Centers of Excellence

LE&RN and Centers of Excellence

William Repicci
President & CEO, LE&RN

In 2018, LE&RN took on the challenge of developing standards for Centers of Excellence in the Diagnosis and Treatment of Lymphatic Diseases (LD). To accomplish this, LE&RN engaged a committee of expert clinicians in the United States to create the initial draft of standards. A Global Oversight Committee refined these standards and expanded their global applicability. This Global Oversight Committee reviews all letters of intent and full applications submitted by institutions seeking a Center designation. Center designation awards are determined solely by the Global Oversight Committee.

Our thanks to the esteemed world leaders in lymphatic healthcare who volunteered their time and talent to this venture. Our deepest gratitude to Steering Committee Chair, Melissa Aldrich, MBA, PhD, and to Global Oversight Committee Chair, Professor Peter Mortimer. Their contribution to this project is inestimable.

United States Steering Committee
Melissa Aldrich, PhD, The Brown Institute for Molecular Medicine, United States, Steering Committee Chair
David Chang, MD, University of Chicago
Joseph Dayan, MD, Memorial Sloan Kettering Hospital
Ketan Patel, MD, University of Southern California
Stanley Rockson, MD, Stanford University
Dhruv Singhal, MD, Harvard University Medical Schools
Global Oversight Committee
Peter Mortimer, MD, St. George's University, United Kingdom, Committee Chair
Melissa Aldrich, PhD, The Brown Institute for Molecular Medicine, United States, Steering Committee Chair
Denise Adams, MD, Children's Hospital Philadelphia, United States
Eric Ansart, LymphaPress, United States
Håkan Brorson, MD, PhD, Skåne University Hospital, Sweden
Cheryl Brunelle, PT, CLT, Massachusetts General Hospital, United States
Wei Chen, MD, Cleveland Clinic, United States
Robert Damstra, MD, PhD, Nij Smellinghe Hospital, Netherlands
Sheldon Feldman, MD, Montefiore and Einstein Hospitals, United States
Catherine Holley, RN, Massachusetts General Hospital, United States
Ionela Iacobas, MD, Texas Children's Hospital, United States
Emily Iker, MD, Lymphedema Center Santa Monica, United States
Vaughan Keeley, MD, Royal Derby Hospital, United Kingdom
Guenter Klose, Klose Training & Consulting, United States
Louise Koelmeyer, OT, PhD, ALERT Program, Macquarie University, Australia
Allison Nauta, MD, Oregon Health and Science University, United States
Dennis Schlaht, ImpediMed, United States
Stephane Vignes, MD, Hôpital Cogacq-Jay, France
Miikka Vikkula, MD, de Duve Institute, Belgium
Giuseppe Visconti, MD, Pondazione Policlinico Gemelli, Italy
June Wu, MD, Columbia University, United States

Program Description

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Program Description

MISSION
The goal of the LE&RN Centers of Excellence (COE) program is to increase access to the best possible multi-disciplinary clinical care and services for individuals affected by Lymphatic diseases (LD) and their families through a geographically diverse network of local and/or regional clinical centers. In addition to clinical and social services, the Centers will provide professional and lay education in the geographic areas they serve, are involved in LD clinical research, and work with LE&RN locally and nationally in its efforts to continually improve the lives of those affected by LD and their families.

OBJECTIVES
  • To design an international standard for best practice multidisciplinary care in the management of LD and providing services for families with LD.
  • To select and support institutions that excel with regard to knowledge and experience in LD, education of LD in their local community, establishment of a multidisciplinary care team for LD, and involvement with LD clinical research.
CENTER OF EXCELLENCE CATEGORIES
There are five categories for Center of Excellence designation:

COMPREHENSIVE CENTER OF EXCELLENCE designation indicates that an institution can provide the listed services on-site, all within the same institution, and can coordinate provision of the services. This includes meeting the minimum requirements of at least three (3) Certified Lymphedema Therapists (CLTs) on-site, and demonstrating proficiency in the following areas: diagnosis, imaging, conservative management, assessment tools, interventional therapies, surgery (with a minimum of 3 surgeons performing lymphatic surgeries), genetics, consultation, research, accountability, collegiality, administration and community involvement.

COMPREHENSIVE CANCER CENTER OF EXCELLENCE designation indicates that an institution can provide the listed services on-site, all within the same institution, and can coordinate provision of the services for patients who have developed lymphedema as a result of cancer treatment. This includes meeting the minimum requirements of at least three (3) Certified Lymphedema Therapists (CLTs) on-site, and demonstrating proficiency in the following areas: diagnosis, imaging, conservative management, assessment tools, interventional therapies, surgery (with a minimum of 3 surgeons performing lymphatic surgeries), genetics, consultation, research, accountability, collegiality, administration and community involvement.

COMPREHENSIVE PEDIATRIC CENTER OF EXCELLENCE designation indicates that an institution can provide the listed services on-site, all within the same institution, for children and young adults, and can coordinate provision of the services. This includes meeting the minimum requirements of at least three (3) Certified Lymphedema Therapists (CLTs) on-site, and demonstrating proficiency in the following areas: diagnosis, imaging, conservative management, assessment tools, interventional therapies, surgery (with a minimum of 3 surgeons performing lymphatic surgeries), genetics, consultation, research, accountability, collegiality, administration and community involvement, as well as referrals for patients no longer treated due to age restrictions.

NETWORK OF EXCELLENCE designation indicates that an institution and its affiliate institutions (within close geographical proximity) can provide the listed services. For example, University “A” School of Medicine, University “A” Teaching Hospital, University “A” Cancer Center, and University “A” Rehabilitation Facility can provide the listed services, and can coordinate provision of the services. This includes meeting the minimum requirements of at least three (3) Certified Lymphedema Therapists (CLTs) within the network, and demonstrating proficiency in the following areas: diagnosis, imaging, conservative management, assessment tools, interventional therapies, surgery (with a minimum of 3 surgeons performing lymphatic surgeries within the network), genetics, consultation, research, accountability, collegiality, administration and community involvement.

REFERRAL NETWORK OF EXCELLENCE designation indicates that the institution and/or nearby collaborating institutions can provide the listed services, and that these institutions can coordinate provision of the services. For example, University “A” School of Medicine, University “B” Teaching Hospital, “C” Cancer Center, and Private Practice “D” Rehabilitation Facility can provide the listed services, and can coordinate provision of the services. This includes meeting the minimum requirements of at least three (3) Certified Lymphedema Therapists (CLTs) within the referral network, and demonstrating proficiency in the following areas: diagnosis, imaging, conservative management, assessment tools, interventional therapies, surgery (with a minimum of 3 surgeons performing lymphatic surgeries within the referral network), genetics, consultation, research, accountability, collegiality, administration and community involvement.

LYMPHATIC DISEASE (LD) SURGERY CENTER OF EXCELLENCE designation indicates that an institution (i.e., a cancer care center or large teaching hospital/network) can provide the listed surgical services. This includes meeting the minimum requirements of at least three (3) Certified Lymphedema Therapists (CLTs) on-site or within the network, and demonstrating proficiency in the following areas: diagnosis, imaging, conservative management, surgery (with a minimum of 3 surgeons performing lymphatic surgeries within the network), research, accountability, collegiality, administration and community involvement.

LYMPHATIC DISEASE (LD) SURGERY NETWORK OF EXCELLENCE designation indicates that an institution (i.e., surgeons in private practice with full clinical and administrative staff) can provide the listed surgical services on-site and within their referral network. This includes meeting the minimum requirements of at least three (3) Certified Lymphedema Therapists (CLTs) on-site, and demonstrating proficiency in the following areas: diagnosis, imaging, conservative management, surgery (with a minimum of 3 surgeons performing lymphatic surgeries within the referral network - i.e. 1 on-site surgeon and 2 surgeons with whom they collaborate/refer), research, accountability, collegiality, administration and community involvement.

LYMPHATIC DISEASE (LD) CONSERVATIVE CARE CENTER OF EXCELLENCE designation indicates that an institution can provide the listed conservative care services on-site or within their own network. This includes meeting the minimum requirements of at least three (3) Certified Lymphedema Therapists (CLTs) on-site or within the network, and demonstrating proficiency in the following areas: diagnosis, conservative management, assessment tools, research, accountability, collegiality, administration and community involvement.

Services and activities that are not required for COE designation, but are encouraged by LE&RN, are listed (without check marks), and may be considered by the selection committee.