
6d4300205a98de0c703cfd6f44458fb6.ppt
- Количество слайдов: 57
Welcome State of the GMI Lerner Research Institute 2007 Operations Report 1
2009 LRI STAR Award Winners This program recognizes individuals who have taken special initiative to help others and enrich the workplace Peter Balint Petra Platzer There were 31 nominations submitted for 2008. Of the 10 winners chosen, GMI had 2 STARs – we’re very proud! State of the GMI 2
GMI Employee of the Quarter Winners This award program offers an opportunity for GMI members to recognize peers for their accomplishments and contributions to GMI and being a pillar of Teamwork, Quality, Service or Innovation. Todd Romigh Nichole Prescott Christina Rigelsky 1 st 4 th 3 rd Quarter, 2009 2008 State of the GMI 3
State of the Cleveland Clinic Highlights State of the GMI 4
State of Cleveland Clinic - 2009 Quality: patient experience (ie. medical, physical & emotional) Status • Increased accuracy in medical care (EMR) and pharmacy data entry (CPOE) • Increased compliance and decreased delinquent medical records • Improved patient access with new facilities • Decreased complaints and increased patient satisfaction scores (above national average, but there is more work ahead) Innovation: Status • Research funding (including NIH) up 6% in 2008; publications up 5% • Building of a new, national Reference Lab Center by 105 th St. • Partnerships with: Google and Microsoft for home monitoring CVS’s “Minute Clinics” for increased patient volume • Increased media coverage, brand awareness & non-Ohio presence (CC Abu Dhabi, Sheik Khalifa Medical Center, and Lou Ruvo Center for Brain Health) State of the GMI 5
Contributors to Premature Mortality % Behavior Genetics Social Medical Access Environmental D. M. Cosgrove, MD, State of the Clinic, 2008 State of the GMI 6
State of Cleveland Clinic - 2009 Teamwork: Key areas: HR, IT, Wellness, Patient Experience, Quality & Safety Status • Strategic Council’s 4 main initiatives in 2009: Patient Experience 2. Operational Excellence 3. Growth 4. Integration of the Health System 1. • Current strategic investments: HR – employee engagement 2. IT – integration, upgrading, and streamlining multiple systems 3. Wellness – employee and patient benefits 1. • Improving communication and messaging to all employees State of the GMI 7
State of Cleveland Clinic - 2009 Service: patient and employee services given and received Status • Reduction of overall wait time for outpatient appointments by 5 days (Same day Appt Initiative) • Improved employee-focused benefits and wellness initiatives – Weight Watchers program (lost 75, 000 pounds so far) – Smoking Cessation – Increased tuition reimbursement programs • Nursing Magnet Status for main campus & Fairview • 23 and. Me, a free service for physicians to participate in genomic screening • Increased Environmental Stewardship, by recycling medical waste, exploring alternate energy sources and reducing energy consumption State of the GMI 8
State of Cleveland Clinic - 2009 Finances: Status • CC is strong overall and Florida is turning a profit for the first time • 90% of CC’s $5 billion revenue from patient revenue; patient portion is declining due to costs of expanding the facilities and payor mix change • Guiding Principles for handling the current economic crisis: Maintain Patient Care 2. Preserve Jobs 3. Maintain compensation 4. Invest in the Future 1. • Expense reduction actions taken thus far are working; Unlike other healthcare institutions, CC has not been forced to lay off any personnel For every $50, 000 the Clinic can “save”, that translates to one job saved State of the GMI 9
State of Cleveland Clinic - 2009 Key take-aways: • Initiatives overall are heading in the right direction • We should not get too comfortable with our successes • Take advantage of this opportunity and let it stimulate us to achieve our best Tom Brokaw: … “we cannot waste the opportunities that lie within this crisis; it isn’t what divides us that’s important; it’s what unites us – and we should continue to “Act as a Unit”…. ” State of the GMI 10
State of the Genomic Medicine Institute 2008 Annual Report Charis Eng, MD, Ph. D. , FACP, Chair & Director June 22, 2009 State of the GMI 11
GMI Core Values To be the expert base for the principles and practice of genomic medicine To promote scholarly activity (research), academic clinical practice and education To provide a work culture that enables us to bring genetics and genomics, through our research and clinics, into all subspecialties of the Cleveland Clinic’s healthcare system To foster innovation ultimately directed at personalized genomic-based healthcare State of the GMI 12
The Research Triad Research Labs “Cores” GMB IGAC Genomics CPGH GMI’s interdisciplinary design as a one-stop shop is aligned with the LRI’s Research Triad Mission and CC’s Tripartite academic mission State of the GMI 13
New Personnel State of the GMI 14
New Investigator Effie Sehayek, MD arrived June 2, 2008 • Research Focus Genetics of sterol metabolism and atherosclerotic cardiovascular diseases Genetics of fat absorption from the intestine • Academic Appointments Effie Sehayek, MD Assistant Professor, Dept of Molecular Medicine, CCLCM • Funding / Awards Scored in top 15 th percentile for recent R 01 submission Laboratory Members: Mike Greenberg postdoc Katie Lintner, Res Tech State of the GMI 15
New Clinicians Marc Shapiro, M. D. Primary Appointment: Taussig Cancer Center • Specialty: Lung, Breast, GI cancer • CPGH role: Breast Cancer Clinical Geneticist Holly Pederson, M. D. Primary Appointment: Center for Specialized Women’s Health • Specialty: Breast Cancer • CPGH role: Cancer Genetics Fellowship State of the GMI 16
Other Recruitment Highlights in 2008 • Stephanie Fritz, Patient Service Representative • Kristi Bennett, Eng lab postdoc Stephanie Kristi Deb Jessi Tom Kathleen • Deborah Zygmunt, Aldred lab Sr Technician • Jessi Mester, Genetic Counselor • Tom Oravec, Labmatrix Data Entry • Kathleen Babb, Research Admin Coordinator State of the GMI 17
Other Recruitment Highlights in 2008 (cont’d) • Gina Keeler, Clinical Manager • Joshua Cowgill, Serre lab Technician Gina Josh • Jim Hester, Serre lab Computing • Jessi Moline, Genetic Counselor Jim Jessi • Michelle Maurer, Medical Secretary • Shirley Tao, Zhang lab postdoc Michelle Shirley State of the GMI 18
Other Recruitment Highlights in 2008 (cont’d) • Charissa Peterson, Eng lab Sr Technician • Patty Arscott, Genetic Counselor Charissa Patty Jason Hui-Hui Shingo Toni • Jason He, Eng lab postdoc • Hui-Hui Liu, Zhang lab postdoc • Shingo Ashida, Eng lab postdoc • Toni Bartling, Ting lab postdoc State of the GMI 19
Other Recruitment Highlights in 2009 (cont’d) • Theresa Welgs, Genomics Core • Junying Lei, Eng lab Sr Technician Theresa Junying Min Monika Yi-Ran Meredith • Min Zhu, Zhang lab postdoc • Monika Hanus, GC Assistant • Yiran Yang, Eng lab postdoc • Meredith Holt, Project Manager State of the GMI 20
Other Recruitment Highlights in 2009 (cont’d) • Jeannie Choi, Ting lab Technician • Hadley Miller, Serre lab Technician Jeannie Hadley Since 2007, we have had 31 people join GMI! State of the GMI 21
Translational Disease-Oriented Research & Clinical Programs State of the GMI 22
GMI’s Disease-Oriented Research Programs Disease Emphasis of GMI Laboratories Ø Cancer Ø Cardiovascular Ø Pulmonary Ø Neuro-Psych Ø Type 2 Diabetes State of the GMI 23
Adjunct Staff: Complement GMI’s Research and Clinical Programs Cancer Heart, Vessels, Blood Bioethics & Health Policy *Wilson Tang, M. D. Cell Biology *Jonathan Smith, Ph. D. Genomic Medicine Opthamology *Ruth Farrell, M. D. *Eric Kodish, M. D. *Richard Sharp, Ph. D. Lung Brain & Spine *Elias Traboulsi, M. D. *Bruce Lamb, Ph. D. Pediatrics, Obstetrics & Specialties *Ruth Farrell, M. D. *Staff members with adjunct appointments in GMI. State of the GMI 24
Outreach to other Research and Clinical Programs Multidisciplinary Programs • Asthma and Pulmonary Hypertension (Erzurum) GMI: Michaela Aldred, Christina Rigelsky • Barrett Esophagus/Esophageal Adenocarcinoma Consortium (Eng) GMI: Charis Eng, Brandie Leach • Heritable Colorectal Cancer Multidisciplinary Research Group & High Risk Cancer (Church) GMI: Charis Eng, David Serre, Angela Ting, Brandie Leach • Endocrine Neoplasia Genomics Research Group and Multidisciplinary Clinic (Eng) GMI: Charis Eng, Emily Edelman • Head and Neck Neoplasia Genetics & Genomics Research Group & High Risk Clinic GMI: Michaela Aldred, Charis Eng, Emily Edelman • Von Hippel-Lindau Disease Multidisciplinary (Virtual) Clinic (Eng) GMI: Charis Eng, Amy Shealy State of the GMI 25
Outreach to other Research and Clinical Programs (cont’d) • Gorlin Syndrome (Virtual) Clinic (Eng) GMI: Charis Eng, Amy Shealy • Marfan Syndrome Multidisciplinary Clinic (Greenberg) GMI: Rocio Moran, Christina Rigelsky • Tuberous Sclerosis Multidisciplinary Clinic (Gupta) GMI: Rocio Moran, Charis Eng, Amy Shealy (new in 2008) • Gene Dosage and Disease Susceptibility Research Group (Nadeau) GMI: David Serre, Angela Ting • Diabetes Genomics Research Group (Serre) GMI: David Serre • Neurofibromatosis Multidisciplinary Clinic (Rothner) GMI: Vickie Zurcher, Rebecca Mitchell, Allison Schreiber • Hearing Management Clinic GMI: Rocio Moran, Allison Schreiber • Vascular Anomalies Multidisciplinary Clinic GMI: Rocio Moran, Amy Shealy State of the GMI 26
Satellite Genetics Clinic Expansion • CORS/DDI Colon Cancer GC: Brandie Leach • Hillcrest Prenatal/Preconception GC: Diane Clements (new in 2009) • Vascular Surgery Clinic GC: Christina Rigelsky, Patrica Arscott • Vascular Medicine Clinic GC: Christina Rigelsky • Fairview Moll Pavilion Breast Cancer GC: Kate Lynch, Shanna Gustafson • Beachwood Cancer Prenatal/Preconception GC: Kate Lynch, Shanna Gustafson GC: Diane Clements • Shaker Developmental & Behavior Pediatrics APN: Rebecca Mitchell State of the GMI 27
Publications & Education State of the GMI 28
Publication Highlights 2006 2007 2008 Total Publications 30 24 38 Articles 29 22 36 4 7 8 1 2 2 (Impact Factor >10) Books / Chapters State of the GMI 29
Teaching: Cleveland Clinic Lerner College of Medicine Course Instructors Primary Personnel Secondary Personnel • Michaela Aldred, Ph. D. • Marvin Natowicz, M. D. , Ph. D. • Charis Eng, M. D. , Ph. D. • Ruth Farrell, M. D. • Pieter Faber, Ph. D. • Donna Hansel, Ph. D. • Banu Gopalan, M. S. • Eric Kodish, M. D. • Shanna Gustafson, M. S. • Wilson Tang, M. D. • Rocio Moran, M. D. • Elias Traboulsi, M. D. • Mohammed Orloff, Ph. D. • David Serre, Ph. D. • Amy Shealy, M. S. • Angela Ting, Ph. D. State of the GMI 30
Teaching: Molecular Medicine Ph. D. Program Cleveland Clinic Lerner College of Medicine of Case Western Reserve University Admissions Committee: GMI Representative: Michaela Aldred, Ph. D. Two of nine inaugural class students rotated in the Eng lab and one selected this lab for their thesis work. Ying Ni Inaugural Class State of the GMI 31
Funding State of the GMI 32
LRI Research Funding Total Research Funding (Internal & External) $245 $166 $180 $202 Federal Funding Trend $258 $223 $69 $68 2003 $76 2004 $84 $90 2005 $85 $91 2006 $82 $101 $97 $75 2007 2008 Declines in NIH funding are being offset by gains in other federal non-NIH sources (i. e. , DOD, NASA, DOE, etc. ) State of the GMI 33
Research Funding Highlights New Grants in 2008 • Charis Eng, M. D. , Ph. D. , NIH – PO 1: “Genetic alterations that initiate follicular carcinogenesis” ($223 ADC, 5 yr); BCRF: “Genes that affect mitochondrial function as novel mediators of beast cancer susceptibility” ($129 K ADC, 1 yr); BCRF: “Differential biallelic expression of PTEN in patients with heterozygous germline PTEN mutations as a novel mechanism of modulation of breast cancer risk” ($79 K ADC, 1 yr); Hearst Foundation: “Inherited Breast Cancer Research Program ($150 K ADC, 2 yr) • Aldred, Michaela, Ph. D. , AHA: “Progenitor Cells in Pulmonary Hypertension” ($70 K ADC, 4 yr) • Zhang, Bin, Ph. D. , NIH – March of Dimes: “Receptor-mediated ER-to-Golgi transport of Coagulation factors V and VIII: Deficiencies in the early secretory pathway as pathogenic mechanisms of congenital disorders” ($68 K ADC, 2 yr); RO 1: “Receptormediated ER-to-Golgi transport of Coagulation factors V and VIII” ($225 K ADC, 5 yr) New extramural funding in CY 2008 ~$1. 1 M ADC, or ~$5. 9 million total funding State of the GMI 34
Philanthropic Funding 2006 2007 2008 # of donations 1 2 5 Amount (total) $100, 000 $8, 000 $410, 000 • Ambrose Monell Foundation: ($100 K ADC, 3 yr) “Cancer Genomics Training Fellowship Program” • Arthur Blank Foundation • William W. Baker Family Foundation • Norma & Albert Geller • Roger & Sharon Vail Dr. Eng received first endowed chair in Cancer Genomics Research: $1. 5 million endowed chair funded by Sondra and Stephen Hardis to further Cancer Genomics Research State of the GMI 35
Clinical Revenue • New Genetic Counseling service reimbursement model implemented; utilizes first genetic counseling-specific billing code • Decoupling Geneticist and Genetic Counselor billing schema has: § increased patient access § decreased patient appointment wait times § provided opportunities for satellite clinic service expansion • Two recent Cleveland Clinic initiatives: Same Day Appointments § Provider-based billing § • Net effect on clinical revenue is being analyzed GMI’s Center for Personalized Genetic Healthcare is a pioneer in transforming traditional clinical genetics services to a financially self-sustainable model with: § increased patient access § improved patient service State of the GMI 36
Innovations & Commercialization • “e. GMI” § Patient-entered family history tool § Collection of personal and family medical history information § Creation of pedigree § Automated risk assessment § Utilizes My. Consult/e. CC and Progeny • 4 provisional patents filed § Charis Eng, M. D. , Ph. D. (3) § Effie Sehayek, M. D. (1) State of the GMI 37
Employee Engagement State of the GMI 38
Gallup Employee Engagement Survey March, 2008 GMI* LRI CC Gallup 50 th% Gallup 75 th% Overall Engagement 3. 54 3. 81 3. 80 3. 94 4. 27 Overall Satisfaction 3. 43 3. 71 3. 68 3. 93 4. 29 5 -point scale: 1= Highly disagree 5= Highly Agree * 38 GMI employees GMI Strengths Committed to Quality 4. 26 4. 04 3. 94 4. 11 4. 44 Have Materials & Equip 4. 18 4. 22 3. 22 4. 00 4. 38 GMI Opportunities Know what’s Expected 3. 34 4. 26 4. 43 4. 50 4. 71 Mission/Purpose 3. 82 4. 11 4. 44 3. 32 3. 74 GMI Commitment: “to make GMI the best workplace for GMIers” State of the GMI 39
Engagement Initiatives • Communication Improvement: § Increased forums (Town Hall, open staff meetings, Newsletter, etc) • Employee Recognition: § GMI Employee of the Quarter award • Socializing Opportunities: § Summer Picnic and Table 45 Happy Hour • Job Expectation Clarification: § Review and redefining of all position’s key job responsibilities (KJR) § Creation of a Job Specification and Performance Roadmap (JSPR) • Organizational Chart Refinement: § Defining subunit structures and mission statements State of the GMI 40
THE GENOMIC MEDICINE INSTITUTE Dr Eng Chair Key: Director, Transl Devel Rerko Business Advisory Board Admin Support Staff Management Team Admin Asst Blount Executive Team Manager, Integ Devel Platzer Admin Asst Wilcox Research Admin Coordinator Babb Genomics Core P Faber Research Clinical Research Program Mgr: X Res Admin Cdtr Babb PI Admin Assts Blount/Wilcox Eng Lab Aldred Lab Zhang Lab Ting Lab Serre Lab Sehayek Lab Research Study/Prog Coordinators Biorepository Mgr: X Computing Balint Center for Personalized Genetic Healthcare Dir: Eng Cancer Genetics / General Genetics Clinic Med Dir: Eng / Moran Clinical Mgr: Keeler MDs Int Genomics & Analysis Mgr: Gopalan Bioinformatics/ Biostatistics Labmatrix Genetic Counselors GMI Enterprise Rerko Project Mgr Holt e. GMI Platzer Genetics Educ Cdtr X IT Architect X ANP Reimbursement Specialist PSRs, GC Assts, Med Sec Database Proj Mgr GC
Engagement: Next Steps • Completion of all employee JSPRs • Continued implementation of constructive and regular performance feedback • • Continued focus on improving communications Continued supervisor/manager training to be “engaging managers” Next round of subgroup meetings to identify next action item plans 2009 Gallup survey: June 24 - July 17 § LRI goal: improve scores by 5% State of the GMI 42
Community Benefit & Wellness State of the GMI 43
Institute Diversity Program • GMI Members on Diversity Council 2008: Banu Gopalan, Coordinator Kylie Drake • Conversational English Program (CEP) - Todd Romigh (coach) - Several GMI participants Institute Wellness Program • Commit 10 Challenge Program Rebecca Mitchell GMI TRIes • Triathlon Club (runners, bikers, swimmers) Nichole Prescott State of the GMI 44
Community Benefit • United Way campaign – Last year, CC raised $1. 8 million for local community resource centers – In 2008, GMI had 45. 2% participation – 2009 campaign about to begin; GMI team captain is ? – 2 GMI folks participated in “United Way Day of Caring” • LRI’s Harvest for Hunger- generated 215 pounds of food, $2, 400 in donations • Bolton School Supplies- generated ~$16, 000 of supplies • GMI Feature in Cleveland Clinic-Community Breakfast & the Community Service Booklet • Rebecca Mitchell, M. S. N, C. N. S. , camp nurse at Knox County 4 -H Camp resulted in Caitlin Pugh Scholarship Fund donations. State of the GMI 45
Educational & Outreach Highlights • 6 th Intl Conference on the Biology of Childhood Renal Cancers Invited Lecturer: Michaela Aldred, Ph. D. • Genetics Education Campaign Kickoff Dr. Eng, Dr. Traboulsi, Dr. Moran, Cheryl Scacheri and Champions “Genetics in Health and Disease” symposium • Cold Spring Harbor Laboratory Invited Lecturer: David Serre, Ph. D • 8 th Intl Anticancer Research Conference Invited Lecturer: Angela Ting, Ph. D. • 27 th Annual Meeting of National Society of Genetic Counselors Session Co-chair: Emily Edelman, M. S. , CGC Educational Breakout Session: Amy Shealy, M. S. , CGC State of the GMI 46
Educational Highlights (Continued) • 18 th Annual Symposium of Society of Black Academic Surgeons Invited Lecture: Charis Eng, M. D. , Ph. D. • Aspiring Physicians & Research Scientists Conference Invited Panelist: Mohammed Orloff, Ph. D. • Neurofibromatosis: A 21 st Century Perspective Invited Participants: Vickie Zurcher, M. D. , Rebecca Mitchell, MSN, C. N. S. , Allison Schreiber, M. S. , CGC • 6 th Annual Pediatric Neurology Update Seminar Invited Presenter: Rocio Moran, M. D. • American Society of Human Genetics Invited Science Session: “Organismal and Cellular Phenotypes of Breast Cancer Susceptibility Genes” Chair: Charis Eng, M. D. , Ph. D. • The CPGH Genetic Counseling Internship program trained 2 GC students State of the GMI 47
Special Events & Community Outreach • WKYC: Family Health History Day Dr. Eng, Shanna Gustafson • Cleveland Museum of Natural History • Exhibit: “RACE: Are we so different? ” • Dawn Caraballo Genomics Town Hall Dawn Caraballo, Drs. Moran and Serre, Cheryl Scacheri • PBS: “In the Family” documentary Cheryl Scacheri (message board) • Minority Men’s Health Fair Dawn Caraballo • School, Library and Support Group talks in 2008 Over a dozen educational talks given by various GMI personnel in 2008 State of the GMI 48
Awards & Honors • GMI was honored as the featured member of the month (August) by the Personalized Medicine Coalition • Charis Eng, MD, Ph. D, Chair GMI, named Chair of the Clinical Science Committee of the Personalized Medicine Coalition. • Charis Eng, MD, Ph. D was elected to the 2008 -2009 Best Doctors in America database for her work in Clinical Cancer Genetics and Cancer Genomic Medicine. • Charis Eng, MD, Ph. D was a Visiting Professor in the Human Manpower Development Planning Programme of Singapore’s National Cancer Center • Charis Eng, MD, Ph. D was awarded the LRI Excellence Award for Outstanding Science and Marvin Natowicz, MD, Ph. D was awarded the LRI Excellence Award for Outstanding Educator • Kristi Benett, Ph. D and Ying Ni, MS were both awarded entry into the AAAS/Excellence in Science Program award for 2008 -2009 State of the GMI 49
Awards & Honors • Stacy Williams and Crystal Sterling were awarded the Mc. Nair Undergraduate Summer Research Scholarship for Minority Students Excelling in the Sciences • Shireen Ganapathi was awarded the American Cancer Society Joseph F. Silber Undergraduate Research Fellowship • Guillaume Assie, MD, Ph. D was named a Finalist for the Cotterman Award for Best Trainee-First Authored Paper published in Am J Hum Genet • Rebecca Mitchell, RN and Patricia Pritchard were awarded LRI Star Awards in 2008 CONGRATULATIONS State of the GMI 50
2009 Brief Updates • Angela Ting, Ph. D. received a Wilson Foundation grant ($91 K ADC, 2 yr) • Bin Zhang, Ph. D. , received an R 01 summer student supplement ($8. 5 K) • Brandie Leach, MS, CGC and group received a National Society of Genetic Counselor SIG grant ($2 K) • Published our first GMI Newsletter, “Translations” • Met with CC Employee Health Plan to develop a model for appropriate genetic testing recommendations and reimbursement schemas • Providing education to CC surrounding direct-to-consumer genomics companies and their utility • Highlighted by the Advisory Board Company in their Genomic Centers of the Future Presentation State of the GMI 51
GMI Goals & Challenges State of the GMI 52
Short-term Goals for 2009 • • Meet budgetary expectations Increase clinical revenue and satellite services Increase GMI grant funding by >20% Implement Cancer module of e. GMI prototype in GMI and Taussig Cancer Center • Improve employee engagement by at least 5% • Improve developmental opportunities for Assistant Staff and employees • Recruit key personnel in Clinical Research Study and Genetics Education Programs • Increase quantity and quality of publications • Obtain next generation high-throughput sequencer State of the GMI 53
Continuing Objectives • Reduce GMI’s dependency on CC operating revenue across all units by 2011 • Further increase depth and breadth of research programs • Continue to re-examine clinical genetics and genetic counseling process to standardize and implement the best models • Develop and implement relevant e. GMI modules to integrate genetic screening processes into CC patient care • Continue outreach and education efforts for understanding and utilizing genetics and genomics processes in patient care • Further train next generation of biomedical researchers in CCLCM and Molecular Medicine programs • Increase endowment funding and philanthropic support State of the GMI 54
Challenges ahead • Stagnant NIH budget • Small annual allocation of capital funding for research from CC • Growing Federal regulations lead to compliance concerns • Lack of unassigned laboratory, office and clinic space • Integration of genomic medicine into CC processes and medical specialties • Scarcity of qualified clinical geneticists or genomic medicine physicians • Legislative reform for Genetic Medicine State of the GMI 55
GMI Goals & Successes: Quality Service Innovation Teamwork Thank you all for your hard work and a productive year! We are on the right trend and together as a unit, we will accomplish our mission. State of the GMI 56
Questions? Now for a visual highlight of 2008 from Peter …. State of the GMI 57