure. So two pieces of technology
30:01that I wanted to review with you
30:03today and then we'll also get into
30:05some perspective technology and
30:07projects that we're working on.
30:09But these are two that are
30:10available to you right now.
30:13Sorry, it's Tracy. I just want to,
30:15I'm sorry, but like we're if you guys
30:18could try and just wrap up in the next
30:195 minutes or so because we do have
30:21another presentation, I apologize.
30:23Yes, no problem.
30:24So Alerts is a is an app that is
30:28available to all Yale New Haven
30:30Hospital employees right now.
30:32So Alerts you say now is a smartphone app.
30:35You can sign up through Infor
30:37under Quick Links.
30:38You go through a credentialing
30:40process and then you can download
30:42the app from the App Store.
30:44Basically there's three main features
30:47that we leverage with this app.
30:48Users can send a a photo or a video and
30:51it gets issued directly to Protective
30:53Services and you can text back and forth.
30:56We have canned reports under this
30:59kind of like a share problem which
31:03is suspicious person vehicle.
31:05You know you see the same car
31:08in the parking garage for five
31:10weeks and it's filled with dust.
31:11You can send a photo and and
31:13we'll check it out through to,
31:15you know,
31:16there's pan handlers in the garage
31:18or you see kids hitting door handles
31:20and you get something on video.
31:22You can share that with us.
31:25Two of the the more important features
31:27I would say is you can directly
31:30dial 911 through the app and the
31:32credentials that you sign in with.
31:34So we know Nick Proto just dialed 911.
31:37We have his telephone number because
31:38he signed up with that and we can
31:41follow up with him from the hospital
31:43perspective to make sure that our
31:45employee is OK and also file a report.
31:47And then you can also hit a panic button,
31:50which is not,
31:51does not go to 911 comes to us directly
31:54and we can follow up with you as well.
31:56So all of these features are are 24/7 365.
31:59As a Yale New Haven employee,
32:01you can use it on or off site.
32:03So whether you're working in
32:05New Haven or an ambulatory site
32:07or you're not working at all,
32:08if there's something happening
32:10in your community and you cannot
32:12safely call 911 and you feel
32:14like you need to be discreet,
32:16you can contact us and we can
32:18call the local PD on your behalf.
32:20So again,
32:20you can sign up through through
32:22info and I can provide more
32:24information and then links.
32:25We also talked about earlier
32:26on in the presentation,
32:27which is the computer keyboard panic
32:30system where if if you have it,
32:33get familiar where you can hit F1 and F-12.
32:36They're stickers about both of those
32:38what were referred to as hotkeys.
32:40If you're in a situation where you
32:43feel like behavior is escalating,
32:45you can discreetly hit both of
32:46those buttons at the same time and
32:49security is notified and we will
32:50call you because one dispatcher is
32:53calling to get more information.
32:54We're we're also dispatching an
32:57officer or group of officers to your
33:00area to help you in that situation.
33:02Quickly,
33:03I'll share with you that there
33:04are some other initiatives that
33:06we're currently working on under
33:08the executive sponsorship of Ann
33:10Diamond from Bridgeport Hospital.
33:12She gives a proof for Yale
33:13New Haven to get
33:14more robust infrastructure outside,
33:16which we're referring to as
33:17the safe walkway initiative.
33:18So as Nick discusses, you know crime
33:21in the community and parking lot crime.
33:23You will soon see more blue phones
33:26and more cameras and increase
33:28lighting between both campuses,
33:30especially as summer months are approaching.
33:31We know that folks like to walk
33:33versus utilizing the shuttle service.
33:35We will always say if you could wait
33:36for the shuttle, please take it.
33:38But in the event that you don't,
33:40we felt it was important to increase
33:43some technology across the way between
33:45both campuses and the parking lots.
33:48So that was something that
33:49was approved as well.
33:51As you know,
33:51we talked about Elerts being the current app.
33:54Everbridge is our current
33:56mass notification system.
33:57And Everbridge did come up with
33:59a very similar app as Elerts
34:01called Safety Connection.
34:02So we did receive funding for that.
34:04It has all of these features plus a few more,
34:08so it's definitely more robust.
34:10And with that they're allowing us
34:13to pilot 50 wearable panic devices
34:16that we will start in the home
34:19health Hospice region that will have
34:21cellular enabled chips in them.
34:23So you know rather than having
34:25to rely on the cell phone app,
34:27you can utilize this wearable
34:29badge and it will work the same
34:32way as it goes back to dispatch.
34:34So that I know that has been a hot topic
34:36with home health and B and A services.
34:38You know unfortunately we lost that
34:41nurse in Connecticut in the fall.
34:42So those are some other things that
34:44we're currently working on right now.
34:48Thank you, Stephanie and and Tracy I will,
34:51I will wrap it up with just
34:52a couple more comments.
34:54So if you have not seen this video,
34:56this is a called active
34:57shooter life threatening event.
34:58It's on in four.
34:59Please take a look at it.
35:01These horrific events are
35:02happening all over the country.
35:03It doesn't matter who you are,
35:04where you are, where you go,
35:05where you socialize, where you work.
35:07These coward events are happening everywhere.
35:11Please know, you know the concept of
35:14run height fight is still very active.
35:16Know to call 911 or 155
35:18wherever you're located.
35:19Run height fight is critical and
35:22know that there's going to be a
35:24very robust police and Protective
35:26Services response to isolate,
35:28contain and neutralize that
35:29threat as quick as possible.
35:31It will be a sad day in this hospital.
35:33Something like this happens,
35:34but we're taking every precaution,
35:36working with every department to keep the
35:38institution as safe as we possibly can.
35:40Look at this video.
35:41It's not a bad idea.
35:43And finally,
35:44and we could send this out to everyone,
35:46I think we send out safety tips twice a year.
35:50And these are just, you know,
35:51be aware of your surroundings.
35:52If you're confronted by an
35:54individual who's threatening,
35:55demanding,
35:55give over your possessions so you
35:57could read these and post them in your
36:00areas and remind staff during your huddles,
36:02during your safety talks,
36:03please remind staff of these things.
36:05It's a,
36:06it's a good reminder,
36:07you know every time you come to work,
36:09every time you leave and also at
36:10home with your families as well.
36:12So Tracy,
36:12I know we're out of time,
36:14but I just want to thank you for
36:16the opportunity you and Renee for
36:17putting this together and I want
36:19to thank everyone for listening
36:20and we are always here to support
36:22our staff and anything we could do,
36:24we look forward to working with you.
36:26Great,
36:27Nick and Stephanie, I appreciate it.
36:28Two questions that we'll just
36:30touch on quickly is will the
36:33return of metal detectors.
36:34I know we piloted metal detectors
36:36and we have Ellian asking if
36:39that's going to be implemented.
36:42We are working right now with Ann Diamond,
36:44who's our executive sponsor and we're
36:46putting together a business case.
36:48So early to determine whether or
36:49not that's going to come to fruition
36:51or not, but it's in process,
36:54right. And then the other one
36:55was around who makes the decision
36:57to search a patient and do we
36:59get patients consent for that.
37:02We search patients who have behavioral
37:04health, mental health issues and
37:06substance abuse issues for their safety
37:08and the safety of staff and that's
37:10at the request of clinical staff.
37:15Thank you both very much.
37:17We're now, we're now going to
37:19turn it over to the to the Stewart
37:21Seropian and his team who will
37:23talk about cellular therapies.
37:33Thanks. Can you hear me OK?
37:40Yes, we can
37:45just share my screen here.
37:51So I'm, I'm going
37:53to introduce the program I think quickly
37:55because I I want to give time for our
37:58our other speakers to tell you about
38:01our our recent fact accreditation.
38:03That'll be Alex Stormala, Program Manager.
38:06And then Doctor Sufi's going to talk
38:09about our our cell therapy products
38:13for hemologic malignancies and then
38:15Mike Kurwitz is going to tell us about
38:19cell therapy in solid tumors. So
38:25the the transplant and cell therapy program's
38:28the only program in Connecticut and it's
38:31been in existence couple of decades.
38:33So we do stem cell transplants of
38:36course and then more recently CAR T
38:39cell and other cell therapies and are
38:42now getting into the business of gene
38:44therapy for some hematologic disorders.
38:49So there's a lot of planning going
38:51on for new cell therapy products
38:54for sickle cell disease,
38:56thalassemia and a number of
38:59non malignant indications,
39:01rheumatologic diseases.
39:02So it's a pretty exciting time
39:05in the cell therapy field.
39:08The program's been around since the 90s.
39:11The adult program started then
39:13and then the pediatric program
39:15in its current form in 2011.
39:18The CAR T program is relatively young.
39:21It's now on its fifth year and he's just
39:25the beauty of our our program volumes
39:29and you can see on the right side there,
39:32we do about 200 procedures a year and
39:35the growing field is the CAR T cells.
39:38It was a little bit of a low
39:40with COVID a few years ago,
39:41but we're really quite busy with all
39:44these procedures and I think with time
39:46we'll see more of the cell therapies,
39:49perhaps less of some of the
39:53transplant procedures.
39:54So Harrison and Mike have to
39:57get a go over the product.
39:59So I'm not going to belabour this.
40:02There there are CAR T that are
40:04FDA approved for blood cancers
40:07and now there's tumor infiltrating
40:09lymphocytes for Melanoma.
40:10Down at the bottom you can see
40:13that there are a number of CAR T
40:17in development for non malignant
40:19diseases and as the the content
40:22experts for these types of therapies
40:24we will be involved in helping our
40:27colleagues in medicine try and develop
40:29these sorts of therapies as well.
40:31A number of gene therapies are
40:34are coming forward for inherited
40:36metabolic diseases as well.
40:38These are quite rare.
40:42So the program is a big program,
40:44there's a lot of departments involved
40:47and I'm going to show you pictures of
40:50our our team here as we go through this.
40:53So a pheresis where stem cells
40:55are are collected.
40:56That program is run by Chris Tormey and Alex.
41:01Cell processing is where cells
41:03go to be evaluated, frozen,
41:05thought out and delivered to our patients.
41:08This takes a lot of expertise.
41:10This is our cell processing team.
41:12They receive cells from the registry.
41:16Of course,
41:16there's a ton of providers on
41:19the adult and pediatric side,
41:22a lot of coordination, a lot of nursing.
41:24I can't put every picture of
41:27everybody in the program,
41:29but he's a bunch.
41:30The coordinators in particular are
41:33really what the sort of the the
41:35engine that keeps our programs going.
41:37We have great data management and
41:41pharmacy support and we have a very
41:44robust quality management program and
41:46this is now headed up by Lori Crouch
41:49and Alex is our program manager,
41:52really gets everything together
41:56for the entire program.
41:59All the people you just saw really
42:01she keeps keeps us afloat here.
42:03And I'm going to hand it over to Alex
42:06to tell us about our recent fact
42:10re accreditation for a few slides.
42:15Hi everyone. So, yes,
42:16I'm going to talk a little bit
42:19about our factor creation as it's
42:21an important part of the program.
42:23So FACT is the foundation for
42:26accretation of cellular therapies.
42:27It was a Co founded in 1996 by the
42:31International Society for Cell and Gene
42:34Therapies and the American Society for
42:37Transplantation and Cellular Therapy.
42:39So FACT establishes standard for
42:41high quality medical and laboratory
42:44practice in cell therapies.
42:46So that includes, oh, sorry,
42:49can you hear me? Yeah. OK.
42:53That includes auto and auto stem
42:56cell transplant and CAR T infusion.
42:58It will also include the tail and the gene
43:02therapies that includes also commercial
43:05product but also research product.
43:07The standards consist of clinical
43:10program requirement that go from
43:12nursing to provider training,
43:14specific SOP cell collection requirements
43:18such as cell product storage,
43:20temperature,
43:20humidity and cell processing
43:22requirements like safe handling
43:25and processing of the product.
43:27So the fact that creation is
43:29so important for our program
43:30because it elevates our position
43:32as a quality organization,
43:37it informs patient health insurance
43:39companies and government that our
43:41organization is dedicated to excellence
43:43in patient care and lab services
43:46and it's also in some cases required
43:48for patient care reimbursement
43:50from some government agencies
43:51and health insurance companies.
43:56Next slide please.
44:04So this is a quick road map to show
44:07how long it it took to get to the
44:10accretation which we should receive soon.
44:13It all started in June 2022.
44:15We do file a compliance application which
44:18we did in August states review by fact.
44:21They asked us For more information and
44:23they finally assembled their team in
44:25September of 2023 with the inspection
44:28that occurred in November of 2023.
44:30They extend a report that goes out for
44:33fact which was reviewed in December and
44:35we received more question in February.
44:38We just submitted our responses and now
44:41we are waiting for our accreditation.
44:44So next slide.
44:46So this is a quick step shot of all
44:49the department and units that are
44:52participating in this fact accreditation.
44:54And I'm not going over everything,
44:57but there's many nursing units
45:00that are involved in patient,
45:02outpatient, the research team,
45:06yes, the West Pavilion,
45:10ORICUSEDS and really any area where
45:12herself the reputation may go could
45:14potentially be visited by fact
45:17and we'll have to work with us on
45:19the accreditation and next slide.
45:24So this is just a slide of the team
45:28working and under fact inspection and I
45:31just wanted to have that to say just a
45:34huge thank you to everybody involved.
45:36The inspection was a great success and
45:38it's because of you all. So thank you.
45:44OK, thanks Alex. We, we, in fact,
45:47I think had our best fact
45:50inspection in 20 years,
45:53really due to the work of
45:55all the people you see here.
45:57All right, we're going to turn
45:58it over to Irisa Sufi.
46:00She is an associate professor
46:01in our program and Clinical
46:03Director of our CAR T program.
46:05She's going to tell you about
46:09hematologic malignancy.
46:10So I'll stop sharing.
46:14Thanks, Stewart.
46:28So I've been leading the the cell therapy
46:33clinical program for heme malignancies
46:36and we are at a very exciting time in
46:40cell therapy for heme malignancies.
46:44As you can see here,
46:45we have 6 commercial products that were
46:48approved in the last several years and
46:51they have been approved across several
46:53different hematologic malignancies.
46:56Initially,
46:56the first approvals came in B cell,
46:59childhood B cell ALL and Diffuse
47:02large B cell lymphoma.
47:04The therapies were initially studied
47:06in the third line setting for high
47:09grade B cell lymphomas and subsequent
47:11to that they were moved to the
47:13second line for high risk patients.
47:15So we have now two products,
47:18Oxycaptogen and Lysocaptogen that are
47:20approved in the second line setting
47:23for patients who have aggressive
47:25diseases like primary refractory
47:26large cell lymphomas or large cell
47:29lymphomas that relapse within 12
47:31months of their upfront therapy.
47:33And these studies in the second line were
47:37actually compared to stem cell transplant.
47:40And as I'll show you in the next slide,
47:42there's been a significant improvement
47:44in both progression free and overall
47:46survival with these cellular therapies
47:48for aggressive lymphomas in patients who
47:51previously had very limited life expectancy.
47:55And subsequent to that,
47:56we now have approvals in mantle cell
47:59lymphoma after one line of therapy
48:01as well as third line for relapsed
48:04and refractory follicular lymphoma.
48:06And then finally,
48:07we have two new products that were more
48:11recently approved in multiple myeloma.
48:13So those were Ida,
48:15Captogen, occlusanal,
48:16siltacaptogen,
48:17Autoluso that have a different target than
48:21the CD 19 target in the B cell lymphomas.
48:24So the target in multiple myeloma is the
48:27BCMA and they have both been approved
48:30in the 4th and plus line setting.
48:32So these were patients that
48:34were very heavily pretreated.
48:35They had had exposure and
48:38resistance to multiple therapies
48:41including immunomodulating agents,
48:42proteasome inhibitors and monoclonal
48:45antibodies targeting CD38.
48:49And now we're waiting to hear from
48:51the FDA regarding even approvals
48:54in earlier line settings.
48:56The in just in March of this year
48:58actually the FD as Oncologic Drug
49:01Advisory Committee has voted in
49:03favour of both of these products
49:05based on a benefit risk profile
49:07analysis for earlier lines.
49:09So myeloma between one or three
49:13lines of therapy based on two
49:16large phase three studies,
49:17the KARMA 3 and Cartitude 4.
49:20So we're waiting to hear on those
49:22approvals for earlier lines of
49:24therapy and multiple myeloma.
49:26And we now as of this publication in New
49:29England Journal of Medicine just last year,
49:32we have randomized phase three data
49:35confirming overall survival advantage
49:37of chimeric antigen receptor cell
49:40therapy in the second line setting
49:42compared to stem cell transplant.
49:44So for for high risk patients this has
49:47already replaced at all of the stem cell
49:49transplant and has a survival benefit.
49:52So these therapies are not investigational,
49:55investigational.
49:55They are FDA approved and they
49:58have a very good track record
50:02with very good outcomes.
50:04So now I'm going to shift gears
50:06to the our research portfolio,
50:08which we have managed in parallel to
50:12all of these Commercial
50:146 commercial approvals.
50:15And with our clinical trial portfolio,
50:19we're trying to target populations that
50:23do not necessarily have an approved
50:27FDA product that we can administer
50:30or in cases where we think they might
50:33benefit from enrollment in a clinical
50:36trial because of maybe high risk
50:38features of their disease or patients
50:40who may have failed and progressed
50:43after upfront cortisol therapy with
50:46a commercially approved products.
50:48So my area is lymphoma here in
50:52blue and we have two very exciting
50:55clinical trials that are phase
50:57two multi institutional.
50:59One of the trials is studying by
51:02a specific Corti cell therapy.
51:04So instead of just targeting
51:06the CD 19 antigen,
51:08the cells target both CD19 and
51:11CD20 with the goal of decreasing
51:15the risk of resistance.
51:17And then now the study has an open arm
51:22for patients with primary CNS lymphoma
51:24and secondary CNS lymphoma that that
51:27who have failed a first line therapy.
51:30And so these patients as you probably
51:33all know have very limited options.
51:36So we're very excited about the
51:38opening of this arm on this study.
51:41And then for patients who
51:43progress after CD19 CAR,
51:45we have a very exciting phase two
51:48study with a new target which is CD 22.
51:52There's already very good phase one
51:54data with CD22 directed autologous CAR T
51:59cells in patients who have had CD19 cars.
52:03And based on that very promising
52:05phase one data,
52:06we have moved this to the second
52:09to the second phase and are
52:12investigating it at Yale as well.
52:15And then for multiple myeloma,
52:17Dr.,
52:18Barr is leading all of our cell
52:22therapy clinical trials and she
52:24has several both in the upfront
52:27and in the relapse setting.
52:29For example,
52:30here we have Cortitut 5 and this is
52:33a phase three study that's bringing
52:35cortisol therapy to the front line.
52:37So multiple myeloma patients who
52:39are not planned for immediate
52:41transplant and instead of getting
52:44their initial induction with VRD
52:46and going on prolonged maintenance
52:48with Lenalidomide and Revlimid,
52:51they have the chance to go onto a
52:54cortisol therapy with Silta Cell
52:56which is a one time therapy.
52:58And hopefully they can come off
53:00treatment and be monitored rather
53:03than remain on sort of indefinite
53:06maintenance therapy until progression.
53:09And then Dr. Gauda and Dr.
53:12Seropian are involved in the leukemia
53:14cellular therapy investigations
53:16and and we have several exciting
53:19phase one trials in the leukemia
53:21area as well for patients who
53:24are candidates for transplant.
53:26And then we have several studies
53:29in the pipeline.
53:30And I just wanted to highlight here
53:33a couple of studies that are also
53:37dual targeting antigens targeting
53:39both BCMA and GPRC 5D because in
53:43multiple myeloma now we're already
53:45getting patients who have progressed
53:48after antibody treatments that
53:50are already targeting BCMA.
53:52And so it's an exciting time for the
53:54patients to be able to participate in
53:57these studies that are dual targeting.
54:00And we are also taking patients
54:04who have high risk disease
54:06with certain genomic abnormalities and
54:09taking those patients that relapse
54:11within 12 months of their initial therapy
54:15including transplant and then enrolling
54:17them in these Corti trials as well.
54:20So if you do have patients with either
54:24early relapsed high grade lymphoma within
54:2712 months of their initial therapy or
54:31patients with multiple myeloma with
54:33high risk features who who also may
54:36have progressed within 12 months of
54:39their therapy or who have already
54:41had BCMA exposure and progressed,
54:43it's would be a good time for our
54:46team to evaluate them.
54:48And then finally as as Alex mentioned,
54:51this is indeed the multidisciplinary
54:53team effort.
54:53You can see here that the program
54:56does not function as a whole without
54:59each of these individual pieces.
55:01And we are also in very close
55:05collaboration with oncologists
55:06throughout the state who are both
55:09part of the SMILO network or outside
55:12of the network who do refer patients
55:15to us for cellular therapy.
55:16And we remain in close contact
55:19regarding bridging treatment while
55:21we can manufacture the cellular
55:23therapy products.
55:24And so with that,
55:27I am going to stop sharing and
55:29leave the rest of MIC.
55:34I think we're at the top of the hour here.
55:36I don't know if people are still on.
55:38Should I keep going?
55:39Yeah, lots of people are on.
55:40There's 88 people listening. So,
55:43OK, so I'll try to be brief.
55:47Are you guys seeing it?
55:48There we go. All right.
55:51So on the on on the solid side,
55:53we're also doing cell therapies
55:55just for very quickly.
55:57I just wanted to sort
55:58of give a sense of what,
56:00what it is for a patient to
56:01go through these therapies.
56:02They're pretty involved in that whether
56:04it's something called till therapy,
56:07which is tumor infiltrating lymphocyte
56:08therapy or whether it's CAR T or
56:10an engineered type cell therapy.
56:12You know you have to either take out
56:14a tumor or take out someone's cells,
56:16those cells and then and then T
56:18cells are are isolated from whatever
56:20you take out and then those are
56:23grown up in vitro for like a month.
56:25You know that there there are various
56:27times usually it's anywhere between
56:283 weeks and in fact in one trial
56:30it takes four months to make the
56:32product that you're going to make.
56:33And some of them are just growing up
56:35cells and making them very active
56:36and some of them are growing up cells
56:38and transfecting in adna construct
56:39to make some sort of protein that
56:43results in targeting the tumor.
56:46And so for patients,
56:47it's you know having something
56:49done to take T cells out,
56:51waiting for them and then right
56:53before they actually get the
56:54T cells put back into them,
56:56they have to get lymphodepletion,
56:57they have to get a chemotherapy,
56:58a pretty intense chemotherapy so
57:00that their body is ready for this.
57:02And for lack of time,
57:03I'm not going to go into it
57:04in too much more detail,
57:05but just a sense of what we have open
57:08right now in solid tumor cell therapies,
57:11we have all the ones in blue are open.
57:13So we have four different cell therapies
57:16open right now and you can see the
57:18diseases that they're covering.
57:19So at the moment we have things for
57:22smoking related non small cell Melanoma.
57:24We also have four other subsets
57:26of of non small cell and triple
57:28negative breast cancer and these
57:30are ones that express ROAR ONE.
57:33These are there's a CAR T trial
57:35and ROAR one is expressed about 40%
57:38of non small cell and about 60%
57:40of triple negative breast cancer.
57:41And we also have something called
57:43TCR TS sort of a variation on this
57:46and they also have a a number of
57:49diseases and this trial has four targets,
57:51but you have to be HLA mass to them.
57:53So it's somewhat complex.
57:55We hope to open soon.
57:57They're in the pipeline,
57:58something for renal cell carcinoma
58:00and some others.
58:01For example,
58:01one that that hits all K Ras G12V tumors,
58:04another that hits all her two
58:06positive tumors.
58:07What you'll notice is I have
58:08the sponsor down here,
58:09none of these are actually from Yale
58:12Science because we're probably not there yet.
58:14It's very expensive to
58:15get these things going.
58:16And so for the most part
58:18we're using industry sponsors,
58:19but we hope in the future to get Yale
58:21Science into patients because there
58:23are a lot of Yale scientists
58:25doing this kind of work.
58:26And finally, we have the first standard
58:28of care T cell therapy for solid tumors
58:30and that's for Melanoma and that was
58:32approved I think about a month ago.
58:33And we're probably going to have it open
58:35within the next month and know from
58:37other people that's probably the fastest
58:39of of maybe any site in the country.
58:41So that's exciting.
58:42Well, I'll leave it at that since
58:44people have to have to get out of here.
58:49Thank you. Thank you all the,
58:51I don't see any questions in the chat.
58:52If anyone had any questions
58:54for the cellular therapy team,
58:56please put them in the chat.
59:02If anyone has any questions
59:03about your patients by the way,
59:04just reach out to us directly.
59:06I mean I'll, I'll talk to anyone
59:08about any solid tumor stuff.
59:14So I guess I will say I don't
59:16have any particular questions.
59:18I I think it is just I hope others
59:22in our clinical
59:23community can get
59:25a sense of the promise and excitement
59:28that these therapies offer for
59:30many of our patients. You know
59:33as both Mike
59:34and Aris and and Stuart also
59:36alluded to, these are very
59:38complex therapies and they require
59:43kind of the resources,
59:44the deep expertise and coordination that
59:46only that centers like ours have to offer.
59:50But they truly offer hope and a
59:53unique therapeutic offering to a
59:55group of patients who are either
59:58not eligible for other therapies are
01:00:00failing other therapies and they
01:00:03also offer the hope of durable remission
01:00:08or even cure in situations that
01:00:11otherwise would would be hopeless.
01:00:13And I think that you know these are
01:00:16this team was very modest in the
01:00:20description of the and and
01:00:22even circumspect in their
01:00:23description but but this is. Really,
01:00:26I don't think it's overstating it to
01:00:28say we are on the threshold of a of
01:00:30a new era and this is just the tip
01:00:32of the iceberg we're talking about.
01:00:34So more to come, and it's great
01:00:37to be part of that. Yep.
01:00:41Which I, I forgot to say,
01:00:43the acknowledgement of actually the
01:00:44team who actually makes this happen.
01:00:46So these people should be up there,
01:00:48'cause they're amazing.
01:00:48They're the ones who actually make it
01:00:50possible for us do any of this stuff. Thanks.
01:00:58Thanks, Mike. I think
01:01:00we'll wrap up. Thanks everyone.