Opened in 2014, Mission Hospital's Neuroscience & Spine Institute stands as the premier neurosurgical facility in Orange County

Mission Neuroscience Institute

Awards and Recognition

The greatest reward that Mission Hospital has, is seeing our patients living full, happy, active lives. But it is also nice to have outside recognition. Here are just a few ways the Mission Neuroscience Institute has been recognized.

Codman Award

“Improving Outcomes in Severe Traumatic Brain Injury”

Mission Hospital’s trauma team strives to provide care based on best practice. The clinical outcomes of patients sustaining severe traumatic brain injury (TBI) were marginal at best, 43% expiring and 30% suffering severe disability. Research in the past decade has utilized new technology for monitoring the effects of secondary brain injury and examined the effects of various treatment modalities on the outcomes of TBI patients. In 1995, evidenced based clinical guidelines for managing severe TBI were published recommending changes in care. The guidelines challenged hospitals to evaluate their care practices and examine the clinical outcomes of this high-risk group.

Motivated by the new practice recommendations and potential for greatly impacting patient outcomes, the multidisciplinary trauma team convened in 1997 to begin the process of performance improvement. Current practice was examined and new hospital based clinical guidelines developed. Numerous changes were recommended as the team dismantled current practice patterns and constructed new care priorities. Every aspect of caring for the severe TBI patient from admission to rehabilitation was examined. The result was a series of algorithms with established outcomes at every phase of the patient’s hospital course.

Three years after integrating the changes into practice, outcomes for the severe TBI population showed 70% of the patients achieved a good outcome to moderate disability, 15% sustained severe disability to persistent vegetative state, and 15% died. These outcomes confirmed that the changes in practice and intense cooperation resulted in a difference to patients. Using a performance improvement approach, the quality of care provided to the TBI population has been significantly enhanced.

The Adam Williams Traumatic Brain Injury Initiative

The Adam Williams Traumatic Brain Injury Initiative was created by Mary Kay Bader RN, MSN, CCNS (Neuro/Critical Care Clinical Nurse Specialist (CNS)) in collaboration with philanthropist Nancy Williams. Nancy’s son, Adam Williams, had sustained a severe traumatic brain injury (TBI) in 1999. Following his recovery and graduation from school, Nancy sought ways to improve the outcomes of brain injury patients in the Mission Hospital community. Following a meeting with Nancy in which she asked how she could help advance the care of severe TBI patients across the country, Mary Kay suggested the concept of creating an initiative where funding would be provided to train hospital staff and fund the purchasing of multimodality brain monitoring. Nancy’s initial donation of $750,000 was the foundation for beginning the initiative.

A committee of hospital staff (see participants below), physicians, and community members developed an application process for outside level I and II trauma centers. Information on the AWTBI is available on the internet (http://www.awtbii.org/). The website is easy to navigate and provides the application for centers to complete. The fund provides for three members of the chosen trauma center to fly to Mission Hospital and spend three to four days with the surgical intensive care unit (SICU) and trauma team. While at Mission Hospital, the visiting nurses/physicians receive a four hour lecture by Mary Kay. They spend two days at the bedside with Mission Hospital’s nurses learning how to critically manage the severe brain injured patient. All expenses are paid by the AWTBI fund. In addition, the team receives three copies of all of Mission Hospital’s protocols, twenty-five articles from the literature and the BTF Guidelines book. After the Mission Hospital visit, Mary Kay along with the Nurse Manager/Clinical Director of SICU, and neurosurgeon Sylvain Palmer MD, travel to the site to provide a three hour lecture to the physician/leadership team and a four hour lecture to the nurses/therapists and staff from the chosen site. All expenses are paid for by the AWTBI fund. The fund provides $50,000 in capital equipment including two brain oxygen monitors, one cooling machine and one pupillometer. In addition, the fund provides $5000 to the BTF for the center to enter data for two years into the BTF database. The initial training of the centers has been scheduled for five centers per year.

Participants:

  • Mary Kay Bader RN, MSN, CCNS, CCRN, CNRN, FAHA
  • Connie Gagliardo, RN, MSN, Executive Director Critical Care and Trauma Services
  • Margie Whittaker, RN, MSN, Nurse Manager Surgical Intensive Care Unit
  • Surgical ICU Staff all participate to serve to mentors during two-three day visits

Since the launching in 2004, the Mission Hospital team has visited twenty-nine trauma centers in the United States. From 2009-2011, the team visited the following hospitals:

  • Northwestern Memorial Hospital, Illinois
  • Spartanburg Regional Medical Healthcare System, South Carolina
  • Morristown Memorial Hospital, New Jersey
  • Alaska Native Medical Center, Alaska
  • University of California Davis Medical Center, California
  • St. Lukes Hospital, Kansas
  • Boston University Medical Center, Massachusetts
  • Sinai Hospital of Baltimore, Maryland

The training does not end with the Mission Hospital team’s visit. Consultation occurs on a regular basis. Mary Kay conducts a follow-up visit one to two years after each center is launched. She conducts interviews with nurses and physicians to determine the impact of the initiative. An outcome report is sent back to the AWTBI team on the status of each center.

An excellent example on how our internal expert and external consultant positively impacted patient outcomes is represented in the 2010 outcome data from Sanford Hospital in Sioux Falls, South Dakota. Prior to the AWTBI intervention, Sanford Hospital had only 28% of TBI patients with an outcome of “good recovery.” This is compared to 63% classified as having a “good recovery” following AWTBI (see graph EP 7 Figure 9 and attachment sanfordhospitaltbidata.ppt).

By providing a comprehensive package to outside trauma centers, the AWTBI has impact patient outcomes (see attachment TBI newspaperarticle.doc). The relationship that is produced from the site visits builds strong connections. Nurses from the AWTBI hospitals call Mary Kay and Mission Hospital’s Surgical Intensive Care Unit, asking questions regarding patients the center is managing at the time of the call. Guidance is provided to the team. Mary Kay receives email from the site’s personnel and consults with them on specific issues (see attachment example of emails.doc). The ability of these centers to access Mary Kay as an external consultant enables them to have complex questions and clinical situations resolved by an expert. This support is integral to help other centers overcome certain barriers in systems and teams.

The utilization of internal and external experts brings advanced knowledge and clinical wisdom to nurses at the bedside. Supporting practitioners enhances care practice and improves patient care outcomes.