Vaccine Update: Week of February 22, 2021

Sent on behalf of Jon Stallkamp, MD

 

Colleagues,

 

Just two months after we began vaccinating our staff and a month after we began vaccinating our patients and community, I am happy to report that we have vaccinated over 25,000 people. While I know that each of you continues to receive calls from patients who have questions about our vaccine approach or when they will be vaccinated, I think that 25,000 people in our region vaccinated is an incredible accomplishment for our System and I appreciate your patience and partnership during this process.

 

As our efforts continue, I want to provide you an update on where we stand with vaccination criteria and distribution. First, I am happy to say that we have invited many patients of our independent physicians. Our goal is to distribute the vaccine equitably to private practice and MLHC providers, and we will continue to balance this need to ensure that our vaccinations are allocated equally to all medical staff.

 

As you may be aware, we are facing a shortage of Moderna supply following the mistaken allocation of second doses across the state. More information on this is available here.

 

At Main Line Health, we have been prudent in our vaccine allocation and our team has been diligent about ensuring first and second doses are separated and administered appropriately. As a result, none of our appointments will need to be canceled or rescheduled due to supply issues.

 

However, as the state seeks to rectify these issues, we anticipate that we may not receive our standard Moderna supply over the next several weeks. With this in mind, we are moving slowly into our next phase of vaccination so that we do not overpromise supply.

 

When we can be sure that we have adequate vaccine supply to move to our next vaccination phase, we will do so as soon as possible. Our next vaccination phase will include several groups:

 

  • Patients age 70 and older who have an active MyChart and have received care at a Main Line Health facility in the past two years
  • Pregnant patients between 20-32 weeks EGA
  • Patients on dialysis
  • Cancer patients who are actively receiving chemotherapy
  • Transplant patients and patients listed to be transplanted

 

The decision to vaccinate these groups as part of our next phase was made by the MLH Vaccine Ethics and Steering Committees. These committees were charged with providing a limited supply of vaccine to the highest risk population abiding by CDC and ACIP ethical principles to maximize benefits and minimize harms, promote justice, and mitigate health inequities.

 

As we move through these vaccination groups, we are also offering the vaccine to medically underserved groups. Our goal is to reserve 25% of the vaccines to the underserved communities to eliminate health disparities and continue our efforts to reach all demographics.

 

Our vaccine strategy will continue to evolve based on guidance from the DOH as well as supply.

 

As eager as so many patients are to be vaccinated, I know that you may also be approached by patients who have questions about the vaccines’ safety, risks, etc. and many of you and your staff have been fielding questions about MyChart access and adoption. With this in mind, we have created a provider toolkit (attached and available on Wellspring) to give you the information you need to answer these questions. The toolkit includes information about vaccine safety, instructions on accessing MyChart as well as some scripting to answer common patient questions. I hope that you’ll find this helpful and encourage you to share it with your staff.

 

Jon Stallkamp, MD
Interim Chief Medical Officer

COVID-19 Vaccine Education Toolkit

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COVID-19 Service of Remembrance: Remembering Those We’ve Lost and Honoring our MLH Staff

As the one-year anniversary of the COVID-19 pandemic approaches, we invite you to join us on Wednesday, March 10 for our virtual COVID-19 Service of Remembrance to remember those who are no longer with us and to recognize the resilience and perseverance of all our MLH health care heroes. This year has challenged us at every turn, but we have come together as a health care community committed to the lives of our patients and the value of human care. Join MLH leaders and our site chaplains to acknowledge the losses of the past year and the dedication of our health care staff.

 

An invitation will be sent to you to join this virtual event. We hope you can join us!

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Clinical Trial of the Week: Device study for patients who need tricuspid valve replacement

By Donna Loyle, communications manager, LIMR

 

Triscend II is a multicenter randomized clinical trial that is comparing EVOQUE, a system to replace a heart valve, along with optimal medical therapy (OMT) to OMT alone for treatment of patients with severe tricuspid regurgitation (TR).

 

Eligible participants are randomized into two study arms. Group 1 undergoes tricuspid valve replacement with the Edwards EVOQUE system and receives OMT from their physicians. Group 2 undergoes OMT alone.

 

Participants then receive follow-up care at discharge, 30 days, three months, six months and annually through five years.

 

Primary outcomes being studied include TR grade reduction, reduced major adverse events, and all-cause mortality.

 

Note: A single-arm registry for patients ineligible for randomization also is available. Contact the clinical trial coordinator for more information.

 

William Gray is the MLH principal investigator for this study approved for Lankenau Medical Center. For more, visit https://www.mainlinehealth.org/research/clinical-trials/triscend-ii

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Clinical Trial of the Week: Device trial for severe arterial blockage in the leg

By Donna Loyle, communications manager, LIMR

 

The LIFE-BTK randomized clinical trial, approved for Bryn Mawr Hospital, is evaluating the ESPRIT™ BTK Everolimus Eluting Bioresorbable Scaffold system for planned treatment of narrowed arterial infrapopliteal lesions causing critical limb ischemia to improve luminal diameter.

 

The primary outcomes being measured include composite limb salvage and primary patency, and freedom from major adverse events and perioperative death.

 

Eligible participants are those with symptomatic critical limb ischemia, Rutherford category 4 or 5, requiring treatment of up to two de novo or restenotic infrapopliteal lesions, and vessel diameter of >2.5mm to <3.75mm, and total lesion length up to 100 mm.

 

Eligible participants are randomized into two study groups. One receives the ESPRIT BTK system; the other receives percutaneous transluminal angioplasty.

 

The MLH principal investigator is Antonis Pratsos, MD. For more, visit www.mainlinehealth.org/research/clinical-trials/life-btk

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Platelets Pathogen Reduction System (Intercept Blood System)

Intercept Blood System treated platelets (psoralen treated) platelets are a transfusion-ready product that deliver significant clinical benefits to patients to reduce risk of sepsis, transfusion infections and prevent graft-versus-host disease. ARX (American red cross) our blood product supplier, is slowly switching platelets to pathogen-reduced platelets and in due time will switch all platelets to pathogen reduced platelets. This will not cause any change in physician orders; we will continue to give platelets whether platelets are pathogen reduced or conventional. The Intercept Blood system is approved by the FDA as an alternative to gamma radiation for the prevention of transfusion associated graft-versus-host disease. Pathogen reduced platelets provides CMV inactivation level and therefore can be used for patients instead of CMV negative platelets. There is a slight difference in pathogen reduced platelets bags, the new bag is 2.8 inches longer than conventional bag and the new bag contains 2 words “psoralen treated”.

 

If you have any questions, please call Dr. Bhagat at 484-476-3521.

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Lankenau Medical Center and Riddle Hospital Awarded America’s Top Hospitals in 2021 by Healthgrades

Main Line Health is pleased to announce the recognition of Lankenau Medical Center and Riddle Hospital by ‘Healthgrades 2021 America’s Best Hospitals.’ Both hospitals have been continuously awarded this achievement since 2019, demonstrating their commitment to patient care through a culture of excellence.

 

For the third year in row, Lankenau Medical Center has been awarded ‘America’s 50 Best Hospitals Award’ by ‘Healthgrades 2021 America’s Best Hospitals.’

 

LMC also received Healthgrades’ Specialty Clinical Quality Awards for its excellence in cardiac care, earning ‘America’s 50 Best Hospitals for Cardiac Surgery Award’ (2021, 2020 and 2019) as well as America’s 100 Best Hospitals for Cardiac Care Award’ (2021, 2020 and 2019). Lankenau is one of only three hospitals in Pennsylvania to be awarded this coveted recognition. These awards highlight Lankenau’s commitment to having embraced a culture of excellence through quality improvement.

 

Riddle Hospital has once again been awarded a top 250 hospital ranking by Healthgrades, having received this recognition in 2019, 2020 and now in 2021! This designation places Riddle in the top 5% of hospitals throughout the nation for clinical excellence. Riddle continues to excel in providing outstanding care, receiving Healthgrades’ Critical Care Excellence Award in 2021, 2020 and 2019. These achievements are the direct result of Riddle’s patient-centered approach to consistently deliver superior patient outcomes. Congratulations to the entire staff at Riddle!

 

View the full article here or visit the Healthgrades site. Congratulations to the teams at Lankenau and Riddle!

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Latest Clinical Research from LIMR

By Donna Loyle, communications manager, LIMR

 

Research studies with clinical implications for COVID-19, breast cancer, tricuspid regurgitation, aortic surgery, atrial fibrillation, sternotomy and posterior glottic stenosis were published in peer-reviewed journals by investigators at and affiliated with the Lankenau Institute for Medical Research (LIMR) in January.

 

COVID-19 patients treated with tunneled dialysis catheters

Bedside tunneled dialysis catheters conserved resources, prevented transport-related complications and reduced personnel exposure among 36 COVID patients who were treated last spring at Lankenau Medical Center. LIMR investigator: Alexander Uribe, MD, and other LMC clinicians. The manuscript: “Bedside Tunneled Hemodialysis Catheter Placement in Patients with COVID-19” in Annals of Vascular Surgery.

 

Metabolic syndrome in breast cancer patients

In a retrospective review of 177 triple negative breast cancer patients (TNBC) treated from 2007 through 2013, metabolic syndrome was significantly associated with poorer outcomes, but overall survival was not impacted. Obesity was found to have a small potential benefit among TNBC patients. LIMR investigators: Kaitlyn Kennard, MD; Meghan Buckley; Sharon Larson, PhD; Ned Carp, MD; Thomas Frazier, MD, and other MLH clinicians. The manuscript: “Metabolic Syndrome: does this influence breast cancer outcomes in the triple-negative population?” in the journal Breast Cancer Research and Treatment.

 

Good results of Cardioband clinical trial

Results of a clinical device trial for patients diagnosed with tricuspid regurgitation (TR) showed high procedural feasibility with no 30-day mortality, a significant reduction of functional TR, and improvements in patient status. Main Line Health is participating in this early feasibility study that is testing the Edwards Cardioband™ tricuspid valve reconstruction system. LIMR investigator and MLH principal investigator for this trial: William Gray. The manuscript: “Early Feasibility Study of Cardioband Tricuspid System for Functional Tricuspid Regurgitation: 30-Day Outcomes” in JACC Cardiovascular Interventions.

 

Patient-reported outcomes after aortic surgery

Following minimally invasive aortic surgery, patient-reported scores for pain, depression and anxiety returned to preoperative levels or improved at one month, and even more so after three months. LIMR investigators: Serge Sicouri, MD, and Meghan Buckley. The manuscript: “Assessment of pain, anxiety and depression, and quality of life after minimally invasive aortic surgery” in Journal of Cardiac Surgery.

 

Detecting subclinical atrial fibrillation

Results of the REVEAL AF clinical trial, in which Main Line Health participated, showed that only heart palpitations were associated with subclinical atrial fibrillation (SCAF). No other prescreening symptoms that the researchers evaluated were associated with an increased likelihood of SCAF detection. LIMR investigator: Peter Kowey, MD. The manuscript: “Relation of Antecedent Symptoms to the Likelihood of Detecting Subclinical Atrial Fibrillation with Inserted Cardiac Monitors” in The American Journal of Cardiology.

 

Patient outcomes of mini- vs. full-Bentall procedures

Researchers compared outcomes of 97 consecutive patients who underwent upper ministernotomy Bentall procedures (mini-Bentall; 48 patients) to full sternotomy (full-Bentall; 49 patients) by a single Lankenau surgeon. They found that patients who underwent mini-Bentall required significantly less ventilation time and reoperations for bleeding vs. full-Bentall. No significant differences were seen in cardio bypass, aortic cross-clamp times, or ICU and hospital stay between the groups. LIMR investigators: Serge Sicouri, MD, and Meghan Buckley. The manuscript: “The mini-Bentall approach: a comparison to full sternotomy” in JTCVS Techniques.

 

Treatment for posterior glottic stenosis

A new, minimally invasive technique for the management of mild to moderate posterior glottic stenosis was introduced, along with a literature review and case study. “The two-stage procedure should reduce the risk of recurrence, but more experience is needed,” noted the authors. LIMR investigator: Robert Sataloff, MD. The manuscript: “A novel surgical technique for posterior glottic stenosis using a silastic implant” in Journal of Voice.

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Clinical Trial of the Week: Device trial to treat patients with tricuspid regurgitation

By Donna Loyle, communications manager, LIMR

 

Main Line Health is participating in a randomized, controlled pivotal study that is evaluating the safety and effectiveness of the Edwards PASCAL Transcatheter Valve Repair System and optimal medical therapy (OMT) compared to OMT alone in patients with severe tricuspid regurgitation.

 

Eligible participants are those at an intermediate or greater estimated risk of mortality if they underwent tricuspid valve surgery. The primary outcomes being measured are mortality, heart failure hospitalization, need for surgery on the tricuspid valve, and improvement of quality of life.

 

Patients are randomized into one of two study arms:

  • Arm 1 patients undergo transcatheter tricuspid valve repair with the Edwards PASCAL system
  • Arm 2 patients proceed with continued medical management of their tricuspid disease (i.e., serial echocardiograms, appropriate medications)

 

Patient follow-up occurs post-procedure at 30 days, six months, and then annually through five years.

 

Inclusion criteria:

  • Must have been diagnosed with functional or degenerative, severe tricuspid regurgitation
  • Must be symptomatic, New York Heart Association (NYHA) class II-IVa or heart failure hospitalization in the prior 12 months
  • Must have the appropriate tricuspid valve anatomy to support implantation of the medical device
  • Other significant inclusion and exclusion criteria apply

 

The MLH principal investigator for the CLASP II TR clinical trial is William Gray. The trial is approved for Lankenau Medical Center.

 

For more, visit https://www.mainlinehealth.org/research/clinical-trials/clasp-ii-tr

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LMC Awarded ‘America’s 50 Best Hospitals Award’

Main Line Health is pleased to announce that, for the third year in row, Lankenau Medical Center has been awarded ‘America’s 50 Best Hospitals Award’ by ‘Healthgrades 2021 America’s Best Hospitals.’

 

LMC was also received Healthgrades’ Specialty Clinical Quality Awards for its excellence in cardiac care, earning ‘America’s 50 Best Hospitals for Cardiac Surgery Award’ (2021, 2020 and 2019) as well as America’s 100 Best Hospitals for Cardiac Care Award’ (2021, 2020 and 2019). Lankenau is one of only three hospitals in Pennsylvania to be awarded this coveted recognition.

 

These awards highlight Lankenau’s commitment and dedication to consistently deliver superior outcomes and patient care, having embraced a culture of excellence through quality improvement. View the full article here or visit the Healthgrades site. Congratulations to the team at Lankenau!

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LGBTQ Inclusive Care Survey

To ensure that members of our LGBTQ community—both employees and patients alike— continue to feel supported and safe, Main Line Health LGBTQ Inclusive Care is asking for your help in taking a short survey to help identify and address any concerns or gaps in care. This survey is open to all MLH staff and will close in mid-May. An external survey will also be shared externally with our patients.

 

We’ll continue to provide you with reminders to fill out the survey if you haven’t done so as your feedback is essential in shaping our strategies that support our LGTBQ community. Once the surveys close and the data is reviewed, we’ll share the results and our next steps with you. Your feedback is invaluable – we appreciate it!

 

The team at LGBTQ Services thanks you for taking to time to better our entire MLHS community!

 

Link to survey: https://surveys.nationalresearch.com/survey/selfserve/1fd5/201236?list=1#?

 

For more information, please contact Dane Menkin, Director of LGBTQ Services at MenkinD@mlhs.org

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