May 2015 WINDOW 6-1-15 - Jewish Healthcare Foundation
Transcription
May 2015 WINDOW 6-1-15 - Jewish Healthcare Foundation
May 2015 THE WINDOW A round‐up of JHF news, events, milestones, publications, and more. Inside this issue Princeton Conference on Health Economics and Policy Takes Pulse of U.S. Health System’s Quality, Safety Overthepasttwodecades,anavalancheofresearchhas demonstratedthatthatworld’smostexpensivehealthcare systemisalsoitsgreatestunderachiever.IstheU.S. inally movingtheneedleindeliveringcarefoundeduponprevention, healthoutcomes,andsystemsthinking,ratherthanreaction, volumeandquick ixes?JHFPresidentandCEOKarenWolk Feinstein,PhD,moderatedapaneldiscussionthatexaminedthe stateoftheU.S.healthsystem’squalityandsafetyduringthe 22ndannualPrincetonConference,heldfromMay12‐14atthe RobertWoodJohnsonFoundationinNewJersey. JHFisasponsoroftheinvitation‐onlyPrincetonConference,a con luenceofacademic,industry,andgovernmentthought leaderswhomeettoexplorecriticalhealthpolicyissuesthrough themedpresentationsandinteractivepanels.Dr.Feinsteinis partoftheplanningcommitteefortheconference,whichtackled topicsincludingtheeffectofnewpaymentanddeliverymodels onconsumerandproviderbehavior,cultivatinga21stcentury healthcareworkforce,thefutureofMedicareinanaccountable careworld,healthsystemconsolidation,andspecialty pharmaceuticsthatcouldimprovehealthbutspikecosts. Duringherpresentation,Dr.FeinsteinnotedthattheU.S. healthcaresystemhasmadedisappointingprogressin (ConƟnued on page 2) PCRC Team Shares Model for Smooth Care Transitions on National Stage 3 Robert Ferguson Named JHF’s Director of Government Grants and Policy 5 MAI Outreach Workers Map Road to Retention for HIV‐positive Clients 6 Robert Ferguson Shares Impact of Community Health Workers in MAI Program at Statewide Summit 8 Karen Feinstein Honored as a 2015 Woman of Distinction by the Crohn’s & Colitis Foundation of America 8 Karen Feinstein Explores Finding Health Care’s True North at Academic Consortium Meeting 10 Nancy Zionts Explores Health Reform with other Conversion Foundations at JFNA Summit 11 JHF Takes HPV Education, Cancer Prevention Message into Communities 12 Motivational Interviewing: Focusing the Conversation 13 Mark Valenti Showcases PRHI’s Approach to MI at Cleveland Clinic Summit 14 PRHI Recognized for Excellence in Nursing Education 14 Nancy Zionts Talks Closure, PA POLST at Caregiver Support Conference 15 Inspired by JHF Visits and Closure, Israel’s Emek Medical Center Expands Services to Enhance End‐of‐Life Care, Communication 16 Kaiser Foundation Media Fellows Learn More About PRHI’s Approach to Health Reform 17 Karen Feinstein Discusses Successful Aging, Med Ed Reform at Pitt’s Geriatric Division Conference 17 From Allegheny County to Atlanta, 2015 Summer Interns Bring Impressive Credentials to JHF 18 NHMH Recognizes PRHI as Leader in Integrated Care 19 Karen Feinstein Discusses Employee Engagement, Workplace Culture at Pitt Interdisciplinary Leadership Forum 20 PRHI Board Member Spotlights VA’s Commitment to Rehabilitation Services 20 David and Meryl Ainsman Honored as Guardians of Israel 21 JHF Happenings 21 (ConƟnued from page 1) advancingsafety,reliability,andef iciency. Shepositedthatoneoftheprincipalreasons isthatthere’stoomuchtimespentthinking aboutqualityimprovementmethods,andnot enoughspentconsideringthespeci ic contextinwhichthosemethodsareapplied. UsingLeantoitsfullestpotentialrequiresan environmentthatstimulatessystem‐wide qualityimprovement,withengaged leadership,acultureofqualityandsafety, de inedtargetsandmeasurements, consumerandpatientengagement,and incentivesforperformanceexcellence. “Leanisn’ta lavorofthemonth,andit’snot forspotrepairs,”Dr.Feinsteinsays.“It’san enterprisesolutionthatforcesyouto anticipate,harnesstechnology,andcreatean infrastructureforproblem‐solving.Without thoselayersofQI,there’snospreador sustainability.It’slikeplantingaturnipin cement.” (L‐R): During the 22nd Princeton Conference, JHF President and CEO Karen Wolk Feinstein, PhD, discusses the state of U.S. healthcare quality and safety with Michael Millenson, president of Health Quality Advisors, LLC and author of Demanding Medical Excellence: Doctors and Accountability in the Information Age; Gordon Mosser, MD, MLitt, a senior fellow at the University of Minnesota School of Public Health’s Division of Health Policy & Management and co‐founder of the Institute for Clinical Systems Improvement; and Neel Shah, MD, MPP, assistant professor at Harvard Medical School, co‐author of Understanding Value‐Based Care, and executive director of Costs of Care. Dr.Feinstien’spanelalsofeatured: MichaelMillenson,presidentofHealth QualityAdvisors,LLCandauthorof DemandingMedicalExcellence:Doctors andAccountabilityintheInformationAge GordonMosser,MD,MLitt,aseniorfellow Stuart Altman (left), PhD, Sol C. Chaikin Professor of National Health Policy at Brandeis University’s Heller School for Social Policy and Management, chairs the annual Princeton Conference. Karen Feinstein (right) serves on the planning committee. attheUniversityofMinnesotaSchoolof PublicHealth’sDivisionofHealthPolicy&Managementandco‐founderoftheInstituteforClinical SystemsImprovement(ICSI) NeelShah,MD,MPP,assistantprofessoratHarvardMedicalSchool,co‐authorofUnderstandingValue‐ BasedCare,andexecutivedirectorofCostsofCare Millensonalsolamentedtheslowpaceofimprovementinhealthcarequalityandsafety.Heframedthe (ConƟnued on page 3) 2 (ConƟnued from page 2) issueintermsofdutyversusinterest,withafee‐for‐serviceenvironmentcreatingadividebetween what’sbestforpatientsandwhat’sbestforpro its.Healthcarereformhasstartedtobridgethatchasmby creating inancialincentivesthatrewardprovidersforevidence‐based,outcomes‐drivencare. Dr.Mosserexaminedtheroleofmanagementinfosteringahigh‐performinghealthsystem,statingthat leadershipfallsshortunlessitconsidersthecontextofqualityimprovementeffortsandpromotes collaboration.Medicalschoolscouldbegintoaddressthesemanagementshortcomingsbycreatinga learningexperiencewhichemphasizesqualityimprovementandteam‐basedprinciples. Dr.Shahdrewuponhisexperiencesasanobstetrician‐gynecologist,notingthatpre‐termbirthsinthe U.S.havedeclinedoverthepastdecadeduetoprocessimprovements(suchasreducingnon‐medically necessarycesareansections),greateraccesstomaternitycare,andeffortstoreducesmokingamong women.Thatdecline,inturn,hasledtofewerdevelopmentalcomplicationsandlowerlegacycosts.Other healthcaresectorscouldsimilarlybene itbycraftingmultifacetedsolutionstocomplexproblems. “ThePrincetonConferenceisaone‐of‐a‐kindintersectionofhealtheconomicsandpolicy,withthe audiencebecomingpartofthepanelandlearningexperience,”Dr.Feinsteinsays.“Youhaveleadersfrom variousbackgrounds—non‐pro it,for‐pro it,Republican,Democrat—analyzingissuesthroughdifferent lenses.Thecultureistorespectfullylisten,butoccasionallychallenge.Therearenopolemicshere.” PCRC Team Shares Model for Smooth Care Transitions, Patient and ProviderCentered Services on National Stage Througharecentno‐costextensionapprovedbytheCentersforMedicare andMedicaidServices,PRHIcanharnessnearly$1.5millioninunused grantfundingtocontinueitsPrimaryCareResourceCenter(PCRC)project intothefallof2015.Sofar,twoofthesixhospital‐basedPCRCsites,which offercomplexpatientsdisease‐speci iceducation,medicationmanagement, andcaretransitionsupport,havealreadycommittedtoself‐fundingtheir PCRCsafterthegrantends. Donna Scanlon RN, lead care InApril,PRHIshowcasedtheprogressitsPCRCpartnershavemadein reducingreadmissionsandimprovinghealthforpatientswithchronic obstructivepulmonarydisease(COPD),heartfailure,andacute myocardialinfarctionwithnationalhealthcareleadersatDorlandHealth’s 7thAnnualCareCoordinationSummitandCurrentAdvantage’s ReadmissionsPenaltyZoneConference. manager at Indiana Regional Medical Center, explained how key components of the PCRC model (including patient education sessions like the one pictured here) help complex patients avoid preventable hospital readmissions. (ConƟnued on page 4) 3 (ConƟnued from page 3) AttheCareCoordinationSummit,heldMay4‐6inBethesda,MD,thePCRCteamsharedhowtheytailor caremanagementservicestotherootcauseofapatient’shospitaladmission,andpartnerwithhome healthagenciesandskillednursingfacilitiestopreventavoidablebounce‐backs. NearlyhalfofPCRCpatientsareinitiallyadmittedtothehospitalbecausethey’renotadheringtocare guidelinesfortheirdiseaseandmakelifestyle/dietchoicesthatexacerbatetheircondition,accordingto datapresentedbyKathyKayBrown,RN,MSN(formerPCRCprojectdirector)andDonnaScanlon,RN, leadcaremanageratIndianaRegionalMedicalCenter.Toaddressthoseissues,PCRCstaffofferpatients servicesincludingclassesoneatingahealthydiet,properlyusingmedication,andquittingsmoking.PCRC staffalsoappliesmotivationalinterviewingtechniquestouncoverwhypatientswouldfeelcompelledto makesuchchanges–beitwantingtoattendagrandchild’sLittleLeaguegame,hittheroadonafamily trip,orplanttomatoesintheirgarden. The PCRCs feature dashboards that track progress made in coordinating care, preventing readmissions, and implementing quality improvement projects. To support these efforts, the PCRCs are designed to include space for individual patient counseling and larger education sessions on topics including nutrition and smoking cessation. BrownandScanlonalsoexplainedthatthePCRCsaimtocreateasmoothtransitionforpatientsby coordinatingcarewithskillednursingandhomehealthproviders.ThePCRCs,forexample,sharepatient chartsduringtransition‐of‐caremeetings,provideeducationtoskillednursingandhomehealthstaff,and conductapharmacistmedicationreviewbeforedischarge.Relationshipswithpost‐acutecareagencies arecrucial,consideringthatpatientsaremorefrequentlyreadmittedtothehospitalwithin30dayswhen dischargedtohomehealthservices(21%)andskillednursing(24%)thanwhendischargedtotheirhome (14%). TheReadmissionsPenaltyZoneConferenceonMay28‐29inTampaBay,FL,focusedonbestpracticesfor treatingpatientswithCOPDandheartfailure.SusanCampus,BSN,leadcaremanageratMonongahela ValleyHospital,presentedonhowthePCRCpilotsitedevelopedcarepaths,physicianoutreach (ConƟnued on page 5) 4 (ConƟnued from page 4) strategies,anddatacollectiontoolsthatledtoa45%reductioninCOPDreadmissions–andprovideda blueprintforthelargerproject. PRHIChiefMedicalOf icerandPCRCProjectDirectorKeithKanel,MD,gaveapresentationonhowPRHI appliesdesignthinkingtomakecarepathwaysandproceduressustainableforparticipatinghospitals. NursesatMonongahelaValleyHospital,forinstance,felttheyneededadditionalresourcestosupport COPDpatientstryingtokickanicotinehabit.WithPRHI’sassistance,thePCRCnursesbecamecerti iedas smokingcessationinstructorsandsetuptheirownclinic. “Thebestadjustmentstowork lowareaccomplishedbythoseactuallyperformingthework,”Dr.Kanel says.“WemadesurethateveryonetakingpartinthePCRCprojectreceivedtraininginLeanquality improvementaswellasadvanceddiseasemanagement.Then,wehelpedeachpersontoexaminetheir ownwork lowandcraftmoreef icient,durableprocedures.Whenwaysofworkingbecomeembedded intothedailylifeofthesite,you’vecreatedsustainablechange.” Robert Ferguson Named JHF’s Director of Government Grants and Policy RobertFergusonhasanewtitle—onethat KarenFeinsteinandFoundationleadershipsay nowfullyre lectsthemanyresponsibilitiesthat hehasassumedsincejoiningJHFbackin2009. FergusonhasbeennamedDirectorof GovernmentGrantsandPolicy. “It’sauniqueandrewardingopportunityto workinanenvironmentthatchallengesyouto workondifferentprojectsandtopics,gainand applydiverseskills,anddevelopnetworksat thelocal,state,andnationallevelwithsupport andguidancefromJHF’sleadership,”Ferguson says.“It’sanhonor,andIlookforwardtonew opportunitiesandpartnerships.” JHF’s newly‐appointed Director of Government Grants and Policy Robert Ferguson (right, pictured at JHF’s Community Health Workers Summit on April 22 speaking with Pennsylvania Health Funders Collaborative Executive Director Ann Torregrossa) has played a key role in advancing integrated primary care initiatives since joining the Foundation in 2009. DuringhistenureatJHF,Fergusonhasplayedakeyleadershiproleindesigning,implementing,and managingmulti‐stateinitiativestoprovideintegratedbehavioralandphysicalhealthservicesinprimary caresettings,includingthePartnersinIntegratedCare(PIC)andCareofMental,Physical,andSubstance UseSyndromes(COMPASS)projects.Healsosupportsthe30‐plusorganizationsthatcomprisethe (ConƟnued on page 6) 5 (ConƟnued from page 5) PennsylvaniaHealthFundersCollaborative(PHFC)astheyadvancepolicypriorities,andcontributesto JHF’svariousfellowshipandinternshipprograms. MAI Outreach Workers Map Road to Retention for HIV-positive Clients Onebyone,MinorityAidsInitiative(MAI) outreachworkerssteppedinfrontoftheirpeers andsketcheditemsthatsymbolizetheir profession.Comedyandtragedymasks, representingclients’ever‐changingmoods.A handbag,packedwithsnacksandbustokensto keepclientsnourishedandontimefor appointments.Abridge,depictinghowthey connectthoseinneedandhelpshoulderthe“two tonsofproblems”thatleadsomeHIV‐positive individualstofallthroughthecracksofthe healthcaresystem. During a Minority AIDS Initiative learning session held in TheimpromptuartshowwaspartofanMAI sharedlearningsession,facilitatedbythe FoundationinPhiladelphiaonApril30.Through interactivesessions,participantsfromthenine PennsylvaniaAIDSserviceorganizations currentlypartneringwithJHFtolinkandretain HIV‐positiveclientsinmedicaltreatment—and ultimatelylowercommunityviralloads— gatheredtode inesuccessfuloutreachstrategies andplanforsustainablelost‐to‐carepractices. Philadelphia, AIDS service organization workers designed their ideal outreach worker. MAIoutreachworkerstailorinterventionsto diversepopulationsanduniqueagencysettings, includingbothhospital‐basedclinicsand JHF Senior Quality Improvement Specialist Jennifer Condel, SCT (ASCP)MT, facilitates a group discussion on the triggers that lead communityorganizations.Agenciesused HIV‐positive clients to become lost to care, and ways that the MAI scenariosrepresentingeachoftheirclient program can address social determinants of health such as housing, food access, and transportation. populationstoidentifytriggersthatin luence clientsbecominglost‐to‐care,suchaslossofbene its,incarceration,unstablehousing,andco‐ morbidities.Then,bymappingeachclient’s“roadtoretention,”theyoutlinedavarietyofwaystoremovebarriers— (ConƟnued on page 7) 6 (ConƟnued from page 6) includingassistingclientstoobtainidenti icationandbene its,settingindividualclientgoals,and maintainingatrustingrelationship. Duringthelearningsession,JHFProgramCoordinatorSueSteelediscussedtheFoundation’seffortsto preventHPV‐relatedcancersbyboostingvaccinationratesinsouthwesternPennsylvania.Agency partnersthenlookedforopportunitiestopromotethispreventativeinterventionamongHIV‐positive andat‐riskindividuals. On April 30, representatives from all ten Minority AIDS Initiative sites gathered to share strategies for linking HIV‐positive individuals to medical care and sustaining their outreach programs. Severalagenciesalsohadtheopportunitytoparticipateinon‐sitepeerexchangevisitswhilein Philadelphia.OnApril29,AaronArnold,communityresourcescoordinatoratPittsburghAIDSTaskForce andChristinaFarmartino,executivedirectoratTheOpenDoorattendedaprison‐linkagesseminar facilitatedbyActionAIDSfollowedbyasitevisittolearnaboutprocessesforcoordinatingoutreachwith comprehensivecasemanagement.FarmartinoalsovisitedPreventionPointPhiladelphiatodiscusstheir planstoreplicateTheOpenDoor’sharmreductionhousingmodel.Thispartnershipwasinitiatedasa resultofthecollaborationthroughtheMAIgrant.Teammembersfromboththeclinicalandsocialwork teamsatPinnacleREACCHvisitedPhiladelphiaFIGHTandAlbertEinsteinMedicalCentertoobserve clinic‐basedoutreachprocesses. “ThroughtheMAIgrantandthesemeetings,welearnalotfromeachotherandmotivateeachother,”one participantinthelearningsessionsaid.“JHFbringsustogethertoseewhat’spossible.” 7 Robert Ferguson Shares Impact of Community Health Workers in MAI Program at Statewide Summit Sincelate2012,the20AIDSserviceorganizationswhohavepartneredwiththeFoundationthroughthe MAIprogramhavecontactedmorethan1,500HIV‐positiveindividualswhohadfallenthroughthecracks ofthehealthcaresystem,andlinked84%ofthosepeopletomedicalcare.OnMay5,RobertFerguson presentedaposteronthevitalcontributionsofoutreachworkersintheMAIprogramattheinaugural CommunityHealthWorker(CHW)Summit,adaylongeventsponsoredbytheEastcentralPennsylvania AreaHealthEducationCenterandthePennsylvaniaOf iceofRuralHealth. SeveraloftheparticipatingorganizationsinMAI wereatthesummitinStateCollege,PA,including OdessaSummers,seniorprisonmedicalcase managerforActionAIDS.Manysummitattendees expressedinterestinhowMAIpairsmotivational interviewingwithLeanqualityimprovement, tailoringtheinitiativearoundtheneedsandgoalsof eachAIDSServiceOrganization. Odessa Summers, an outreach worker with ActionAIDS, is partnering with JHF through the Minority AIDS Initiative. “I’m happy to see the fruits of our labor on display,” Summers said while attending the Community Health Worker Summit at Penn State on May 5. “JHF truly understands our needs.” Onedayafterthesummit,FergusonandSummers attendedthePennsylvaniaCommunityHealth WorkerStrategicPlanningSession,whichhelpedto laythegroundworkforcreatingCHWtaskforcesasa follow‐uptoboththeCHWSummitinPennStateand theFoundation’sCHWStatewidePolicySummit, whichtookplaceinHarrisburgonApril22. Karen Feinstein Honored as a 2015 Woman of Distinction by the Crohn’s & Colitis Foundation of America Shortlyafterhisseventhbirthday,PatrickMaywasdiagnosedwithCrohn’sdisease.TheSouthHills nativehasundergoneamyriadoftests,treatments,andsurgeriestoaddressthechronicin lammatory boweldisease,buthesaysan“infusionarmy”ofnewdrugskeepshisimmunesystemstrong.Nowtwelve, Patrick’srunning5Ks,playingthecello,andevenindulgingincheesecake. Thisinspirationalpre‐teenwaswiseandarticulatewellbeyondhisyears. “Researchwilleventually indacure,”PatricksaidwhilewelcominggueststotheCrohn’s&Colitis FoundationofAmerica(CCFA)WesternPennsylvania/WestVirginiaChapter’sSeventhAnnualWomenof DistinctionAwardsLuncheon,heldattheFairmontPittsburghonMay8.“AndtheCCFAisfundinglotsof (ConƟnued on page 9) 8 (ConƟnued from page 8) research.Ihopetoinspireeveryonetowalk,run, andfundraisesomyarmystayseffective.” TheWomenofDistinctionAwardsLuncheon honoredthreelocalleaderswhohave demonstratedacommitmenttoPatrickandthe1.6 millionotherAmericanswhosufferfromCrohn’s diseaseandulcerativecolitis.KarenFeinstein, MARCUSAPresidentandCEOMicheleFabrizi,and RoslynNeimanofHowardHannaRealEstate Serviceswereselectedasthe2015Womenof DistinctionbytheCCFA,whichstrivestoimprove thequalityoflifeforpatientswithCrohn’sdisease andcolitis—andonedayeradicatethose 2015 Crohn’s & Colitis Foundation of America Women of conditionsthroughresearch,fundraising,and Distinction (L‐R): Rosyln Neiman of Howard Hanna Real Estate Services (honoree in business); Karen Feinstein (honoree in advocacy. Duringtheluncheon,Dr.Feinsteinwas introducedbyDebraL.Caplan,secretaryofJHF’s BoardofTrusteesandaHealthCareersFutures Boardmember.CaplansaidDr.Feinsteinhas shapedJHFintoanationalleaderinpatientsafety, healthcarequality,andworkforceadvancement, andhaspioneeredinitiativesforwomen’shealth includingWorkingHearts®andthecurrent campaigntopreventcancerthroughHPV vaccination. regional vitality), and MARC USA President and CEO Michele Fabrizi (honoree in corporate philanthropy). “Karenhasboundlessenergy,”Caplansaid.“Her intellect,wisdom,anddeterminationtomakea differenceforourcommunityareinspiring.I’m honoredtopresentmyfriendandcolleagueasthe During the luncheon, Patrick May, a pediatric patient and volunteer for the CCFA, explains that each bead of his necklace 2015honoreeinregionalvitality.” represents a treatment or triumph in his struggle with Crohn’s Disease. Whiletheheartisassociatedwithloveand affection,andthebrainwithclevernessandintelligence,intestinesareassociatedwiththingsmuchless attractive,Dr.Feinsteinnotedduringheracceptancespeech.Theyare“25feetofmysterious,uncharted territorynavigatedbydistraughtpassengers. (ConƟnued on page 10) 9 (ConƟnued from page 9) “We,thehonorees,”Dr.Feinsteinsaid,“honortheCCFAforsupportingthoseworried,wearytravelers.” Debra L. Caplan (left), a secretary of JHF’s Board of Trustees and a Health Careers Futures Board member, and Karen Feinstein. CCFA Women of Distinction Awards Luncheon host Nancy Polinsky Johnson, Owner and Publisher of SHADY AVE Magazine, calls Karen Feinstein “a force of nature, making a mark on our community.” Karen Feinstein Explores Finding Health Care’s True North at Academic Consortium Meeting Inhisbestsellingbook,TrueNorth,formerMedtronicCEOBillGeorgeimplores readerstodiscoveranauthenticleadershipstylethathelpscrafthigh‐performing organizations.OnMay3,KarenFeinsteinsharedherkeysforcreatingauthentic healthcareleadersduringtheAcademicConsortiumforIntegrativeMedicine& Health’sannualmeeting,heldattheSheratonPittsburghatStationSquareHotel. TheAcademicConsortiumisamosaicofmorethan60academicmedicalcenters andaf iliateinstitutionswhichacceleratesintegrativemedicineprinciplesthrough clinical,educational,policy,andresearchworkinggroups.Thegroup’s2015 meetingfeatureda“DiscoveringYourTrueNorth”seminarwithGeorge.Dr. FeinsteinbuiltuponGeorge’sthemebyidentifyingfourwaysthathealthcare professionalscanlead:bycreatingacultureofqualityimprovement,bolstering (ConƟnued on page 11) 10 (ConƟnued from page 10) thecapacityofprimarycare,helpingseniorsstayintheirhomesandcommunities,andre‐shaping medicaleducationtoproducesystemsthinkerswhowelcometwo‐waycommunicationwithpatients. “TheAcademicConsortiumisexploringdramaticallynewmodelsofprimarycare,andamore comprehensiveapproachtohealing,”Dr.Feinsteinsays.“It’sfarbeyondhavingasocialworkerina physicalhealthsetting.It’severythingfrommassagestomeditationtostressreductiontechniques.They realizethathealthcareleadershipisanongoingjourney,andwhatyoulearninmedicalschoolisn’tthe sumtotalofwhathelpspeoplelivepain‐free,engagedlives.” Nancy Zionts Explores Health Reform with other Conversion Foundations at JFNA Summit OnMay21,ChiefOperatingandProgramOf icer NancyZiontstraveledtoClevelandtodiscussJHF’s experiencesasaconversionfoundationandthe implicationsoftheAffordableCareActduringthe JewishFederationsofNorthAmerica’s(JFNA)2015 HealthandLong‐TermCareSummit.Conversion foundationsareestablishedastheresultofamerger oracquisitionofanonpro ithospitalorhealthcare organization.Federallawrequiresthattheproceeds fromthesaleofassetsoftax‐exemptentitiesbe directedtocharitablepurposes. (L‐R): During the Jewish Federations of North America’s 2015 Health and Long‐Term Care Summit, Nancy Zionts discussed the implications of health reform and JHF’s experience as a conversion foundation with leaders including Marsha Atkind, executive director of the Healthcare Foundation of New Jersey; Gerald D. Temes, MD, founding board member of the Jewish Heritage Fund for Excellence of Louisville; and Mt. Sinai Health Care Foundation President Mitchell Balk. Ziontswasafeaturedspeakeronapanelthat includedleadersofseveralotherconversion foundations,includingMarshaAtkind,executive directoroftheHealthcareFoundationofNewJersey; Mt.SinaiHealthCareFoundationPresidentMitchell Balk;andMt.SinaiBoardofDirectorsChairKeithLibman. JHFhasbeena“healthreformchamp”sinceitscreation,Ziontsnotedduringthepanel.TheFoundation hasdisbursedatotalof$120millioningrantsovertheyears,andthoseinvestmentshaveleveraged$550 millioningrants.And,muchofthePittsburghRegionalHealthInitiative’soriginalagenda—increasing healthaccessandcoverage,strengtheningworkforcedevelopmentandIT,controllingcosts,andtesting newmodelsofcare—formsthebedrockofthe2010ACA. In2014,JHFprovidedagranttosupportJFNA’sStrategicHealthResourceCenter(SHRC),whichwill (ConƟnued on page 12) 11 (ConƟnued from page 11) launchthisyear.TheSHRCwillserveasaresearchandpolicydevelopmenthubforissuescrucialtothe Jewishcommunity,includingpromotingscreeningandpreventioninitiativesforJewishgeneticdiseases, homeandcommunity‐basedmodelsoflong‐termcare,andprimarycarethattreatsbothbodyandmind. ZiontsservesontheSHRC’sadvisorycommittee. JHF Takes HPV Education, Cancer Prevention Message into Communities FromDowntowntoClairton,andfromMt.Oliverto McKeesRocks,JHFisblanketingthePittsburghregion toensurethatkidsandyoungadultsareprotected frompreventablehumanpapillomavirus(HPV)‐ relatedcancers.Throughhealthfairsandcommunity educationeventsinMay,Foundationstaffand GrandmotherPowermembersengagedmorethan 500parents,healthcareproviders,andteachersin conversationsaboutpreventingcancerthroughHPV vaccination.JHFalsoprovidedsupportforPlanned ParenthoodofWesternPennsylvaniatodevelop separatetwo‐lessonmodulesonHPVformiddleand Joyce Penrose (left), CRNP, an adjunct associate professor highschoolstudents,whichhavereachedmorethan at the University of Pittsburgh’s School of Nursing, and Cecile Springer, co‐founder of the Women and Girls 300youngadultsthusfar. Foundation, represent Grandmother Power and spread the cancer prevention message during the 5th Annual Allegheny Family Network Mental Health Expo, held on May 5 at the Pittsburgh Marriott City Center. Theseeventsprovidecommunitymemberswiththe opportunitytolearnmoreabouttheHPVvaccine, whichisrecommendedforboysages11‐21andgirls ages11‐26andiscoveredbyinsuranceorthefederalVaccinesforChildrenprogram.Thevaccinecan reducetheriskofdevelopingHPV‐relatedcervical,vaginal,vulvar,anal,throat,andpenilecancersbyup to99%.Yetjust38percentofgirlsand14percentofboysreceiveallthreedosesofthevaccine, accordingtotheCentersforDiseaseControlandPrevention. ResponsetoJHF’scommunitypresencehasbeenpositive,withsomeparticipantssharingstoriesofhow HPVtouchedtheirlivesandexpressingjoythattheycankeeptheirchildrenandgrandchildrenfrom enduringsimilarstruggles.MembersofthegrassrootsGrandmotherPowergroup—includingJoyce Penrose,CRNP,anadjunctassociateprofessorattheUniversityofPittsburgh’sSchoolofNursing,and CecileSpringer,co‐founderoftheWomenandGirlsFoundation—areforgingcommunityconnectionsand lettingfriends,family,andpeersknowhowtheycantakeactiontopreventHPV‐relatedcancers.JHFstaff ispreparingforanotherbusymonthinJune,withafocusonincreasingtheirpresenceincommunities withthelowestvaccinationrates. 12 Motivational Interviewing: Focusing the Conversation Whenprovidersaskopen‐endedquestions,they’re applyingamotivationalinterviewing(MI)skillthat allowspatientstosharetheirgoals,values,andfears. ThisinitialMIstepofEngagingisvitalinestablishinga relationship,andunearthingapatient’sinspirationfor makingpositivehealthchangesrangingfromquitting smokingtolosingweighttobettermanagingachronic disease. MIisactivatingpatientsandpromoting positivebehavioralchangesinanumberof PRHIinitiatives,includingthePCRCproject, CareofMental,Physical,andSubstanceUse Syndromes(COMPASS),andtheMinority AidsInitiative(MAI). Thoughthiscertainly“meetsthepatientwheretheyare,” newMIlearnersoftenfeelfrustratedwithconversations thatseemvagueandalmostlike…therapy.Movingtothe nextMIstepofFocusing,whichguidestheconversation tomeetbothpatientandprovidergoals,takespatience andpractice. PRHIalsooffersMItrainingsessionsboth withinhealthcaresettingsandatits downtownof ices.Trainingsessionsmaybe supplementedbyonsitecoachingand observation,whichhelpstoreinforceand honelearnedskills. LEARN MORE ABOUT MI Formoreinformation,contactPRHIDirector TerriAspinall,RN,aPrimaryCareResourceCenter ofEducationandCoachingMarkValenti (PCRC)caremanagerwithButlerHealthSystem,is ([email protected])orvisitPRHI’sevents honingtechniquesthatfocuspatientconversations.“It page(prhi.org/events). hasbeenajourney,”Aspinallsays.“Afterspendingtimeat PRHI’smotivationalinterviewingworkshopsand receivingon‐sitecoaching,I’vebecomebetteratpickingout themesinpatients’conversations—themesthatleadto mutuallybene icialchanges.” DuringarecentPCRCpatienthomevisit,Terrimetwitha patientwhochattedabouthisexperiencesinthemilitary, theoriesonsecretagents,anddesiretoeatmorefresh vegetables.Aboveall,hefearedbecomingdependentonothers ifhisheartconditionworsened. The steps of motivational interviewing. “Youreallyknowwhatyouwantforyourself,”Terriaf irmed. “Wheredoyouseeyourselfayearfromnow?” Thepatientpausedandsaid,“Iwanttobeinmyhome.” 13 Mark Valenti Showcases PRHI’s Approach to MI at Cleveland Clinic Summit FromMay17‐20,theClevelandClinicPatientExperience:Empathy+InnovationSummitbrought togetherpatientexperienceleaders,healthcareexecutives,nursingleaders,andotherstakeholdersfor presentations,debate,andcandiddiscussionofkeyissuesthatdriveapositivepatientexperience. Over2,100attendeeshadachancetohearhow organizationsaroundtheworlddeliverthebest clinical,physical,andemotionalexperienceto patientsandfamilies. Atthesummit,MarkValentipresentedaposteron PRHI’suniqueapproachtotraininghealthcare professionalsinmotivationalinterviewing(MI). ValentiexplainedhowMIhelpsforgepartnerships betweenpatientsandproviders,andidentifygoals At the Cleveland Clinic Patient Experience: Empathy + thatdrivehealthylifestylechanges.Valentialsohad Innovation Summit , PRHI Director of Education and Coaching Mark Valenti explains how motivational theopportunitytoconnectwithneworganizations interviewing guides patients toward their health goals. andpotentialpartners,andlearnaboutinnovative approachestopatientandfamilyactivation.SomeoftheseideashavethepotentialtoimpactPRHI’s CenterforHealthInformationActivation(CHIA)andotherprojectswhereprovider‐patientcollaboration iskey. PRHI Recognized for Excellence in Nursing Education ThePennsylvaniaStateNursesAssociation(PSNA)has renewedPRHI’scerti icationasanapprovedproviderof ContinuingNursingEducation(CNE)credits.Therenewal, throughMayof2018,recognizesPRHI’scommitmentto developingeducationmaterialsthatadvancethenursing profession. SeniorQualityImprovementSpecialistTerriDevereaux, MPM,workedonPRHI’srenewalalongwithProgram AssociateBrandiKelly.Devereauxwillspearheadthe developmentofnursingeducation,includingeventsandself ‐directedlearningopportunities,toensurethattheymeet PSNAstandardsandalignwiththegoalsofPRHIanditsprojectpartnersandgrantees.Therenewal allows,forexample,nursestoreceiveCNEsforcompletingPerfectingPatientCareSMUniversityor (ConƟnued on page 15) 14 (ConƟnued from page 14) engaginginlearningactivitiesthroughTomorrow’sHealthCareTM,PRHI’sweb‐basedknowledgenetwork. “We’redesigningeducationalexperiencesthataregroundedinadultlearningtheory—they’reevidence‐ basedandcanbeapplieddailyonthefrontlines,”Devereauxsays.“Wecreatedastandardworkprocess fordevelopingnursingeducationcredits,andthePSNAisinterestedinusingthatframeworkacrossthe Commonwealth.” Nancy Zionts Talks Closure, PA POLST at Caregiver Support Conference Morethan120professionalandinformalcaregiversgatheredatEdgewoodCountyClubinChurchillon May13todiscusspatientadvocacy,end‐of‐lifecare,work/lifebalance,andtappingcommunityresources duringtheUrsulineSupportServices2015Conference.JHFsponsoredthedaylongcontinuingeducation event,called“StockingtheCaregiver’sToolbox:TechniquesandTipsforFamiliesandProfessionals.” Duringtheconference,NancyZiontspresentedonJHF’s25‐yearcommitmenttoprovidingcaregiversand seniorswiththetools,resources,andinformationtheyneedtoachievetheirgoalsandmakeinformed healthcaredecisionsthroughinitiativessuchasCaregiverChampionsandClosure.Ziontsalsodiscussed theimportanceofadvancecareplanningatallstagesoflife,andtheroleofthePennsylvaniaOrdersfor Life‐SustainingTreatment(POLST)forminensuringthatseriouslyillpatientsreceivethekindofmedical treatmenttheydesireintheeventtheyareunabletomake/communicatedecisionsforthemselves. Theconference’sfeaturedspeakerwasTheresaBrown,PhD,RN,aclinicalnurseandauthorwho contributedtotheJHF‐supportedCreativeNon ictionFoundationworkIWasn’tStrongLikeThisWhenI StartedOut:TrueStoriesofBecomingaNurse. Conference‐goershadtheopportunitytonetworkwithfellowcaregiversandtalkwiththedozen‐plus exhibitorsrepresentingcaregiversupportprogramsinAlleghenyCounty,includingAgeWellPittsburgh, theJewishCommunityCenter,PresbyterianSeniorCare,andtheUnitedWayofAlleghenyCounty. 15 Inspired by JHF Visits and Closure, Israel’s Emek Medical Center Expands Services to Enhance End-of-Life Care, Communication ClalitHealthServices’EmekMedicalCenterischangingtheconversationaroundend‐of‐lifecareinIsrael. Emek,whichservesmorethan500,000patientseachyearfromitsfacilitiesintheJezreelValley,has collaboratedwithJHFtocultivateend‐of‐lifeandpalliativecareservicesthatpromotepatientautonomy andclearcommunicationwithproviders.Now,thoseserviceswillbeavailabletoevenmorepatients, families,andmedicalstaff. AJHF‐sponsoreddelegationfromEmektraveledtoPittsburghlastMaytomeetwithexpertsinend‐of‐life careandexploretheFoundation’sworkinthisspace,fromeducation,planning,andoutreachinitiatives (Closure)todocumentaries(TheLastChapter)tocreativenon iction(AttheEndofLife:TrueStoriesAbout HowWeDie). Thatvisitin luencedthedevelopmentofEmek’sPalliativeCareService,establishedin2014tosupport patientsandfamiliesfacingseriousillnessbyemphasizingtreatmentgoals,symptomassessmentand management,andhospitalstaffknowledgeofpalliativecareprinciples.TwomembersoftheJHF‐ sponsoreddelegationleadthePalliativeCareServiceprogram:DirectorEhudPaz,MD,aspecialistin InternalMedicineandIntensiveCare,andNursingCoordinatorKziaCohen,RN,MSc. Thisspring,EmekpartneredwithtwoorganizationsworkingtoimproveIsraeliseniors’qualityoflifeto launchprojectsfocusingonadvancedcareplanningandmedicalstaffcommunicationskills,amongother items.Movingforward,Emekisplanningalong‐termexpansionofitsPalliativeCareServicethatwould createamodelfeaturingin‐hospitalconsultationsandcare,anoutpatientclinic,andhomehospicecare. Inspired by Closure, JHF’s education, planning, and outreach initiative to raise expectations for end‐of‐life care, Israel’s Emek Medical Center has established a forum for professionals working in palliative care. More than 20 people — including staff from home hospice, long‐term care, and retirement communities — attend the first session of Shula’s Forum, named in memory of long‐time EMC nurse Shula Barbivai. InspiredbyClosure,Emekhasalsodevelopedaforum(Shula’sForum)forpalliativecareworkersin NorthernIsraeltoprovideprofessionalenrichmentactivitiesandidentifywaystostrengthenservices (ConƟnued on page 17) 16 (ConƟnued from page 16) bothinthehospitalandthecommunity.Shula’sForumwasestablishedthroughadonationinmemoryof ShulaBarbivai,along‐timenurseatEmekwhoreceivedend‐of‐lifecarefromDr.Paz. Kaiser Foundation Media Fellows Learn More About PRHI’s Approach to Health Reform HowisPennsylvaniaimplementingprovisionsoftheAffordableCare Act—andhowisPRHIhelpingleadthechargetowardvalue‐based carethatbettermeetspatients’needs?OnMay14,acontingentof nationalandlocalhealthpolicyandbusinessjournalistsmetwith PRHIChiefLearningandMedicalInformaticsOf icerBruceBlock,MD, ChiefCommunicationsOf icerLaurieGottlieb,andNancyZiontsto discussPRHI’shealthreformexperienceaspartoftheKaiser Foundation’sMediaFellowshipsprogram.Since2011,theKaiser Foundationhassponsoredsimilarbrie ingsforjournalistsin California,Florida,Georgia,Massachusetts,Texas,andWashington State. ThePRHIbrie ing,heldatHotelMonaco,includednationalreportersfromModernHealthcare,TheNew YorkTimes,theLosAngelesTimes,andKaiserHealthNews,aswellasstate‐basedjournalistsfrom PublicSource,thePhiladelphiaInquirer,andThePatriot‐News. Karen Feinstein Discusses Successful Aging, Med Ed Reform at Pitt’s Geriatric Division Conference OnMay1,KarenFeinsteinsharedtheFoundation’svisionforagingwell—andthemedicaleducation neededtohelpcreatethatexperienceforseniors—duringaconferenceheldforfacultyandstudents fromtheUniversityofPittsburgh’sDivisionofGeriatricMedicine. AcomponentofPitt’slargerInstituteonAging,theGeriatricDivisionconductsfederally‐fundedresearch, offersintegratedmedical,psychological,andsocialcare,andtrainsbothfutureandcurrentprovidersto addressthefullgamutofseniors’needs.Dr.FeinsteinwasinvitedtospeakbyNeilResnick,MD,chiefof Pitt’sDivisionofGeriatricMedicineandaJHFboardmember. Duringtheconference,Dr.FeinsteinhighlightedJHF’s25‐yearcommitmenttoimprovingseniors’quality oflife,includingprovidingsupportandtrainingforcaregiversandchampioningmodelsofcarethatallow (ConƟnued on page 18) 17 (ConƟnued from page 17) moreseniorstoremainintheirhomesandcommunities,ratherthaninnursinghomes.Currentgraduate medicaleducation,Dr.Feinsteinnoted, doesn’tnecessarilypreparestudentsto deliversuchsystems‐based,prevention ‐focusedseniorcare. “Geriatriciansarededicatedtothe healthstatusofseniors,”Dr.Feinstein says.“They’refocusednotona particulardiseaseororgan,butonan elderlyperson’sall‐aroundwell‐being. Weneedmoreofthatthinkingin medicaleducation,andweneedfaculty toleadbyexample.Ourcurrent organizedsettingsofcaretoooftenfail elderlypatientswithcomplexphysical andsocialneeds.” During a Pitt Division of Geriatric Medicine conference, Karen Feinstein explained that JHF’s aging agenda is designed to tip the scales toward home‐ and‐community‐based care. From Allegheny County to Atlanta, 2015 Summer Interns Bring Impressive Credentials to JHF Thisyear’scohortof12JHFsummerinternsincludesburgeoningbiostatisticians,epidemiologists, pharmacists,publichealthandpolicyleaders,socialworkers,andeconomists.Somehavevolunteered abroadtoservevulnerablepopulations,rushedtoaccidentscenesasanEMT,andadvocatedforhigher‐ qualityseniorcare.StartingJune1,they’llbringtheirtalentstotheFoundationtolearnleanquality improvementconceptsandcontributetoJHF,PRHI,andHealthCareersFuturesprojects. The2015internshailfrom ivedifferentuniversities,rangingfromlocalspots(AlleghenyCollege, CarnegieMellonUniversity,theUniversityofPittsburgh)tothoseintheMidwest(WashingtonUniversity inSt.Louis)andDeepSouth(EmoryUniversity).AllinternswillreceivetraininginPerfectingPatient CareSM,PRHI’s lagshipqualityimprovementmethodologyforrootingoutwaste,errors,andinef iciency inhealthcare.TheywillalsopartnerwithstafftoworkonFoundation/PRHI/HCFprojectsthatalignwith theircareerinterests. Thisyear’sprojectsincludeusingpredictivemodelingtoenhancehome‐and‐community‐basedservices forseniors;researchingcommunityhealthworker(CHW)policiestohelpshapeJHF’snewCHW Championsprogram;anddevelopingtools,content,andmarketingstrategiesforTomorrow’s HealthCareTM,PRHI’sonlineknowledgenetwork. (ConƟnued on page 19) 18 (ConƟnued from page 18) 2015 JHF SUMMER INTERNS Michael Backman Damilola Bamidele-Abegunde Nayanika Basu Tayler M. Bungo Breann Farrier Gabriel Gan University of Pittsburgh University of Pittsburgh University of Pittsburgh Washington University in St. Louis University of Pittsburgh Emory University PhD Biostatistics MPH in Epidemiology Doctor of Pharmacy Master of Public Health Master of Social Work Human Health & History Sarah Howard Nova Hubbard Nayana Nagaraj Haley Roberts Elizabeth Sierminski Minal Singhee Allegheny College University of Pittsburgh University of Pittsburgh Carnegie Mellon University University of Pittsburgh Carnegie Mellon University Economics Master of Social Work PhD in Epidemiology MS in Health Care Policy & Management Master of Public Health MS in Health Care Policy & Management No Health Without Mental Health Recognizes PRHI as Leader in Integrated Care InaDirector’sBlogpost,NoHealthWithoutMental Health(NHMH)ExecutiveDirectorFlorenceC.Fee highlightsPRHI’seffortstodeliverintegratedphysical andbehavioralhealthservicesinprimarycare settings.Feenotesthatthroughprogramsincluding IntegratingTreatmentinPrimaryCare(IPTC), PartnersinIntegratedCare(PIC),andCOMPASS(Care ofMental,Physical,andSubstanceUseSyndromes), PRHIhasuncovered“systemrequirements”for No Health Without Mental Health’s website (nhmh.org) features several PRHI‐created videos which make the case that integrated care achieves better patient outcomes at a lower cost. (ConƟnued on page 20) 19 (ConƟnued from page 19 integratedcaresuchaspracticeleadership,data‐drivenqualityimprovement,andhealthITthatsupports thewaythatproviderswork. NHMHisanon‐pro itorganizationwithof icesinSanFranciscoandWashington,DC,thatseeksto advanceintegratedcareprinciplesthroughsocialmarketingandcommunicationsstrategies. “WecongratulatethehealthcareinnovatorsofPittsburgh—anarearapidlybecomingacenteranddriver of21stcenturymentalhealthsystemsreformandimprovement,”Feesaysinherpost. Karen Feinstein Discusses Employee Engagement, Workplace Culture at Pitt School of Nursing’s Interdisciplinary Leadership Forum Howcanhealthcareleaderspromotethedevelopmentofengagedemployeeswhoemergeasleaders themselves?OnMay29,KarenFeinsteindiscussedtheroleofleadershipinchangingworkplaceculture andenhancingpatientcareduringtheUniversityofPittsburghSchoolofNursing’sInterdisciplinary LeadershipForum. Theforum,co‐sponsoredbythePittSchoolofNursing’sContinuingEducationDepartmentandthe WesternPsychiatricInstituteandClinic’sChildandAdolescentServicesLeadershipInstitute,invites expertsfromhealthcare,business,andeducationtosharetheirleadershipexperienceswith professionalsfrombackgroundsincludingnursing,hospitaladministration,socialwork,pharmacy,and mentalhealth. PRHI Board Member Spotlights VA’s Commitment to Rehabilitation Services TheVeteransIntegratedServiceNetwork(VISN)4—partoftheU.S. DepartmentofVeteransAffairs—servedmorethan320,000patientsin2014, includingsomerequiringsigni icantvisual,speech,andphysical rehabilitation.DavidS.Macpherson,MD,MPH,aPRHIBoardmemberwho servesasVISN‐4’schiefmedicalof icerandactingdirectoroftheVA PittsburghHealthcareSystem,paystributetoveteransandrehabilitation staffworkingtowardsahigherqualityoflifeinthelatesteditionofVisionfor Excellence,theVISN‐4’sbi‐annualnewsletter. 20 David and Meryl Ainsman Honored as Guardians of Israel OnMay18,JHFBoardTrusteeDavidAinsmanandhiswife,Meryl,werehonoredduringtheJewish NationalFund’sWesternPennsylvaniaGuardianofIsraelAwardDinneratPhippsConservatory.Since 1988,theGuardianofIsraelAwardhasrecognizedleaderscommittedtothebettermentoftheJewish communitylocally,nationally,andglobally. JHF Board Trustee David Ainsman and his wife, Meryl, were recently honored with the Guardian of Israel Award by the Jewish National Fund’s western Pennsylvania chapter. JHF Happenings (L‐R): Senior Quality Improvement Specialist Terri Devereaux; Quality Improvement Specialist Anneliese Perry; Communications Director Carla Barricella; Research Associate Emily Stahl; Quality Improvement Specialist Deborah Murdoch; Quality Improvement Specialist Stacie Bonenberger; HIV/AIDS Program Manager Richard Smith; and Accounting Manager Lindsey Kirstatter Hartle were among those who represented JHF during the Pittsburgh Marathon 5K Run on May 2. On May 27, Karen Feinstein (far right) held a debrief meeting with a group of entrepreneurs and healthcare professionals who served as mentors during JHF’s 2015 QI2T Health Innovators Fellowship. The mentors provided guidance to 30 interdisciplinary graduate students as they developed products designed to activate patients and help them make informed healthcare choices. Neil Busis, MD, UPMC Neurology (speaking); Larry Miller, executive in residence at Innovation Works; and Evan Facher, PhD, director of Enterprise Development, University of Pittsburgh Innovation Institute were among those who shared their experiences and helped the Foundation plan future fellowship programs. 21