March 2024

Froedtert Bluemound Rehabilitation Hospital

Olivia Park, MD, Medical Director, Froedtert Bluemound Rehabilitation Hospital

Census Update:  

Month to date performance through 2/11, we have had 29 admissions and an estimated ADC of 43.5.  Last week was a heavy discharge week with 24 patients discharging from FBRH (that is over 53% of our capacity that left in one week!). We were able to maintain census in the 40s even with the higher discharge volumes. Our goal for the month of February is to achieve 45 ADC and end the month at 50 census. We appreciate the flexibility and collaboration with Drs. Orr, Del Toro, Sayyad, Shields, Vaccaro, Hua, Shuda, Goodfriend to ensure our physician teams are able to accommodate the high census.  

FBRH captured 70% of the total FMLH discharges to acute inpatient rehab for the month. For patients captured by an external IPR hospital, we saw that almost half of these patients were not referred to FBRH. Work remains underway to educate acute care staff to encourage liaison referrals are placed in a timely manner for any patient that may requires post acute care.

Staffing update: We have a wound care nurse Beth Seiler who is here M/Tu/Th/Fr 0700-1630. Jill Redding is present on Wednesdays for debridements and consults. Outside of these days/hours, virtual wound care consults available (Joe Beiler). Agency staffing remains very high, especially at night. Our business manager Kaila Mitchell will be leaving FBRH on 1/23/24 to become the new DA for the ENT department. Denise Gilmore will be our interim. We are also recruiting for another referral liaison and a Bluemound APP. Below is the FBRH weekly admission & ADC performance update.  

Hospitalist service: We currently have three rotating hospitalists (Dr. Kottapalli, Dr. Yafai, and Dr. Ugwu) with a full time APP Jessica Denton. We are grateful for their presence as a second set of eyes on our patients, especially as CMI continues to increase. We continue to encourage robust communication between the PM&R and hospitalist teams to ensure the highest level of care is being delivered. The hope is that once the hospitalists reach a consistent census of 45, we will obtain another full time APP.  

Dr. Diane W. Braza stepping down as Chair of Physical Medicine and Rehabilitation

"I wish to share with you that Diane W. Braza, MD, Professor and Chair of the Department of Physical Medicine and Rehabilitation (PM&R) at the Medical College of Wisconsin (MCW), has informed me of her intention to step down from her role as Chair after nearly 13 years of leadership service. Dr. Braza is still considering her next steps after leaving the Chair role.

Dr. Braza has graciously agreed to remain in the Chair capacity during the search for her successor. A search committee, chaired by Joseph Gravel, MD, will convene shortly.

Dr. Braza joined the faculty at the Medical College of Wisconsin in 1992 as an Assistant Clinical Professor of PM&R and rose through the ranks to become a tenured Professor in 2012. Dr. Braza served as Interim Chair of PM&R from 2011-2012, when she ascended to the permanent Chair position. Dr. Braza also held a secondary appointment in the Department of Neurosurgery (2006-2012) and a secondary appointment as a faculty advisor in the Department of Population Health/Masters in Public Health Program. Dr. Braza co-founded MCW SpineCare, a comprehensive integrated transdisciplinary spine care program with the Department of Neurosurgery in 1995 and served as Medical Director of the program until 2011. She continues to practice clinically within SpineCare. Since 2013, Dr. Braza has served as the Froedtert Health (FH) Co-dyad Leader of Rehabilitation Services, along with Sue Knuth, the current FH Executive Director of Rehabilitation Services. Dr. Braza has served as FH & MCW Spine Service Line Co-director since January 2022.

As Chair of PM&R, Dr. Braza has prioritized administrative leadership, financial stability and recruitment and retention of faculty and staff. Under her leadership, the Department has focused its strategy for inpatient rehabilitation – covering units on the Froedtert Hospital and Froedtert Menomonee Falls Hospital (formerly Community Memorial Hospital) campuses. In December 2020, the Froedtert Hospital Bluemound campus business plan was approved, which included a 50-bed standalone in-patient rehabilitation unit and an onsite dedicated research lab space. This facility, which opened in July 2022, was the first-ever proposed, designed and operated remote hospital unit of Froedtert Hospital. Additionally, under Dr. Braza’s mentorship – and following years of planning – the Acute Inpatient Rehabilitation Service at Children’s Wisconsin opened in February 2023.

The Department’s research, education and community engagement missions also have grown during Dr. Braza’s tenure as Chair. The Department has experienced a significant increase in extramural research funding and increased growth in research clinical trials. In collaboration with

Further, the Department has increased community engagement participation through adaptive sports and recreation medical coverage, and participation in the Saturday Clinic for Underinsured.

Dr. Braza has an extensive portfolio of service – locally and nationally. She chaired the search committees for MCW’s Neurology and Emergency Medicine chair searches, co-chaired the national search for the Neuroscience Institute Executive Director, participated in the 2030 Medical College of Wisconsin & Froedtert Health (FH) Strategic Visioning, and is an active member of the Medical College Physicians’ (MCP) Compensation and Finance Committees. Dr. Braza was an elected member of the FH Medical Executive Committee, served as Chair of MCP Quality Committee and was the inaugural Chair of the FH Quality Peer Review Committee (2015 and served on that Committee through August 2023. Dr. Braza was appointed as a Board Director of the American Board of Physical Medicine and Rehabilitation (2016) and re-elected to a second six-year term in 2022. Dr. Braza served as Chair and Chair Council for the Association of Academic Physiatry (2018-2020) and Appointed Member of the American Association of Physical Medicine and Rehabilitation Pain Management and Opioid Task Force (2018-2023). Since 2019, Dr. Braza has been an Invited Member of the American Board of Anesthesia Pain Medicine Exam Committee.

Dr. Braza has participated in more than 50 invited lectures, workshops and presentations – both locally and nationally. She has published more than 50 original peer-reviewed journal articles, non-refereed journal articles, book chapters and abstracts. Dr. Braza was selected as a Fellow for the 2013-2014 Hedwig van Ameringen Executive Leadership in Academic Medicine (ELAM) Program for Women and has consistently been selected to Milwaukee Magazine’s “Top Doctors,” Castle Connolly’s “Top Doctors” and “Best Doctors in America®.”

Dr. Braza received a Bachelor of Science degree from the University of Wisconsin-Milwaukee in 1983 and her MD from MCW in 1987. She served an internship at St. Joseph’s Hospital in Milwaukee from 1987-1988 and a combined residency in PM&R and Internal Medicine at MCW from 1988-1992.

Please join me in expressing my sincere gratitude and deep appreciation to Dr. Braza for her many contributions and steadfast commitment to the Medical College of Wisconsin. We look forward to her continued contributions in the coming years."

- Joseph E. Kerschner, MD, Provost, Executive Vice President and The Julia A. Uihlein, MA, Dean of the School of Medicine

New Staff Member in Research

The research team continues to grow! In February we welcomed Morgan McIlwee to the team. Morgan is a recent graduate from the University of Wisconsin - Milwaukee and received her Bachelor of Science in Psychology. She also graduated with a minor in Biology and participated in the university’s Honors College.  In her free time, she enjoys hanging out with animals, and has a cat of her own. Morgan also enjoys music and curating playlists and participated in an a cappella group in high school. This past fall, she completed an internship at MCW called GC-CREW, the Genetic Counseling Career Research and Exploration Workshop. She is delighted to be a part of the PM&R Research Staff and excited to see what this new position holds for her and her future career. Please stop by and introduce yourself to the newest team member!

MCW PM&R ranked 20^th in nation in 2023 Blue Ridge Rankings

Every year since 2006, the Blue Ridge Institute for Medical Research (BRIMR), an independent non-profit organization, has published rankings of institutions, departments, and investigators based on the funding they receive from the US National Institutes of Health (NIH). For fiscal year 2023, MCW’s PM&R Department achieved its highest ever ranking at #20 in the Physical Medicine clinical science discipline, with $807,965 in total NIH funding. 

Research Presentations

Mary Elizabeth Nelson-Biersach and Michael Acosta presented their poster “Evaluating Resident Confidence and Competence Troubleshooting Intrathecal Baclofen Pump Emergencies Across Residency Levels” at the 2024 North American Neuromodulation Society (NANS) meeting that recently took place in Las Vegas in January. Dr. Acosta was further invited to give a podium presentation in more depth on their work. He presented “Mock Intrathecal Baclofen Pump Emergencies as a Teaching Aid for Housestaff”.

Dr. Nelson-Biersach also gave an invited lecture to the Institute for Disability and Rehabilitation Research in Canada on February 12th. Her topic “Beyond care: Exploring nursing's integral role in rehabilitation care and advancing rehabilitation research” sparked a lively conversation. She received invitations to speak at further events for this group. IDRR is the Canadian equivalent of the USA’s NIDILRR, so this was a prestigious request for her to speak to their group. Congratulations Dr. Nelson-Biersach on representing PM&R on an international level!

Grant Funding

Karin Goodfriend and her collaborator Samuel Nemanich from Marquette University were notified that their NIH R21 grant entitled “Game-based Mobile-Health Quantification of Upper-Limb Motor Performance in Children with Hemiparetic Cerebral Palsy” received a 4^th percentile score at the February Study Section. Congratulations to Drs. Goodfriend and Nemanich on this incredible score! We will look forward to receiving an official award notice on this grant application with a projected start date of 7/1/2024.

Featured Study of the Month

New to the research section of the department newsletter, we would like to highlight one research study each month. In honor of Nick Ketchum leaving the research team, we would like to first highlight the Ipsen DIRECTION study and all his hard work on this trial to date. The DIRECTION trial is a Phase IV, double-blind crossover study to compare the efficacy of Dysport to Botox in upper limb spasticity. PM&R started enrolling in this trial in February 2023. Simon Orozco is the lead coordinator on this study. Since that time, Dr. Ketchum and Simon have enrolled 18 patients! This is a remarkable achievement and Dr. Ketchum is currently the 3^rd leading national enroller for this study. Thank you to Dr. Ketchum and Simon for all their dedicated work on this study. Karin Goodfriend will take over as PI for this study in March, and the study team looks forward to working with her to enroll another 7-12 patients for this trial. This study may recruit from PM&R inpatient and outpatient, so if you see a patient with spasticity at the finger, wrist and elbow, send them our way to be pre-screened for eligibility!

Dr. Mary Elizabeth Nelson's Lecture at Ontario's IDRR 

Dr. Mary Elizabeth Nelson had the honor of being the February invited lecturer for Ontario Tech University’s Institute for Disability and Rehabilitation Research virtual speaker series. The IDRR is Canada’s multidisciplinary team of scientists committed to developing and advocating for innovative strategies and policies to improve the quality of life and wellbeing of people with disabilities, and to develop effective rehabilitation interventions for Canadians and people worldwide. Their teams are global leaders in rehabilitation research and requested Dr. Nelson’s expertise in advocacy for rehabilitation as last month's focus. Presenting her lecture: “Beyond Care: Exploring Nursing’s Integral Role in Rehabilitation Care and Advancing Rehabilitation Research” sought to facilitate the generation of integrated and collaborate approaches to research in rehabilitation. Lively discussions followed the lecture regarding team dynamics, research implementation and how to effectively measure the health and disability of populations. The day ended with discussions surrounding Health Policy and Systems Research opportunities to organize the health system and effect positive change.  

AAP 2024 Annual Meeting Presentations

This year's Annual Association of Academic Physiatrists meeting took place in Orlando Florida from February 20th to the 24th. Two of our very own PM&R Residents presented at this year's meeting! Resident Ragav Sharma provided the conference with his presentation titled “Does Meeting the ACSM Guidelines Reduce the Likelihood of Burnout in PM&R Residents”. Resident Sarah Meeuwsen provided the conference with her presentation titled "Race- and Ethnicity-Based Health Disparities in Post-Stroke Rehabilitation". Both Residents are pictured above with Department Chair Dr. Diane Braza! 

In addition, our very own Dr. Carley Sauter co-hosted two workshops titled: "Building the Physical Medicine and Rehabilitation Workforce: Strategies for Providing Early Exposure and Mentorship for College and Medical Students" and "Advising the Advisor: An update on Helping Students Create a Holistic Residency Application".

PM&R Philanthropy Case 

Please contact Meg Bilicki, Senior Director of Development  mbilicki@mcw.edu or Dr. Braza dbraza@mcw.edu for more information.

To support Physical Medicine and Rehabilitation click on this link!

Winner of the 'Guess the Person to their Childhood Photo’ February Department Engagment Contest! 

The PM&R Department had a February Engagement contest to ‘Guess the Person to their Childhood Photo’ of people within our department. We had 8 submissions along with their childhood photo to be matched. The winner was determined by who was able to guess all 8 correctly. Second and third place winners were determined by the time their guess was submitted. 

• In 1st place was Alan Young!!
• In 2nd place was Gabriel Merkow!!
• In 3rd place was Meghann Sytsma!!

Congratulations Drs. McGonigle and Ketchum! 

Drs. McGonigle and Ketchum welcomed their son on January 31st! Baby boy Conor McGonigle Ketchum was born at 3lbs, 14 oz (McGonigle is the middle name). Dr. McGonigle and Conor are doing well!

Department Mascot's Outfit for the Month of March

For the month of March our department mascot 'Randy the Rhino' (who loves basketball) shares a photo of him attending a Milwaukee Bucks game in Honor of March Madness with his friend from Illinois Ryan the Rhino. He is also hoping the Wisconsin Badgers come out with a big win for his draft pick! 

The answer to the riddle below will be provided in next month's newsletter. See if you can solve this following riddle:

"What has hands but cannot clap"

Answer to last month's riddle: The anwser is beauty. "beauty is in the eye of the beholder"

Monthly Wellness Feature: How to Spot Health Misinformation

The internet provides a fast, convenient way to research reliable health and medical data. Unfortunately, it is also packed with misleading and false claims. A majority of Americans use the internet and social media to find health and medical information — raising concerns about the quality of these sources.

The U.S. Surgeon General Dr. Vivek Murthy defines misinformation as any “information that is false, inaccurate or misleading, according to the best available evidence at the time.” Many websites and social media have increased their scope of health content, too often posting data that only resemble trustworthy, legitimate sources. And following misleading or incorrect information about health and medical conditions can harm your health.

Dr. Murthy has said that health misinformation is a serious threat to public health. It leads to confusion, results in increased health problems and health care expenses and slows patients’ recovery to good health. Search for Health Misinformation at hhs.gov.

Use these tips whenever you read health and medical content:

1. Check the CDC (cdc.gov) or your local public health department website to confirm the value of the claims made.
2. Reputable non-profits, such as the American Heart Association (heart.org), the American Cancer Society (cancer.org) and American Diabetes Association (diabetes.org), provide current, science-based information for specific diseases.
3. Ask your primary health care provider, nurse practitioner or nurse for confirmation or additional guidance.
4. Search the claim at the National Library of Medicine (pubmed.ncbi.nlm.nih.gov) to learn if it is verified by credible health care sources.
5. Review the About Us page on each website for assurance it is a trustworthy source. Look for credentialed professionals, such as medical doctors and dietitians, who review the content.

These steps can help you to better understand, identify and curb misinformation, and help others do the same.

For more information and resources click here.

Healthy Recipie of the Month - Buffalo Cauliflower Bites 

INGREDIENTS:

• 1 head of cauliflower, cut into florets
• 3/4 cup flour
• 1 teaspoon ground paprika
• 1 teaspoon onion powder
• 1 teaspoon garlic powder
• 1 teaspoon salt
• 3/4 cup buttermilk
• 2 tablespoons butter (or coconut oil) melted
• 1/3 cup Buffalo Sauce (we used Frank’s!)

DIRECTIONS:

Preheat the oven to 375°F and line two baking sheets with parchment paper. Set aside.

• In a large bowl, combine the spices, salt, and the flour. Add the buttermilk and stir until combined. The mixture should be pretty thick!
• Add the cauliflower florets to the bater, coating each piece evenly in the buttermilk mixture. Place the coated cauliflower on the prepared baking pans, leaving room between each piece so the air can circulate around them.
• Bake for 20 minutes and then flip the cauliflower over to it’s other side to get an even bake. Bake for another 20 minutes on the other side!
• While the cauliflower bakes, make the buffalo sauce. Combine the buffalo sauce with the melted butter (or coconut oil) and whisk until well blended.
• When the cauliflower is done, add the florets into the bowl with the hot sauce mixture, and toss to coat the florets and enjoy!

Recipe submitted by department Administration Assistant Sr. Rhiannon Shewczyk 

*If you would like to share your own healthy recipe in next month's newsletter please email department Administrative Assistant Sr. Rhiannon Shewczyk at Rshewczyk@mcw.edu

March is Developmental Disabilities Awareness Month

In 1987, President Reagan recognized March as Developmental Disabilities Awareness Month to increase “public awareness of the needs and the potential of Americans with developmental disabilities” and to provide the “encouragement and opportunities they need to lead productive lives and to achieve their full potential.”

Month-long Observations:

• Developmental Disabilities Awareness Month
• Ethnic Equality Month
• Gender Equality Month
• Greek-American Heritage Month
• Irish-American Heritage Month
• National Colon Cancer Awareness Month
• National Kidney Month
• National Multiple Sclerosis Awareness and Education Month
• National Women’s History Month

Important March DE&I calendar dates:

• March 1 – Employee Appreciation Day
• March 8 – International Women’s Day
• March 8 – Maha Shivarati (Hindu)
• March 10 –  Ramadan begins (Islam)
• March 14 – Pi π Day
• March 14 – Equal Pay Day
• March 17 – St. Patrick’s Day
• March 21 – World Down Syndrome Day
• March 23 – Purim (Jewish)
• March 25 – International Day of Remembrance of the Victims of Slavery and the Transatlantic Slave Trade
• March 24 – Holi (Hindu)
• March 24 – Palm Sunday (Christian)
• March 29– Good Friday (Christian)
• March 31 – International Transgender Day of Visibility
• March 31 – Easter (Christian)

COVID-19 Guidelines 

Both Froedtert and MCW employees with an approved COVID-19 vaccination exemption are no longer required to wear masks at Froedtert & MCW facilities except when and where masks are required for all. To remain consistent within all adult clinical spaces, MCW clinics will follow this same guidance. Masks have not been required for unvaccinated individuals in MCW non-clinical spaces since October 2022.

The COVID-19 vaccine requirement was discontinued for employees effective on June 13, due to recent guidance from the CDC and Centers for Medicare and Medicaid Services (CMS). COVID-19 vaccinations and boosters will continue to be strongly recommended, but not required as a condition of employment with MCW.  Vaccination will continue to be required for students and learners who participate in clinical care due to many healthcare partners who have not yet lifted their COVID-19 vaccine requirement. This requirement is being actively re-evaluated as a high priority, and we will provide follow-up information as soon as feasible. Individuals who work in partner healthcare facilities that require vaccination must also continue to follow the guidance and requirements of those facilities. 

For additional information visit the COVID-19 page on infoscope. 

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