Duke University Hospital Program Earns Distinguished Three-Star Ratings

By Tracey Koepke, Duke Heart Center

We are pleased to share with you that our Adult Cardiac Surgery program at Duke University Hospital has, for the first time, earned three simultaneous distinguished three-star ratings from The Society of Thoracic Surgeons (STS) for its patient care and outcomes in the following areas: isolated coronary artery bypass grafting (CABG) procedures; isolated aortic valve replacement (AVR) surgery, and isolated mitral valve replacement and repair (MVRR) surgery. The three-star rating, which denotes the highest category of quality, places our program among the elite for CABG, AVR and MVRR in the U.S.

“This is a significant validation of the quality and performance that we are able to deliver in cardiac surgery — the three-star rating means that our outcomes are in the top 10 percent of all centers in the United States,” said Peter K. Smith, MD, chief of the division of Cardiovascular and Thoracic Surgery and co-director of Duke Heart Center. “That we have achieved this within each of the three most important domains of cardiac surgery — bypass surgery, aortic valve replacement, and mitral valve repair or replacement – is a tribute not just to the surgeons but our entire team of dedicated health care professionals in our Operating Room, Intensive Care Unit, and Step-down Units.”

The STS star rating system is one of the most sophisticated and highly regarded overall measures of quality in health care, rating the benchmarked outcomes of cardiothoracic surgery programs in the U.S. The star rating is calculated using a combination of quality measures for specific procedures performed by an STS Adult Cardiac Surgery Database (ACSD) participant. We achieved a two-star rating in each of the remaining two areas of reporting: AVR+CABG and MVRR+CABG.

“Any scoring system has its limitations, but this is one of the most scientifically validated systems for heart surgery. It involves a huge amount of data from almost all centers in the U.S. and a very complicated and well thought out risk-adjustment model,” according to Carmelo Milano, MD, Chief of the Section of Adult Cardiac Surgery in the division of Cardiovascular and Thoracic Surgery. “Not only are they looking at raw outcomes like survival, but they take into consideration the pre-operative conditions that may make certain cases much higher risk. This is a very well respected grading system for heart surgery.”

The latest analysis of data for CABG covers a 1-year period, from January 2019 to December 2019; the analysis of data for isolated AVR, isolated MVRR, AVR+CABG and MVRR+CABG surgeries covers a 3-year period, from January 2017 to December 2019.

Mihai V. Podgoreanu, MD

Mihai V. Podgoreanu, MD

“Achieving the elite STS three-star rating, one of the most sophisticated and highly regarded overall measures of quality in health care, is a testament to our program’s commitment to quality improvement and safety across the cardiac surgical patient journey – from careful preoperative planning and optimization, to relentless attention to detail and coordination of intraoperative and postoperative decision making among multi-disciplinary heart team members,” added Mihai Podgoreanu, MD, chief of Cardiothoracic Anesthesiology and Critical Care. “In these unprecedented times, we are united in our dedication, resilience, compassion, and innovative spirit to continue pursuing our highest purpose – excellence and quality care for patients in need of cardiac surgery and their families.”

“As an organization and a group – the STS three star rating is evidence of the dedication of our entire Heart Center around how we care for our patients with multi-disciplinary teams that start with the evaluation and identification of patients needing coronary revascularization or valve surgery all the way through recovery, rehab, and return to life,” said Manesh Patel, MD, chief of the division of Cardiology and co-director of Duke Heart Center. “I am excited that during these challenging times our teams have continued the dedication and work to stay focused on patient outcomes.”

The STS National Database was established in 1989 as an initiative for quality improvement and patient safety among cardiothoracic surgeons. The STS ACSD houses approximately 6.9 million surgical records and gathers information from more than 3,800 participating physicians, including surgeons and anesthesiologists from more than 90 percent of groups that perform heart surgery in the US. The Database includes three other components: the Congenital Heart Surgery Database (CHSD), the General Thoracic Surgery Database (GTSD), and the mechanical circulatory support database (Intermacs). Duke has participated in the STS National Database since its inception.

Stacey HiltonDuke University Hospital Program Earns Distinguished Three-Star Ratings
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Dr. Ji Receives Prestigious Award

Ru-Rong Ji, PhD

We are pleased to announce that Dr. Ru-Rong Ji, distinguished professor of anesthesiology, has been selected to receive the prestigious 2020 American Society of Anesthesiologists (ASA) Excellence in Research Award. It recognizes individuals for outstanding achievement in research who has or is likely to have an important impact on the practice of anesthesiology. The individual’s work represents a body of original, mature and sustained contribution to the advancement of the science of anesthesiology. This is only one of two awards presented each year by the ASA to recognize the research accomplishments of members of our specialty.

“Several current and previous members of this department have received this award, and I am very proud to be one of them,” says Ji, chief of basic pain research and co-director of the department’s Center for Translational Pain Medicine (CTPM). “I really appreciate the full support I have received from the department over the last eight years.”

Ji’s work has significant translational potential in almost all areas of pain medicine. He currently serves as the director of the Sensory Plasticity and Pain Research Laboratory. Ji’s research focuses on molecular and cellular mechanisms of chronic pain, including but not limited to mediators of inflammation and pain, neuropathic pain, and cancer pain. He is internationally-recognized for his contributions to demonstrating critical roles of MAP kinase signaling pathways, glial cells, and neuroinflammation in the pathogenesis of chronic pain. His work has demonstrated powerful antinociceptive actions of pro-resolution lipid mediators (e.g., resolvins). His lab has shown that resolvins are among the most potent inhibitors for inflammatory pain and TRP channels. He also determined the down-stream GPCR signaling in macrophages and sensory neurons that mediates the potent actions of these lipid mediators. Recently, Ji’s work has focused on unique neuronal signaling of pattern recognition receptors, such as toll-like receptors (TLRs) and their contribution to pain and itch. And, Ji is notably among the first to establish a connection between mediators of cancer and pain processing showing that tumor cells produce PD-L1 to suppress not only the immune system, but also pain perception permitting cancer growth and metastasis. Ji also has established a broad collaboration with CTPM and Duke University School of Medicine faculty members to develop novel pain therapeutics.

“Dr. Ji is an outstanding scientist and colleague. He has a keen wit and is able to move scientific thought to the next level. Furthermore, he has the ability to implement his thoughts and ideas into productive, high-impact research. He clearly merits this award,” says Dr. William Maixner, vice chair for research and co-director of the CTPM.

Ji lectures internationally and reviews papers for numerous international journals. His research has been published in more than 200 peer reviewed manuscripts in high-impact journals, such as Science and Nature. Ji is one of 54 Duke researchers who made the global list of ‘Highly Cited Researchers’ for 2019; a list he also made in 2018. Ji also serves on editorial boards of Anesthesiology, Pain, Journal of Neuroscience, Neuroscience, and Neuroscience Bulletin. He previously served as an associate professor at Brigham and Women’s Hospital, Harvard Medical School, before joining the Duke faculty in 2012. He earned a PhD in neurobiology at Shanghai Institute of Physiology and completed postdoctoral training at Peking (Beijing) University Medical School, Karolinska Institute, and Johns Hopkins University School of Medicine.

Please join us in congratulating Ji on receiving this well-deserved award.

Stacey HiltonDr. Ji Receives Prestigious Award
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Frito-Lay Honors Couple’s Sacrifice for Patient Care with 76K Bags of Chips

By Morag Maclachlan, Duke Health

Dr. Melanie Hollidge and her husband, Murray Lubja

Dr. Melanie Hollidge and her husband, Murray Lubja

Melanie Hollidge, MD, PhD, jokes that her anesthesiology and critical care medicine colleagues at Duke University Hospital (DUH) say she’s “all that and a bag of chips.”

The phrase describes someone you believe is all that and more. And in this case, it can also be taken literally as Hollidge’s husband worked with Frito-Lay to surprise Duke Health with a donation of 76,752 bags of chips.

“He knows I like to take a bag of chips with me when I work the overnight shift,” Hollidge said. “He saw an ad on TV from Frito-Lay asking people to share stories of how they are supporting their community during the pandemic. So, he submitted our story.”

76,000 bags of chips from Frito-LayHollidge and her husband, Murray Lubja, are originally from Ontario, Canada. When it became clear in mid-March that COVID-19 was quickly spreading throughout the United States, the couple made a difficult decision. Lubja, who has three chronic immunocompromising conditions, would return to Canada so Hollidge could care for patients with COVID-19 without the risk of exposing him. They haven’t seen each other in person since.

“I am so lucky to have such a supportive partner. Throughout my career, he has never once complained when I’ve worked late or picked up extra shifts,” Hollidge said. “He understood that I wanted to keep him safe and that I needed to be here. I don’t see this as a job. It is a privilege to serve patients in their most vulnerable time.”

The Frito-Lay donation is one of the largest food donations Duke Health has received since the COVID-19 crisis, said Aaron West, CPPS, the administrative director at the DUHS Patient Safety and Quality office. Robin Thomas, executive director of Engineering and Operations at Duke Health, said four members of her team unloaded the shipment of 26 pallets and will assist with distributing the snacks across the health system.

“I’m really grateful to Frito-Lay for responding to Murray’s request with such a big gesture,” Hollidge said. “I hope it brings a smile to people’s faces because I’m sure there are lots of coworkers making sacrifices to put patient care first.”

Stacey HiltonFrito-Lay Honors Couple’s Sacrifice for Patient Care with 76K Bags of Chips
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