University Hospitals Ear, Nose & Throat Institute Pivots to Address COVID-19

Leading, learning and growing during a crisis

Innovations in Ear, Nose & Throat | Fall 2020

During the recent COVID-19 pandemic, the team at University Hospitals Ear, Nose & Throat Institute has worked tirelessly to advance safety for its many stakeholders – in and outside of hospital walls. A concerted and collaborative effort was the key to pivoting quickly, so that the department could continue to serve patients safely, provide support to the community, and maintain a supportive environment for residents, physicians and staff.

UH CLINICAL LEADERSHIP

University Hospitals has been at the forefront in addressing COVID-19, regionally and nationally. In the area of clinical research, the health system was one of the first nationwide to conduct Phase 3 clinical trials of remdesivir as a treatment for COVID-19 patients suffering from pneumonia. It is also participating in the Pfizer Inc./BioNTech clinical trial of an investigational vaccine. 

After the initial shutdown, UH also provided Ohio businesses, schools, nursing homes and other healthcare providers with clinical guidance through its University Hospitals Healthy Restart Playbooks – a downloadable guide with practices and procedures for reopening safely. UH clinical leaders and infectious disease experts worked closely with the U.S. Centers for Disease Control and the Ohio Department of Health to align on best practices and to address the many challenges involved with mitigating COVID-19. 

These efforts highlight UH’s commitment to a safe reopening as well as its leadership in the prevention of pandemic diseases.

VIRTUAL HEALTHCARE SERVICES

Rapid implementation of virtual healthcare services has been vital for patients of UH Ear, Nose & Throat Institute during this crisis. Under the leadership of Brian D’Anza, MD, the new Medical Director of Telehealth for UH, the department has shifted from a handful of providers performing fewer than a dozen telehealth visits in all of 2019 to more than 30 providers performing 60 percent of all ENT visits during the height of the first wave of pandemic.

UH ENT physicians have also engaged their audiology and speech-language pathology colleagues in these telehealth visits, ensuring providers can see patients as a multidisciplinary team. By pivoting quickly to offer this option for patients, the department has seen its telehealth services grow tremendously — with virtual visits and consults now an embedded component of visits.

RULE-OUT CLINIC TO LIMIT COVID-19 EXPOSURE

Minimizing possible exposure for patients with chronic and serious diseases, such as cancer, was a top priority for UH during the coronavirus pandemic. To limit this exposure, University Hospitals Seidman Cancer Center President Ted Teknos, MD, devised a special clinic on the center’s first floor. 

The “rule-out” clinic is outfitted with negative air pressure that allows cancer patients with COVID-19 symptoms to bypass the emergency room at UH Cleveland Medical Center. The clinic opened April 1, expediting emergency care for cancer patients.

RESIDENT EDUCATION AND RECRUITMENT

Thanks to the pioneering efforts of Sarah Mowry, MD, Program Director, UH ENT Institute and Residency Program, UH ENT residents were also able to learn and thrive clinically, even while patient volume was lower. 

Determined that resident education would continue during the COVID-19 crisis, Dr. Mowry founded and launched the Great Lakes Otolaryngology Consortium (GLOC) – a virtual group of Midwestern otolaryngology programs. The group collaborated to develop a fully online otolaryngology curriculum via virtual conference. Content was delivered to residents throughout the crisis for several hours daily, with speakers engaged from across the country.

Thanks to the pioneering efforts of Dr. Mowry, our residents were able to continue to learn and thrive clinically, even while patient volume was lower. She recently published a paper with faculty from several other programs who also created virtual learning for trainees during the pandemic.¹ The vision for these virtual consortiums would be to create a national speakers bureau from which programs could invite or download lectures provided by remote faculty. This project continues to evolve.

In addition to resident education, medical student education was severely impacted during the COVID shut down. In collaboration with several UH and CCF faculty, Dr. Mowry and a team of enterprising medical students created a virtual curriculum. This course work, completed all on line with available internet resources, was approved for course credit by the CWRU SOM registrar and has been completed by a number of students from around the country and locally.²

“The silver lining in all of this is that our residents and medical students have stayed incredibly productive with academic activities during these past COVID-19 months,” she says. “They have taken advantage of the time to produce quality abstracts and presentations that I look forward to seeing presented at our upcoming national meetings, and it is a testament to the quality of our program.”

Dr Rod Rezaee and Dr Nicole Fowler – as co-directors of our Head & Neck Surgical Oncology and Reconstruction Fellowship provided us with an example of how to successfully recruit nationally in this new virtual era.  Fellowship applications continue to increase every year.  Making a quick transition to Zoom due to the COVID-19 travel restrictions we held three group fellowship interview dates. We will welcome Danielle Scarola, MD from Emory University in July, 2021. Dr. Scarola will be our first female Head & Neck fellow. 

Graduating Residents

Once again, UH ENT Institute’s most recent class of resident and fellow graduates has pursued exciting opportunities after graduation.

• Clare Richardson, MD, is attending the University of Washington/Seattle Children’s Hospital for her fellowship in Advanced Pediatric Otolaryngology.
• Andrew Stein, MD, was named the inaugural laryngology fellow at the University of Michigan in Ann Arbor.
• Gary Huang, MD, has accepted a position at a general ENT practice in the Akron area.
• Jeanie Sozansky-Lujan, MD, is completing a fellowship in facial plastic surgery in San Antonio, Texas.
• Jonathan Garneau, MD, a UH ENT Institute Head and Neck fellow, joined the faculty at the University of Virginia in Charlottesville.

The team looks forward to seeing them continue to grow and begin their careers in otolaryngology.

Incoming Residents

In July, the department welcomed its newest resident cohort. 

• Temi Adeyeni, MD, and De’Andre Warren, MD, both joined UH from Loyola University School of Medicine. Dr. Adeyeni is from the Chicago area and Dr. Warren is from Southern California. 
• Alec Bonifer, MD, is from Wayne State University and is a Detroit native. 
• Eve Tranchito, MD, is a Cleveland native and graduated from Northeast Ohio Medical University.

View the full list of UH otolaryngology residents.

Incoming Fellows

• Syed Ali, MD, UH ENT Institute Head and Neck fellow, joins the department from Mt. Sinai Medical Center in New York City. 

ENT leaders look forward to a promising year of learning and growth for all residents.

Resident Recruitment

Recruitment of UH ENT residents is virtual this year — a process that can be daunting for medical students interested in otolaryngology. Recognizing this, the department quickly adjusted and revised the structure of its recruitment visit to accommodate for the new type of exposure, and to ensure the experience was complete and reflective of the program’s culture. 

ENT faculty and residents have worked tirelessly to ensure a meaningful, virtual look into the ENT residency program that highlights the culture, clinical expertise and committed team. Some notable updates include:

Expanded curriculum – Under the guidance of Todd Otteson, MD, and Dr. Mowry, a group of School of Medicine medical students developed a virtual otolaryngology elective for interested students. The curriculum was ultimately accepted for credit as an elective, two-week rotation offered for School of Medicine students as well as for students at other U.S. medical schools. The team recently published a review describing the multimodal, multi-institutional solution in Otolaryngology – Head and Neck Surgery.

Virtual “open houses” – The department held two virtual open houses before kicking off its recruitment season in early September and October. A group of current ENT residents met with medical students from across the country who were able to engage in a meet and greet. The session allowed interested recruits to ask questions and find out more about the program before making their recruitment visit decisions.

Social hour – For 2020 recruitment visits, the department has arranged for a resident virtual “social hour” where small groups of current residents and visiting applicants can engage in a relaxed informal setting and discuss all aspects of the program, curriculum and atmosphere of our department, as well as life in Cleveland.

Immersive videos – A series of day-in-the-life videos was created to showcase the highpoints of residency life, faculty interactions and resident participation at various subsites where department residents work. This unique video experience offers resident applicants a first-hand view of what to expect during UH residency.

To reach the UH Ear, Nose & Throat Institute, call 216-868-8943.

¹ Otolaryngology Education in the Setting of COVID-19: Current and Future Implications. Comer BT, Gupta N, Mowry SE, Malekzadeh. Otolaryngol Head Neck Surg. 2020 Jul;163(1):70-74.

² A Multimodal Multi-institutional Solution to Remote Medical Student Education for Otolaryngology During COVID-19. Ruthberg JS, Quereshy HA, Ahmadmehrabi S, Trudeau S, Chaudry E, Hair B, Kominsky A, Otteson TD, Bryson PC, Mowry SE.Ruthberg JS, et al. Otolaryngol Head Neck Surg. 2020 Oct;163(4):707-709