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Mischer Neuroscience Institute Looks to the Future

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After 10 years of growth, the Memorial Hermann Mischer Neuroscience Institute at the Texas Medical Center has become a strong clinical program and a leader in providing quality care. We now aim to place a strong focus on research, innovation and education of the physicians of the future.

In 2006, when the Mischer Neuroscience Institute was formed with a gift from Houston businessman and philanthropist Walt Mischer and his family, the department of Neurosurgery at McGovern Medical School at UTHealth was small with only nine clinical faculty members – of which six were neurosurgeons – and no neurosurgery residency program or fellowships. Memorial Hermann’s neuroscience market share was only 12 percent. Today, the Institute has more than 100 clinical faculty and a market share that has doubled to 28 percent for neuroscience (and 35 percent in neurosurgery).

“It was clear that to perform at the highest level and become the best neuroscience group, we needed to begin by building the clinical enterprise with high-quality physicians and staff, as well as developing residency and fellowship training programs to support our academic mission,” Dr. Kim says. “With that goal in mind, we’ve recruited a comprehensive team of neuroscience specialists, including neurosurgeons, neurologists, critical care specialists, neuro-oncologists, radiation oncologists and pain management physicians, and organized them into a large clinical practice that stretches across the city.”

Patient-Centered Approach

In the past eight years, the Institute has grown 150 percent in volume and reported dramatic reductions in neurosurgery mortality and morbidity, despite increasing patient acuity. A patient-centered approach to providing care has significantly improved patient satisfaction, achieving results above the 75th percentile at both the hospital and 17 clinic locations.

Growing Education Programs

An important component of this growth was the start of education programs. The Neurosurgery department was approved for a one-resident-a-year program in 2008, then two residents a year in 2010. Because neurosurgery training is seven years, we currently have 14 residents. In 2016, the program was allowed to match three residents. This unprecedented growth reflected a major commitment to education. Currently, one in three UTHealth medical students have a two-to four-week rotation on neurosurgery, and our ICU team sponsors eight neurocritical care fellows. This is in addition to the 21 residents and 11 fellows in the department of Neurology. “Teaching is at the heart of an excellent clinical program,” says Dr. Kim. “The best physicians want to train the next generation of physicians, so that the art continues to thrive and improve.”

With this clinical infrastructure in place, with programs in every area of Houston, Dr. Kim has turned more of his focus to the discovery of new knowledge that will change the face of patient care. “We’re thinking much bigger about our future than ever before, especially in terms of innovation that will change the standards of care,” he says. “There are many neurological diseases without effective treatments; our fondest hope is to restore function and improve lives.”

Focus on Discovery

Clinical research is crucial to optimizing care and providing patients with new treatment options. A large number of clinical trials are being conducted at the Institute. In addition, the majority of our neuroscience patients participate in research by consenting to allow their tissue samples to be banked in the Institute’s Neuroscience Research Repository (NRR) for current and future research.

“We’ve found it to be incredibly beneficial to have patients collaborate with us in our research endeavors through programs like the NRR, which improves the care of future patients as well as their own,” Dr. Kim says. “And we continue this collaboration through the Innovation and Quality (IQ) Program, where researchers are testing novel treatments in clinical trials and transitioning the results of that research to clinical practice. As the IQ Program expands, we will design even more trials to help neuroscience patients reach their desired functional potential.”

“A key component of our mission is to design therapeutic intervention strategies that are successful not only in the laboratory but also have real clinical potential,” says Louise D. McCullough, M.D., Ph.D., who leads the Cerebrovascular Research Group and is professor and chair of the department of Neurology at the medical school. “To ensure that these strategies are on track from their inception through application, the Group works closely with the neurology and neurosurgery services at Memorial Hermann-Texas Medical Center, as well as others at the Mischer Neuroscience Institute and The University of Texas Health Science Center at Houston. Targets identified in the lab are validated in clinical samples and translated back to animal models where manipulation in a controlled research environment is possible.”

In addition, through two new research centers – the Will Erwin Headache Research Center and the National Center for Testing Treatments in Chronic Spinal Cord Injury and Traumatic Brain Injury, leadership at the Institute has committed to investment in discovery in two areas that affect Americans profoundly.

“We can now track a range of outcomes across various subsets of our patient population,” Dr. Kim says. “We’re creating a rich data source that includes long-term outcomes and enables us to identify the best interventions for a particular condition. The data source is part of our ongoing efforts to improve patient care, ensuring that we are providing the best possible service and follow-up to our patients.”