TJU Wins Gold Seal, MLB Selects Kathleen Weber, M.D. Team Physician President and Improved Scoliosis Treatment

Joint Commission Gold Seal for Thomas Jefferson University Hospital

Their hard work pays off every day…and now it has been recognized by The Joint Commission. Thomas Jefferson University (TJU) Hospital has earned the country’s first-ever Joint Commission Gold Seal of Approval for Total Hip and Total Knee Replacement Certification.

An independent, not-for-profit organization, The Joint Commission accredits and certifies nearly 21, 000 health care organizations and programs in the United States.

Alexander R. Vaccaro, M.D., Ph.D., M.B.A. is the Richard H. Rothman Professor and Chair of Orthopedic Surgery at Thomas Jefferson University Hospital. In the April 26, 2016 news release he noted, “We take great pride in the safe, quality care we provide to each and every patient, and we look forward to maintaining and improving upon our standard of care for the increasing number of patients undergoing total hip or total knee replacement surgery.”

Dr. Vaccaro told OTW “The steps we take to improve and maintain our care for hip and knee replacement patients include a full time Quality Improvement Director who is charged with monitoring key quality measures such as readmission, infection and reoperation rates, a Clinical Practice Guideline Committee charged with providing our patients with the most up-to-date evidenced-based practices, and surgeons committed to the highest standards of excellence.”

“The most difficult outcome measure to measure is value, which is outcomes over cost. We use indirect metrics such as length of stay, complications, readmissions, etc. Quality and outcomes are things that have to be assessed over time accounting for not only physical function but patient satisfaction and the ability for a patient to return as a productive member of society.”

Major League Baseball Team Physicians Association Selects Kathleen Weber, M.D. To Be It’s New President

She is making baseball history. Kathleen Weber, M.D., Midwest Orthopaedics at Rush sports medicine physician and the Director of Primary Care/Sports Medicine and Women’s Sports Medicine at Rush University Medical Center, has been elected President of the Major League Baseball Team (MLB) Physicians Association (MLBTPA). Dr. Weber is the first female president of this organization.

Dr. Weber is much prepared for her new role, as she is currently team physician for the Chicago White Sox, Chicago Bulls and Chicago Force Women’s Football. She is also the head team physician for the DePaul Blue Demons, Malcolm X College and a physician consultant for Hubbard Street and River North Dance Companies. In addition to her team physician role, she also serves as a member of the LPGA Medical Advisory Board, the NBA Team Physician’s Executive Committee and the NBA research committee.

Dr. Weber has been “in the game” herself as a college athlete. She has also been honored with numerous awards for excellence in patient care, teaching excellence and was recently recognized as a “Health Champion” by Girls in the Game, a non-profit organization.

Dr. Weber told OTW, “To be eligible for nomination for the President you must have been elected and served in the past as a member of the MLBTPA executive committee. The executive committee actively works in collaboration with MLB and PBATS on issues related to the safety and care of the players. Having a three-year term allows for a smooth continuation and coordination of on-going activities. My focus has been to build upon the already established issues and represent the TPA members as a whole. My ultimate goal is to continue to move the organization forward—establishing further guidelines to provide outstanding care for all the players.”

Asked what she would say to those who wonder if a woman is right for the job, Dr. Weber told OTW, “I would say, more importantly is there an experienced and qualified leader in the position. To this I would answer ‘yes.’ Gender has nothing to do with it.”

As for what she most looks forward to, Dr. Weber noted, “Being able to build upon all the accomplishments and progress made thus far by the leaders and members of the MLB Team Physician Association. And of course, I look forward to the day my role is not unique and there are both women and men making a difference for this association and the MLB.”

Beyond The Radiograph: Improved Scoliosis Treatment

If anyone is NOT static, it’s children. So why rely on static technology to guide treatment decisions for their medical care? That was the reason for collaboration between several of the researchers at the Hospital for Special Surgery (HSS) and the State University of New York (SUNY) Downstate Medical Center. The team set out to get “beyond the radiograph” when it comes to caring for young scoliosis patients. The team, led by spine surgeons Dr. Carl Paulino and Dr. Ashish Patel, and on their behalf, Bassel Diebo, M.D, told OTW, “For decades, physicians have leaned on X-rays to plan surgical treatments and assess outcomes for their scoliosis patients. We have reached the limit of the information a two-dimensional static radiograph can provide us. We now want to understand how spinal deformities affect patients dynamically. This tool has already been in practice when planning and treating patients with cerebral palsy. Life is composed of dynamic events, all in three dimensions, and so doctors should be able to plan and evaluate their treatment outcomes based on dynamic requirements.”

“We conducted our dynamic testing using the gait analysis lab at SUNY Downstate. We place dozens of reflective markers on our patients, as they do when making sporting video games, and then ask them to walk within a defined area monitored via high speed cameras and force plates to assess their kinetic and kinematic function. For patients that met the criteria for surgical correction for their advanced scoliosis we conducted our gait analysis both before and after their surgery. Our primary objective was to learn whether intraoperative de-rotational maneuvers that aim to correct the axial plane deformity of AIS (manifested by the twisted rib prominence) were effective at improving overall axial plane motion Interestingly, we discovered that children with scoliosis have an abnormal gait pattern that is different than that of children without this condition. The children with scoliosis are limited in their thoracic/shoulder rotation…their thoracic spines are locked, and they are unable to rotate toward the side of their spinal deformity. By evaluating and correcting their preoperative axial plane dysfunction, we are working toward restoring their ability to rotate the thorax and to give these children a closer to normal axial plane motion.”

“The fact is that the surgeries we are doing are falling short of the mark…we need to do a better job of getting these kids ‘back to normal.’ To that end, with the collaboration with spine service at HSS led by Drs. Frank Schwab and Virginie Lafage, we are moving forward with a grant from the Scoliosis Research Society (SRS) that will enable us to determine how we can improve on surgical techniques for these children using gait analysis technology.”

“One issue is that with scoliosis not only is the spine curved, but it is also twisted. Much of our focus the last few decades has been on correcting the spinal curvature and we have become very good at it. We now need to focus on the other aspects of the spinal deformity, specifically the rotational component, Gait analysis allows us to do this in an objective way. Ideally, industry will work with surgeons to develop more efficient spinal de-rotational devices. Another issue is that not every surgeon objectively assesses spinal axial rotation of every scoliosis patient; doing so would let him or her have a better understanding of their patients’ deformity and thus deliver a better personalized treatment.”