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That Was Then, and This Is Now. Or Is It?

I hold the publication in my hands.  It features an article on “chronobiology” andsleep studies.  It includes some facultynewsmakers, such as Albert J. Stunkard, MD, professor of Psychiatry, one ofPenn’s well-known experts on sleep disorders; Peter Quinn, DMD, MD, a leader insurgically treating the most painful maxillofacial disorders; Richard L. Doty,PhD, director of Penn’s Smell and Taste Center; Gail Morrison, MD, professor ofMedicine; and Frederick Kaplan, MD, professor of Orthopaedic Surgery.

Another article in the issue is about the director ofnursing, an energetic leader full of ideas who wants nurses’ roles to expand –-and “a change of attitude about the role of nursing” among members of thehealth-care community.  In addition,there is a message from HUP’s executive director, which concludes with anexhortation appropriate for all times: “Because there is no better form ofmarketing than a satisfied customer, I say again that you –- every HUP employeeand volunteer –- are key.”  All in all,the publication seems very up to the minute.

Except that it’s the HUPdateof June 1988.

For me, as editor of PennMedicine magazine, there are some startling coincidences.  The Spring 2013 issue of Penn Medicine, just out, features an article on chronobiology.  Although its focus is on the basic scienceunderlying the field, the article also touches on the ways our inner clocksaffect our daily lives, which is also described in HUPdate.  The current issuealso includes a profile of Dr. Stunkard’s pioneering work in a longer articleon the history of Penn psychiatry. 

Dr. Kaplan’s work on Fibrodysplasia Ossificans Progressiva(F.O.P.), one of the rarest and most disabling genetic conditions thatimprisons its childhood victims in a “second skeleton,” has been covered in Penn Medicine at least twice, includingan article when he and Eileen M. Shore, PhD, discovered the cause of thecondition.  This summer, an article onthe condition and Dr. Kaplan, one of the world’s leading experts, is slated forThe Atlantic.  Dr. Morrison, now senior vice dean for education,presided at this month’s graduation exercises of the Perelman School ofMedicine, as she has for several years. Dr. Quinn is now vice dean forprofessional services in the Perelman School of Medicine; he was profiled a fewyears back in Penn Medicine.  Dr. Doty’s most recent book, The Great Pheromone Myth (Johns Hopkins UniversityPress) was reviewed in our Winter 2010/2011 issue; he continues as director ofthe Smell and Taste Center.

In more general terms, Victoria Rich, PhD, RN, chief nurseexecutive at the University of Pennsylvania Medical Center since 2002, iswidely recognized for her pioneering work in patient safety.  She is one of the senior leaders whodeveloped HUP’s Unit Based Clinical Leadership initiative. As described lastyear in Penn Medicine, these arethree-way partnerships that manage quality in our hospital units. Each unit hasa physician leader, a nurse leader, and a project manager for quality.Particularly in reducing blood-stream infections, the impact of UBCLs has beenremarkable. The initiative sounds very much like something Dr. Margaret Sovie,the director of nursing profiled in the 1998 HUPdate, would appreciate.  Isuspect she would also endorse Dr. Rich’s view that the UBCL partnerships werecreated to build greater trust among practitioners, have them learn eachother’s expertise, and improve communication.

One of Dr. Sovie’s other goals, expressed in 1988, was toexamine “what we as nurses need to know to ensure comprehensive care during apatient’s hospitalization, and then let us create the information systems toprovide it.”  Today, the informationsystems to tackle that task exist in a way that may have been scarcely imaginable25 years ago.

So, despite the many similarities at what is now called PennMedicine between 1988 and 2013, there have also been significant advances.   For example, where chronobiology and thestudy and treatment of sleep disorders were emerging in 1988, today the fieldsare much farther along. F.O.P. became the focus of a new research center in1991 -– and the researchers announced the cause of the condition in 2006. The UBCLinitiative is one of several advances that have improved clinical care at Penn-– and the initiative drew praise from people associated with other healthsystems when it was presented at a conference on interprofessionalism in 2011.The study and treatment of obesity has also advanced significantly –- and infact Penn now has the Alfred J. Stunkard Weight Management Program.

One of the regular features of the old HUPdate was a Q & A with staff, faculty, and the occasionalmedical student. The intrepid reporters of HUPdatewould position themselves in areas where people congregated and query thepassersby.  For June 1988, the questionwas: “If you could change one thing about the Medical Center, what would itbe?”  There were six responses, includinga visionary –- or just plain crazy –- one: “I’d locate HUP in Valley Forge.”  On the other hand, there were a couple ofprescient answers as well.  Pat Paetow,assistant chairman of radiology, noted “The hospital and University areperceived as separate. They should be advertised as one large entity.”  In some ways, that’s what the creation ofPenn Medicine has done: brought about closer ties between the hospitals andother services in the Health System on the one hand and the medical school withits links to the University.

And Michael Kozant, then a first-year medical student,responded: “I’d make fewer academic lectures for med students and give themmore clinical contact earlier in the curriculum.” That, too, is becoming true.The Longitudinal Experience to Appreciate Patient Perspectives (LEAPP) wasinstituted to bring more of the patient-centered experience into the first yearby matching each student to a patient. As Gail Morrison described LEAPP in Penn Medicine in 2006, the program isunique “because it is required of allmedical students from day one . . . and the entire experience is fullyintegrated into the medical school curriculum.”

The Penn Medicine way: continuity, yes -– and progress aswell.

 

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