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Impact Report | Fiscal Years 2017–2018
For two decades, Johns Hopkins Medicine International has served as the global ambassador of the Johns Hopkins Medicine mission. In that time, we’ve had a tremendous impact in every corner of the world—providing leading-edge care for patients and families from nearly 190 countries and working hand in hand with affiliates on six continents to raise the standard of health care.
Below you can read highlights of how our transformational work over the last two fiscal years has benefited medical educators and students, rising health care leaders, partners in research and discovery, our faculty members, and, most importantly, patients and families across the globe.
Johns Hopkins Medicine International 1998–2018
In 1998, Johns Hopkins Medicine established a global ambassador, Johns Hopkins Medicine International, to take its mission worldwide. Since then, we’ve worked to help Johns Hopkins Medicine emerge as a pioneer in international collaborative health. Today, we deliver the promise of medicine to people across the globe—through culturally sensitive care at Johns Hopkins Medicine in the United States and groundbreaking collaborations that raise the standard of health around the world.
Johns Hopkins Medicine is home to some of the greatest innovators in the medical field. Our role is to amplify those voices around the globe, building bridges between Johns Hopkins experts and our affiliates.
Working with nurses at Nelson Mandela Children’s Hospital (NMCH) in South Africa—the first children’s hospital in the region—Johns Hopkins nurses found more similarities than differences.
“Nurses all over the world face the same challenges,” says Johns Hopkins nursing consultant Wilma Berends, who traveled with other Baltimore nurses to the 200-bed hospital in Johannesburg as part of a unique, three-year educational exchange.
We are facilitating the exchange, funded through the United States Agency for International Development’s global flagship Maternal and Child Survival Program, led by Johns Hopkins affiliate Jhpiego.
NMCH is a gleaming, state-of-the-art facility stocked with pediatric equipment sized for a child’s body. Colorful art lines the hallways and dangles from ceilings in lofted corridors. Daily life in South Africa can have its obstacles, says NMCH nursing director Jayson Gopiechand.
“There are a lot of service issues in the area,” Gopiechand says. “We have gone three days with no water—how do you run a dialysis unit like that?”
Leaders are devising creative solutions, including installing three 10,000-liter water tanks to keep the hospital open even during South Africa’s growing water crisis.
Gopiechand and other NMCH leaders visited Baltimore in March 2018 to share with and learn from Johns Hopkins and Jhpiego colleagues.
The South African hospital empowers its nurses to help the hospital improve. Our educational exchange supports lectures, simulations and observations so nurses can learn Johns Hopkins’ best practices.
NMCH is positioning its nurses as leaders and experts on the treatment team—and it shows, says Kristina Hoerl, a Johns Hopkins registered nurse educator. In South Africa, she spent time training with the radiology nurse manager, nurses and technicians.
“I went in thinking I would meet with nurses who were a little more reserved in how they advocate for patients,” Hoerl says. “But I was awed at how empowered the nurse manager was.”
Johns Hopkins Medicine aims to provide the best medical care in the world—and to elevate that care every day. We are always striving to discover and apply new ideas, techniques and therapies to improve human health.
In China, due to the 1.4 billion-person population and growing demand for health care, it is not uncommon for patients to wait in long lines at the more than 12,600 public hospitals. For Chinese patients, accessing quality care quickly can be a constant challenge. Home care could be an effective way to improve efficiencies and reduce costs by diverting lower-acuity patients to a new care environment: the home. But, would Chinese hospitals and patients be open to home care, a service currently unavailable in the country, as an alternative for services now provided in an in-patient setting?
Asia Pacific Health Care (APHC) thought home care was a viable and novel solution. It recognized what the latest research indicates: It is often healthier to heal at home. After setting up the groundwork, APHC entered into a collaboration in February 2017 with Johns Hopkins Medicine International and the Johns Hopkins Home Care Group (JHHCG)—a leader in the field—to accelerate the plans.
“Together, we have worked on building APHC’s infrastructure and workforce to include nursing professionals and administrative staff, and we established a design that supports multiple specialties,” says Lou Ann Rau, assistant director of education and special programs for JHHCG and project manager for this effort. Service offerings include postnatal care for both mother and baby, care for postoperative gastrointestinal surgery patients and disease management for the chronically ill.
“It’s not enough to establish a service offering. There also must be a way to attract referrals,” Rau says. The consultancy also covers guidance on how to educate the market about home care and build relationships with local hospitals to increase the number of patients served.
In the coming year, Johns Hopkins and APHC will work collectively to expand APHC’s specialties to include elder care and rehabilitation.
Medical emergencies can happen at any moment.
Our affiliates in Panama and Brazil asked to work with us to elevate their emergency care, wanting to ensure they could offer high-quality services supported by the right infrastructure and clinical protocols.
After collaborating with Johns Hopkins emergency medicine experts, in 2017 Pacífica Salud Hospital Punta Pacífica opened the first pediatric emergency department (PED) in a private health care facility in Panama. Our team consulted on designing the facility, selecting equipment and standardizing care.
Jane Virden, nurse manager of the pediatric emergency department at The Johns Hopkins Hospital, and Karen Schneider, assistant professor of pediatrics at the Johns Hopkins University School of Medicine, shared their expertise and encouraged multidisciplinary work in Pacífica Salud’s new PED. They modified adult codes and rapid response policies to create pediatrics-specific codes, recommended ways to optimize patient flow and efficiency, and helped ensure the new unit had the right equipment and supplies.
We are also working closely with Hospital Moinhos de Vento (HMV) in Brazil to enhance its adult emergency department. Expanding beyond operations, HMV and experts from Johns Hopkins embarked on a joint research project to implement HopScore—an electronic patient triage tool.
Designed by Johns Hopkins researchers, HopScore analyzes patient data and trends from emergency department visits, yielding more nuanced triage scores. To date, the research has produced at least two manuscripts for publication and presentations at international conferences.
The leading-edge medical expertise of Johns Hopkins Medicine draws patients from all over the world. We strive to take care of everything patients need, making them feel at home even when they’re thousands of miles away.
When Hebah Abdullah, now 38, first visited Johns Hopkins in 2015, the swelling, stiffness and joint pain from rheumatoid arthritis had her confined to a wheelchair.
As the inflammatory disorder progressed, she couldn’t do chores around the house or even care for her children—a boy, now 9 years old, and a daughter, 6.
The Kuwaiti embassy agreed to let her seek treatment at Johns Hopkins. Abdullah feels like a different woman now.
She has had nine surgeries—including replacements of hips, wrists and shoulders—and extensive rehabilitation at Johns Hopkins. She spent time at Johns Hopkins Bayview Medical Center, The Johns Hopkins Hospital and Sibley Memorial Hospital, a member of Johns Hopkins Medicine, in Washington, DC.
Seeking care in the United States was unnerving at first. Abdullah had moved here with her husband and children, but the pain made her so weak she couldn’t even hold a cup of water. The situation was overwhelming.
She found relief from Yamina Ennaciri, her international care coordinator at Johns Hopkins.
“Her support helped me,” Abdullah says, clutching Ennaciri’s arm for emphasis. “She told me, ‘You came to the right hospital.’ She didn’t give up on me—she was with me step by step, even during my surgeries. She made me believe there is hope.”
Ennaciri coordinated Abdullah’s care—scheduling appointments, escorting her and interpreting throughout her time at Johns Hopkins. Recently, Ennaciri transferred to Sibley to manage international patient care. Another care coordinator, Marina Paul, stepped in to help Abdullah.
The results of her care have been life changing, Abdullah says. Now, she plays with her children and cares for them the way she wants to—she even carries them.
Abdullah recommends Johns Hopkins to everyone at home.
“When I came here, I thought I was done,” she says. “Thank you so much, Johns Hopkins, Yamina and Marina.”
As their 25th wedding anniversary approached, Wendell and Rose Eve were planning a party and vow renewal in their home country of Bermuda.
Just weeks before the big day, Wendell collapsed in the shower. An aortic dissection—a tear in his artery—had cut off blood to part of his body, damaging his kidneys and intestines.
He was airlifted to The Johns Hopkins Hospital, where surgeons repaired the tear and restored his circulation. His odds for survival were less than 10 percent.
Rose stayed by his side as the hospital’s Department of Physical Medicine and Rehabilitation worked to rebuild Wendell’s strength. Good health includes nurturing both the spirit and body, so the rehabilitation team mobilized when they heard about the couple’s anniversary.
On May 23, Rose donned an elegant dress and met her husband at the statue of Jesus beneath the hospital’s historic dome. The rehabilitation staff members, surgeons, nurses and friends gathered for a vow renewal ceremony. Wendell stood beside his wife with the help of a walker.
A reception included a three-tiered wedding cake and framed photos of their wedding, 25 years before. The tearful couple expressed their gratitude.
Wendell’s care at Johns Hopkins ensured more anniversaries to come—just weeks later, he was well enough to return home to Bermuda.
We don’t treat disease—we treat people,” says Katherine DeRuggiero, vice president of patient services for Johns Hopkins Medicine International. “When a patient feels safe and understood, treatment is less stressful and outcomes improve.”
Patients from around the world come to Johns Hopkins when they are at their most vulnerable, trusting they will receive the highest quality medical care. A critical component of establishing this trust is creating an atmosphere in which people from many backgrounds feel understood and as comfortable as possible.
As more and more patients travel from China to the United States seeking the latest treatments, we have taken several steps to enhance their experience.
In 2017, we revamped our Simplified Chinese microsite (hopkinsmedicine.org/chinese), where patients can learn about health conditions, our specialists, treatment options and services for international patients. It provides a local phone number that connects patients with a Chinese-speaking member of our team, as well as an online form to request information.
We also updated our Simplified Chinese patient brochure and translated Johns Hopkins Leader, an annual publication that shares our latest discoveries with leaders around the world.
Most importantly, we expanded our team of Mandarin-speaking international care coordinators, who accompany our patients every step of the way.
“Our culture is more than language,” says care coordinator Virginia Fung. “Because I understand the culture, I know how to best represent a Chinese patient. I get the nuances of where they are coming from, because that’s where I come from, too.”
Strong leadership can elevate an entire organization and, in turn, the health care in an entire region. Our educational initiatives build a human foundation for stronger health care organizations worldwide, elevating patient care around the globe.
Up for the task of hiring 17.4 million qualified clinicians? That’s the additional staff needed for hospitals around the globe to operate at full capacity, according to the World Health Organization.
Worldwide, more developed nations are elevating the role of nurses not only to bridge these staffing shortages, but also to meet the complex needs of both patients and entire health systems.
“In many parts of the world, hospitals aren’t leveraging nurses’ clinical training, limiting them to tasks such as monitoring and recording vital signs. But by tapping into this rich talent pool, we can relieve physicians to perform the most complex care, reduce costs, and enhance overall quality and safety,” says Karen Haller, vice president of nursing and clinical affairs at Johns
Hopkins Medicine International (JHI).
We also work with our global affiliates to empower nurses by providing clinical training and leadership development, introducing new professional roles and encouraging mentoring across borders.
JHI nurse consultant Wilma Berends and nurse manager Gail Biba tailored a leadership course for nearly 50 participants at Anadolu Medical Center in Turkey, emphasizing how to measure nurse quality, give and receive feedback, and establish a code of conduct.
We worked with the Institute for Johns Hopkins Nursing to share nursing models and new ways of promoting nurses at our global affiliates. As an example, the institute conducted Nursing Leadership Academy training with 44 current and aspiring nurse leaders from across the Pacífico Salud health care network in Peru.
At Johns Hopkins Aramco Healthcare (JHAH), we helped expand nursing roles—including team
leaders, discharge planners and home care nurses. We even introduced case managers—who plan, coordinate and monitor patient care—a role that was new not only to JHAH, but to Saudi Arabia in general.
Ahlam Abdelfatah Sarhan, a JHAH nurse manager, appreciates the development opportunities Johns Hopkins provides to nurses around the world: “I have been working as a nurse for the last 25 years. Now, with Johns Hopkins’ influence, we have power as nurses. It expands the role of nurses and makes us leaders.”
Johns Hopkins researchers are always asking questions. The collaborations we establish with our international affiliates bring those questions—and their lifesaving answers—to the world.
Our research enterprise is enormous,” says Nae-Yuh Wang, a Johns Hopkins biostatistician and epidemiologist, “so we bring a lot of expertise to spur team-based scientific pursuit.”
Johns Hopkins Medicine International (JHI) also contributes to Johns Hopkins Medicine’s research mission in unique ways. JHI colleagues draw from institutional data—and personal experience—to publish research on how academic medical centers can forge transformative partnerships with health organizations around the world.
Other JHI investigators have teamed up with Johns Hopkins clinicians to explore topics such as barriers that prevent Muslim women from seeking health care and globalization’s unprecedented impact on medical education. They published their studies in Globalization and Health and the Journal of Medical Education and Training, respectively.
We also recruit and support Johns Hopkins faculty members to work alongside physicians and staff at our global affiliates to publish papers and present at international conferences.
After five years of collaborative work, researchers from Johns Hopkins and Clínica las Condes published their findings on the genetic origins of obesity in Chile in the peer-reviewed journal Metabolic Syndrome and Related Disorders in 2017.
Urologists from Johns Hopkins and JHI’s affiliates Hospital Moinhos de Vento in Brazil and Pacífica Salud Hospital Punta Pacífica in Panama conducted joint research to eliminate a patient safety issue that causes serious complications, even death. They published their study, “Preventing the Forgotten Ureteral Stent by Using a Mobile Point-of-Care Application,” in the Journal of Endourology in 2017, and won a best paper award at the World Congress of Endourology.
At the 2017 World Congress, our researchers partnered with Johns Hopkins Aramco Healthcare to demonstrate how their international cooperation was instrumental in JHAH’s launch of a robotic surgery program in December 2015 and its continued success today.