UNE students share reflections on fourth and final day of their week-long rural health immersion in Midcoast Maine

June 5th, 2017 by healthinnovation
Third year pharmacy student Neva Gross gets ready to take a group selfie at the top of Mt. Battie in Camden, ME

Third year pharmacy student Neva Gross gets ready to take a group selfie at the top of Mt. Battie in Camden, ME

Thirteen UNE health professions students recently participated in a week long rural health immersion in Midcoast Maine.  The immersion experience is a part of a pipeline program with Maine’s Area Health Education Center (AHEC) program and UNE’s Center for Excellence in Health Innovation (CEHI) to address healthcare provider shortages in rural Maine.  This is the third immersion experience that the Maine AHEC and CEHI have provided for UNE students; last May medical, pharmacy, and dental students participated in a weeklong immersion in Aroostook County and last March medical and nursing students participated in a weeklong immersion in Franklin County.  In this immersion students were split into interprofessional teams consisting of medical, pharmacy, nursing, and dental students.   The students experienced a variety of clinical and community activities in underserved areas in Knox and Waldo county.  Below are reflections from one team after the fourth and final day in the Midcoast area on May 24th, 2017.

Curtis Jensen, owner of Jensen's pharmacy in Rockland talks about his experience of owning a private pharmacy.

Curtis Jensen, owner of Jensen’s pharmacy in Rockland talks about his experience of owning a private pharmacy.

Sara Stafford (third year pharmacy student)

Today was sadly our last day of the rural health immersion. After breakfast at Dots and driving to the top of Mount Battie, we had the opportunity to visit the local YMCA in Rockport and Rockland. We were able to check blood pressure on many of the residents of the area, pass out pedometers and give them information on the File of Life. Nearly everyone we talked to had never heard of the File of Life and giving them the opportunity to have all of their information available in the event that something happened to them where a health care professional would need that information in their home made me feel like I was really making a difference. Aside from the health screenings, we also got to talk with many of the local residents about their experiences in the health care system in their area. It was interesting to hear about the different experiences, with some of them being very negative and some of them being positive. After learning so much about rural health care in the past week, I felt like I was able to relate those negative experiences with the barriers that are presented in an area with such limited resources. After interacting with so many health care professionals, it was wonderful to be able to talk with the actual patients and hear about their experiences in the same system. Whether you’re a provider or a patient, everyone experiences shortcomings in this area and that needs to be recognized by more people.

After visiting the YMCA and eating lunch at Clan MacLaren, we visited Jensen’s Pharmacy in Rockland. As a pharmacy student, this was a great chance to see how a pharmacist at an independent pharmacy fits in to rural health care. Throughout this week, I had been wondering how a pharmacist could make a difference in a rural community and I felt like this experience gave me some answers to that. Unlike some of the other community pharmacies I have seen, there seemed to be more collaboration between the pharmacist and the physician, which is essential for good patient care. In addition to the enhanced patient care at this pharmacy, I was surprised to see more advanced technology being used in such a rural setting. The technology they had available for counting medication and keeping records not only benefits their business but also ensures their accuracy.

Not only today, but throughout the entire immersion, I was so thankful to be able to work with students from other professional programs; it was amazing to hear their different perspectives and get to know such great people that I would have otherwise not known. Whether it was their respective discipline or just the people that I was able to share this experience with, I have never been so passionate about doing more interdisciplinary outreach and will definitely continue to seek out the opportunities to do so.

UNE students and faculty attend a weeklong rural health immersion in Midcoast Maine (L-R, Row 1 Nancy Simpson, Purvi Patel, Molly Callnan, Emma Mason, Brandi Sargent, Cassidy Carpenter, Row 2 Jennifer Gunderman, Jason Greenbaum, Matthew Fiorilo, Sara Stafford, Kurdistan Pishdary, Heather Curran, Abby Golash, Neva Gross, Katelyn Van Leir , Ian Imbert)

UNE students and faculty attend a weeklong rural health immersion in Midcoast Maine (L-R, Row 1 Nancy Simpson, Purvi Patel, Molly Callnan, Emma Mason, Brandi Sargent, Cassidy Carpenter, Row 2 Jennifer Gunderman, Jason Greenbaum, Matthew Fiorilo, Sara Stafford, Kurdistan Pishdary, Heather Curran, Abby Golash, Neva Gross, Katelyn Van Leir , Ian Imbert)

Neva Gross (third year pharmacy student)

What can I say about this final day? The first three days have been packed with so many eye-opening experiences, how much more could possibly happen on our final day? Well, our chosen breakfast location did just that. After a brief stop at a local spot called Dots to pick up breakfast to-go, we hiked up Mount Battie….Hmmmm correction, the van did the hiking for us then we jumped out and took some pictures of the awesome view (but that was MY perfect kind of hiking).

Our mission today was to offer free health screenings at two local YMCAs, which actually means Young Men’s Christian Association. After doing a bit of research about the YMCA, I learned that the founder (George Williams) wanted to focus on developing a healthy “mind, body, & spirit”. This is actually represented as the three sides of the red triangle in their logo. Mr.Williams would definitely be proud of the PenBay YMCA in Rockport, ME for their absolutely beautiful building and wide range of services that they offer to the members of the community.  We were fortunate enough to be able to offer blood pressure checks from our College of Osteopathic Medicine and Nursing students, File of Life information from our Doctor of Pharmacy students, and very informative emergency iPhone Medical ID info (as well as, all around dental knowledge) from our College of Dental Medicine students. The members of the community that we encountered were very welcoming and seemed to be appreciative of our overall presence. The conversations ranged from blood pressure/health concerns to invitations to join the Zumba Gold class. One conversation that I enjoyed was with a retired pharmacist who was eager to chat with us about the importance of exercise.

After leaving the “Y”, we headed to lunch then visited Jensen’s Pharmacy. One of my classmates actually did a rotation at this pharmacy, so I was excited to see all of the things he had previously shared with me about this location. Curtis, the owner of the pharmacy, walked us around the pharmacy and talked to us about his path to owning an independent pharmacy. He also shared with us the impact of being a local pharmacy in the area and the relationships with the prescribers. It was good to hear about the mutual respect for each others professions, something that we (as interprofessional students) are working on perfecting during this rural immersion.

The purpose of this trip was to identify some of the barriers to care in the rural setting. My personal reflection would not be complete without mentioning the overall need for a public transportation system in this location. The community is overflowing with individuals who are willing to donate their time to serve the underserved population, which was very apparent to me. However, the lack of reliable transportation is blocking the most needy from acquiring these services. I won’t claim to have the answer to this barrier, but I will definitely be researching it. Until then, I will just recap a few things I learned on this trip: the definition of camping, hard water is real, fisher cat is neither a fish nor a cat, singing happy birthday in public is fun, and most of all, this was definitely the BEST immersion crew EVER!

UNE students share reflections on day three of their week-long rural health immersion in Midcoast Maine

June 2nd, 2017 by healthinnovation
After breakfast the students pose for a picture at the amphitheatre in downtown Camden, ME.

After breakfast on Day 3 the students pose for a picture at the amphitheatre in downtown Camden, ME.

Thirteen UNE health professions students recently participated in a week long rural health immersion in Midcoast Maine.  The immersion experience is a part of a pipeline program with Maine’s Area Health Education Center (AHEC) program and UNE’s Center for Excellence in Health Innovation (CEHI) to address healthcare provider shortages in rural Maine.  This is the third immersion experience that the Maine AHEC and CEHI have provided for UNE students; last May medical, pharmacy, and dental students participated in a weeklong immersion in Aroostook County and last March medical and nursing students participated in a weeklong immersion in Franklin County.  In this immersion students were split into interprofessional teams consisting of medical, pharmacy, nursing, and dental students.   The students experienced a variety of clinical and community activities in underserved areas in Knox and Waldo county.  Below are reflections from one team after the third day in the Midcoast area on May 23rd, 2017.

Dr. Mary Ashmore, DO, UNECOM '93, gives the students a tour of her practice in Camden and talks about her work with osteopathic manipulative therapy.

Dr. Mary Ashmore, DO, UNECOM ’93, gives the students a tour of her practice in Camden and talks about her work with osteopathic manipulative therapy.

Cassidy Carpenter (second year medical student)

Today, we toured a private practice and a free health clinic. This was an incredibly valuable experience as it highlighted the discrepancy in healthcare delivery based on socioeconomic status. The first healthcare facility we toured was a private practice where patients have to pay seventy-five dollars per month. The facility, resources, and care were phenomenal and a seemed like a great model for any practice follow.

Later in the afternoon, we toured a free clinic, which provided an entirely different perspective on healthcare delivery. While the doctors, nurses, and staff of the Knox Free Clinic are doing a phenomenal job with the limited resources they have, it showcased the large gap we have in access between “the haves” and “have-nots” in our population. Overall, today provided a great juxtaposition between two clinics that both had the same objectives and goals in terms of patient health, but had very different abilities based on resources and patient population.

Students engage with  Meredith Batley as she shares her experiences of working at the Knox Free Clinic.

Students engage with Meredith Batley as she shares her experiences of working at the Knox Free Clinic.

Molly Callanan (senior nursing student)

Today we started the day by visiting Dr. Mary Ashmore’s private midcoast clinic. This clinic was primary care with a mix of osteopathic manipulation therapy, which is a more holistic approach to treating the patient. I have had little experience with this type of therapy, so I found it fascinating to learn what it was and how it helps patients, especially patients with chronic pain. This facility does not accept most types of insurance (except Mainecare and Medicare) and instead her patient’s make payments of seventy-five dollars per month. I found this business model surprising because most people are not able to afford medical treatment unless it is covered by insurance. I imagine this excludes a lot of possible clients from this clinic. Another aspect of Dr. Ashmore’s clinic is an upstairs area for community classes such as dancing and Zumba, which is a function I really admired. I feel that it is important to provide education and exercise classes to the community because it has a real positive impacted on public health.

Our next stop was the Knox free clinic where we talked with Dr. Kleiner and Meredith Batley. Visiting this clinic after Dr. Ashmore’s private clinic was a great way to note the discrepancies in healthcare based on socioeconomic status. I found these stops to be really inspirational about how we can all find a way to help treat those who truly need it if we are willing to put in a small portion of our time.  I’ve also wanted to be able to help make changes in areas that are in need of it, but I’ve found that knowing the best way to do that is challenging to figure out on my own. Dr. Kleiner made it seem like [caring for the underserved was a] much more reasonable task and it made me excited to be able to volunteer in similar places once I graduate. We also made a stop at the Knox free dental clinic where they have one dental hygienist that works three days a week to help clients [improve their oral health]. I was shocked to learn how desperate the community is for dental care and the little amount of options there are for them. It was impressive to hear how much work this dental hygienist was doing for the community, though, at the same time saddening knowing that they cannot get a dentist to volunteer in the clinic to perform more advanced dental care.

The last stop of the day was to Seaport Health Center. We learned about this health center on our first day from Dr. Loxterkamp. They have a very nice health center with primary care, acute care, social workers, nurse practitioners, PT, and nurses. This health center usually only treats patients who have these doctors for primary care or by referrals. Another aspect of this center is that they provide addiction treatment which we learned about on the first day from Dr. Loxterkamp.

The last stop of the day was at Seaport Community Health Center in Beflast, ME where students get a first hand look at integrated practice.

The last stop of the day was at Seaport Community Health Center in Beflast, ME where students get a first hand look at integrated practice.

Emma Mason (second year medical student)

[Today was my birthday and] the first day of my 23rd year of life was part of the Mid-Coast Maine rural health immersion.  We started out the day having breakfast with Doctor Mary Ashmore, DO, and getting a tour of her private practice in Camden.  We then traveled to Rockland where Dr. Kleiner, MD and Meredith Batley gave us a tour of the Knox Free Clinic.  Being able to see these two different types of services back-to-back allowed us to see the difference in the two types of care.  It was interesting to see the quality of the private practice vs the free clinic and the different populations they serve.  Having grown up in this area I always knew that public transportation was a big issue as there is none but I never thought about it in the context of healthcare access.

In the afternoon, we had some free time to explore the Mid-Coast area.  We went to Cellardoor winery and walked around downtown Belfast.  We then went to our last tour of the day, Seaport Health Center.  This was another great opportunity to learn about a different health center and the way that it is run compared to the others we’ve visited so far.

 

After dinner at Rollies we have cake and sing Happy Birthday to two of the students whose birthdays were during the trip.

After dinner at Rollies we have cake and sing Happy Birthday to two of the students whose birthdays were during the trip.

UNE students share reflections on day two of their week-long rural health immersion in Midcoast Maine

June 1st, 2017 by healthinnovation
UNE students visit local elementary schools in Waldo County and provide education on the brain, oral health, and tick prevention.

UNE students visit local elementary schools in Waldo County and provide education on the brain, oral health, and tick prevention.

Thirteen UNE health professions students recently participated in a week long rural health immersion in Midcoast Maine.  The immersion experience is a part of a pipeline program with Maine’s Area Health Education Center (AHEC) program and UNE’s Center for Excellence in Health Innovation (CEHI) to address healthcare provider shortages in rural Maine.  This is the third immersion experience that the Maine AHEC and CEHI have provided for UNE students; last May medical, pharmacy, and dental students participated in a weeklong immersion in Aroostook County and last March medical and nursing students participated in a weeklong immersion in Franklin County.  In this immersion students were split into interprofessional teams consisting of medical, pharmacy, nursing, and dental students.   The students experienced a variety of clinical and community activities in underserved areas in Knox and Waldo county.  Below are reflections from one team after the second day in the Midcoast area on May 23rd, 2017.

Students meet with former Belfast Mayor and current city councilor Mike Hurley over breakfast to discuss community advocacy in Waldo County.

Students meet with former Belfast Mayor and current city councilor Mike Hurley over breakfast to discuss community advocacy in Waldo County.

Purvi Patel (second year pharmacy student)

Today was a very informative day for me. As far as pharmacy is concerned I haven’t had much experience in a hospital pharmacy setting. I’ve always known that there were specialties in pharmacy but going to Pen Bay Hospital today I discovered that the pharmacist there needed to know about retail pharmacy and hospital pharmacy. Knowing that hospital and retail pharmacy are very different things I realized that they enjoyed their jobs because it was challenging. Also, they had to change how they thought based on what side of the pharmacy they were in (inpatient or outpatient). There were other challenges where they had to prioritize between making a drug for someone in the emergency room, nurses calling about drug interactions, and patients waiting to get their medications in the outpatient pharmacy. Being in a rural setting they have to deal with all these challenges because there isn’t enough staff to handle just one side (inpatient or outpatient). I learned that there are many challenges in a rural setting but I also realize I would want to work in this setting because I know help is needed.

I have always known that compassion is needed in a healthcare provider but today really showed me that it is so much more important than I thought. We got to speak with people that play such a huge role in health policy. The way they spoke and explained the things that lack in the community or things they would like to incorporate, I realized that they joined politics because they wanted to make a real difference. Previously, I had always had a very negative stand on politics, but today I realized that, if we as healthcare providers want to make changes, we need to be more involved in politics.

The hospice tour was very emotional and eye opening. Our Dean is very involved with hospice care and we have learned a lot about it in the past two years. Actually going to a facility, seeing how things truly work and seeing the environment was an eye opening experience. Being in a rural environment I think having this facility is really important. It’s even better that it is so close to the hospital allowing people to have better access.

Overall today was more of an interprofessional day than the day before. I learned so much more about dentists and their jobs. I got to work with medical students and elementary kids that knew about rural environments. I learned a lot from the kids about what kinds of homes they have or what their daily routines are in a rural setting.  It was great riding in a van all day with different professions because we joked about how everyone in the healthcare profession has a superiority complex. Our conclusion to that discussion was that we all matter. Our knowledge is more useful and valuable as a whole. Working across professions is what will help our patients the most, whether it’s a rural, suburban or urban setting.

Students receive a tour of Pen Bay Hospital in Knox County.

Students receive a tour of Pen Bay Hospital in Knox County.

Katelyn Van Leir (second year dental student)

Yesterday was our second day on the Midcoast Maine Rural Health Immersion Trip. It matched the full load the first day presented us with, and kept us very busy. We started at the elementary schools in the area, followed by a tour of PenBay hospital in Rockport, a visit to Dr. Pier’s dental office, and, finally, dinner with Maine State Representative Pinny Beebee-Center.

At the elementary school, we were all very excited to be there. We worked together to teach the children about tick prevention, how the brain works, and oral health (my favorite!). We all had a lot of fun working with children and we were all very shocked by how much they already knew. However, what myself, and I believe my classmates found most interesting was the fact that every student at Troy and Walker schools receives free lunch.  I don’t think we were as shocked by that fact as we were about the children’s morale. Without knowing the fact, based on the quality of the school and attitudes of the children, it was something you would have never guessed. I found myself very surprised at how resourceful the community is, and how much effort it takes to create such a positive environment with such minimal means. We then visited Pen Bay hospital that seemed similar to Waldo County General Hospital (which we visited yesterday). I personally found a lot of interdisciplinary teamwork here as we visited the psychiatric center. As a dentist I wouldn’t have normally had the opportunity to analyze a psychiatric ward; I found myself baffled by the lack of space for so many patients in this area, not at Pen Bay, but where they can go for treatment after being discharged. It was disheartening to see what the nurses in the ward must deal with to have their patients get the help and care they need after their stay at Pen Bay.

Later we visited Dr. Pier’s dental office. I was very excited to see Dr. Pier as we work with him at UNE, and I think he is a great role model as a dentist. Initially, I did not see how he fit for students outside the dental school. It was not until later that night I was chatting with the others that they revealed to me that it was a great experience to visit his dental office. They had their “interdisciplinary ah-ha” moment as they got to see what we as dentists do, and became even further immersed in the interdisciplinary goal of this trip.

Lastly, we met with Maine State Representative Pinny Beebee-Center whom we discussed politics with. At the end of dinner Jason (the other dental student) and I picked her brain and I immediately found myself inspired about how I could make a difference in a community as a healthcare professional. Being from urban Southern California, I find it difficult to rally the troops for a cause because, unlike rural Maine, we don’t have tight knit communities, and do not share similar town/county wide struggles. However, after her conversation, I feel now that I can have a voice if I know who to talk to. Her passion to change the community through politics is infectious, and she instilled upon me to start at the bottom to see change at the top, and in her words specifically, “to work with politics with a little p, not a big P.”

Overall the second day was nothing shy of amazing, and was full of revelations, revelations I have been touched by, and will carry throughout life.

David Pier, DMD, provides a tour of his dental office in Rockport, ME.

David Pier, DMD, provides a tour of his dental office in Rockport, ME.

Heather Curran (senior nursing student)

The second day turned out to be my favorite and most meaningful part of our immersion. Our group split up and headed to two different elementary schools. The night before, we prepared lesson plans to teach the students about the brain, oral health, and tick awareness. My group consisted of nursing, pharmacy, dental, and medical students and we went to Walker elementary while the other group went to Troy elementary. Deciding how we would teach the kids was a bit difficult, since, as we were teaching 1st-4th grade students, we wanted to ensure our teaching style to match their learning level. As a future nurse, I found this significant because I could relate it to providing patient education and patient centered care in the future.

My visit at Walker elementary was eye opening. The first person we talked to was the principal, Glenn Widmer. I was surprised to find out that the school has 100 kids and consists of multiple towns. In addition, Glenn is the principal of both Troy and Walker middle school which really gave us a sense of how rural and close knit the community is. The principal and teachers were very passionate and went above and beyond when it came to their students.

Walker elementary school was different than most schools in more ways than one. It was small in both size and population. This was especially evident when we were told that some of the individual classes consisted of two grades. The school also had a greenhouse and an orchard that the students helped with. The notion behind this is that if the students are involved in growing the fruits and vegetables, then they are more likely to enjoy eating them. After talking with some of my peers we realized that both Troy and Walker elementary students seemed to be exceptionally smart and healthy. The teacher to student ratio as well as the push for healthy habits seemed to be a great way to facilitate the students’ learning, an important aspect that should not be overlooked for children at this age.

Maine State Representative Anne Beebee-Center talks about the role of healthcare providers in local policy.

Maine State Representative Anne Beebee-Center talks about the role of healthcare providers in local policy.

UNE’s Midcoast Maine Rural Health Immersion Kicks-off

May 22nd, 2017 by healthinnovation

 

UNE students and faculty attend a weeklong rural health immersion in Midcoast Maine (L-R, Row 1 Nancy Simpson, Purvi Patel, Molly Callnan, Emma Mason, Brandi Sargent, Cassidy Carpenter, Row 2 Jennifer Gunderman, Jason Greenbaum, Matthew Fiorilo, Sara Stafford, Kurdistan Pishdary, Heather Curran, Abby Golash, Neva Gross, Katelyn Van Leir , Ian Imbert)

UNE students and faculty attend a weeklong rural health immersion in Midcoast Maine (L-R, Row 1 Nancy Simpson, Purvi Patel, Molly Callnan, Emma Mason, Brandi Sargent, Cassidy Carpenter, Row 2 Jennifer Gunderman, Jason Greenbaum, Matthew Fiorilo, Sara Stafford, Kurdistan Pishdary, Heather Curran, Abby Golash, Neva Gross, Katelyn Van Leir , Ian Imbert)

Thirteen UNE health professions students are currently participating in a week long rural health immersion in Midcoast Maine.  The immersion experience is a part of a pipeline program with Maine’s Area Health Education Center (AHEC) program and UNE’s Center for Excellence in Health Innovation (CEHI) to address healthcare provider shortages in rural Maine.  This is the third immersion experience that the Maine AHEC and CEHI have provided for UNE students; last May medical, pharmacy, and dental students participated in a weeklong immersion in Aroostook County and last March medical and nursing students participated in a weeklong immersion in Franklin County.  The students have been split into interprofessional teams consisting of medical, pharmacy, nursing, and dental students.   The students are experiencing a variety of clinical and community activities in underserved areas in Knox and Waldo county.  Below are reflections from one team after the first day in Waldo County on May 22nd, 2017.

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Dr. David Loxterkamp, MD, and Mary Beth Leone, LCSW, provide a training on Medication Assisted Treatment at Athena Health in Belfast, ME

Brandi Sargent (second year medical student)

As a college of osteopathic medicine student, I learned a lot today about not only physicians in a rural health atmosphere, but other care providers as well. We began the morning with a discussion about treating patients with addiction held by Dr. Loxterkamp and Mary Beth Leone at Athena Health. I admired their idea of a “tribe” setup and how important it is for their program that the patients meet as a group and build relationships with people like them. One key takeaway I had from this experience was how often treating patients with addictions will be for us in the future and how we, like the patients, will have to work as a tribe with different health professions to best care for them.

In the afternoon, we had the opportunity to tour Waldo County General Hospital and Stockton Spring Rural Health Center. In each setting, I was excited to learn about the different roles physicians play in a rural setting. Dr. Smith, a hospitalist at Waldo County General Hospital, wore a variety of hats as he treated the patients in the hospital. He also talked about how in another rural setting, he delivered children as well as being a family physician. I had never heard of a TeleHealth intensive care unit before coming to this hospital and found it a really unique and thoughtful way to connect patients in remote areas to experts in the field in other locations. At the Stockton Spring Center, we learned about their patient centered approach to treatment and I was able to experience another physician who was able to do a variety of things in the practice. They also had a trauma room equipped to handle suturing patients, which I found really great in this remote area to be able to provide quick treatment. One of my overall goals for this immersion was to see physicians who were able to experience a variety of patients and procedures due to being in a rural setting and I definitely saw this today. This immersion definitely made me more open to practicing in a rural setting and helping to treat patients recovering from addiction.

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Students discuss rural health care during a visit to the Stockton Springs Regional Health Center in Stockton Springs, ME.

Jason Greenbaum (second year dental student)

Today was the first day of our immersion into rural health in mid-coast Maine. We started our journey in Belfast at the Seaport Community Health Center where we learned about the very serious opioid crisis that is affecting Maine. Dr. Loxterkamp explained what it is like to be a physician who helps run a medication assisted treatment (MAT) program. Mary Beth Leone explained what it is like to be a licensed clinical social worker for the MAT program and how it is important to walk a fine line between establishing trust with your patients and keeping them accountable. As a dentist, I feel that it will also be crucial to walk this fine line between establishing trust and holding patients accountable for their oral hygiene. After our training, I also can appreciate my role as a dentist in preventing the over prescribing of opioid pain medication that may lead to misuse by the patient or others that might have access to the medication. We then toured around the Athenahealth building which surprised me because it seemed like it was some corporate headquarters right out of Silicone Valley. I very much appreciated how this business provides jobs and the opportunity of a fulfilling career for the residents of Waldo county.

Our next stop was to Waldo County General Hospital in Belfast. We were introduced to many of the public health and health education programs that exist in Belfast through Waldo County General Hospital. We toured around the hospital and even got to see the dental clinic that exists there. Dentists are severely lacking in Waldo county and I was shocked to hear that there are about 3,600 patients to every one dentist in the clinic. I was happy to hear that a recent UNE graduate will be taking a position at the Waldo County General Hospital dental clinic after a positive experience during his externship this past year. I enjoyed meeting one of the dentists in the clinic, Dr. John Slaughter, who after retiring came back to practice in the clinic to help meet the dental needs of the residents of Waldo county. We then split up into groups and several of us toured around the inpatient nutrition services and outpatient diabetic clinic. Thankfully one of the UNE CDM faculty, Dr. King, was there to help me look at inpatient nutrition from the aspect dentistry. We conversed about how it is important for the dentist to educate the patient or patient’s parent about the high carbohydrate content of many liquid nutrition diets and how this can affect the dentition. Therefore, it is important to maintain good oral hygiene when on a liquid diet to prevent the progression of dental caries. I am happy to be learning so much on the first day of this rural health immersion. This program is helping to reiterate the reasons why I chose to come to dental school and why I want to stay and practice in Maine.

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Students get a tour of Waldo County General Hospital

Matthew Fiorillo (OMS II)

As a rising second year medical student (and a current Maine resident) I found today’s agenda to be especially interesting.   Unfortunately, the state has a real problem with opioid abuse, and healthcare professionals need to play an active role in helping to resolve the problem. To begin, I thought that Dr. Loxterkamp and Mary-Beth Leone made great points regarding the treatment of addiction patients. Substance abuse can affect anyone, but it tends to involve patients with poor social histories–namely people (1) from lower income backgrounds, or (2) who have suffered physical or emotional abuse.

I thought this was an important point to consider. Some people are–through no fault of their own–more predisposed to addiction. As healthcare providers, we need to be mindful of this concept, and make sure that we afford each of our patients the time and respect that they deserve. With this in mind, an ideal treatment plan should include methods to not only treat addiction, but to also address the issues underlying the addiction. To accomplish this goal, providers need to form close, caring relationships with their patients. Interestingly, this concept was reinforced throughout the day, and was echoed by providers at both Waldo County General Hospital and Stockton Spring Rural Health Center.

One of my goals for this immersion experience was to better understand how interprofessional cooperation could be used to benefit patient care, and I definitely was able to see this today. I am excited to work with everyone over the next few days, and am looking forward to learning more about the intricacies of rural medicine over the next few days!

Students split into interprofessional teams and bowl at the Point Lookout Resort bowling alley.

Students split up into interprofessional teams and bowl at the Point Lookout Resort bowling alley.

New Resources Bring Opportunity for Public Health Emergency Preparedness Volunteers

April 29th, 2017 by healthinnovation

MRC YORK Flier copy

In October of 2016 students and staff from UNE participated in a Public Health Emergency Preparedness exercise with partnering agencies ranging from state and county governments to local healthcare partners. The volunteer driven Flu Clinic and Points of Dispensing (POD) exercise was a success with over 160 vaccines administered and an After Action Report indicated an opportunity to engage local volunteers in preparedness activities in an ongoing capacity (and not rely on spontaneous and unaffiliated volunteers to support public health response in times of actual emergency).

In the months that followed the 2016 exercise a new public health resource was established in the Public Health District serving York County, Medical Reserve Corps Unit 2640 (AKA the “York MRC”). The York MRC is made up of community preparedness volunteers (from both on and off campus) interested in responding during a public health crisis. Maine MRC State Coordinator Jared McCannell remarked that “this unit was established as a direct result of the recent exercise at UNE; it was clear that an opportunity exists to engage students in this work as well as tap into the greater community for support.”

In an effort to launch this collaborative volunteer opportunity the new York MRC unit applied for—and received—a $13,000 “Challenge Award” from the National Association of County and City Health Officials (NACCHO) to increase awareness about Public Health Emergency Preparedness volunteer opportunities and to develop a MRC presence on the UNE campus.

The funds will have a large impact on the growth of the unit as all new members will be eligible for numerous training and exercise opportunities, receive supplies, uniforms, go-bags, first aid kits and other resources. Volunteers will also gain priceless skill building and professional networking experience. “Whether it is a student early in their pursuit of a career in healthcare or a local citizen interested serving their community during times of need, it is not just the volunteers of this new MRC unit that will reap the benefits of this award, but the greater community of York County”, says McCannell.

FMI about joining the Medical Reserve Corps in Maine please email MedicalReserveCorpsME@gmail.com.

To register as a Public Health Emergency Preparedness volunteer with the State of Maine please visit www.maineresponds.org.

Implementing Team-based Health Care: UNE Team Presents at Quality Counts Health Conference

April 29th, 2017 by healthinnovation


The Clinical Interprofessional team at the University of New England Center for Health Innovation presented a breakout session at Quality Counts, Maine’s largest health conference, held at the Augusta Civic Center on April 5, 2017. The group joined nearly 1,000 others from across Maine for the day to learn strategies to improve health quality. Don Berwick, M.D., was the keynote speaker.

 
“Partnering to Improve Provider and Patient Experience Through Interprofessional Practice and Education” was jointly presented by the UNE team and partners at Eastern Maine Medical Center (EMMC), including Felix Hernandez, M.D., Frank Bailey, and Andy Pritchard, M.P.H.

This participatory buzz session featured EMMC and UNE team members presenting lessons learned through their three-year partnership to develop and implement interprofessional practice and education at EMMC, with a focus on how this approach has enhanced the patient experience as well as improved the relationship between provider and patients. The session featured interprofessional student home visits with pharmacy and osteopathic medical students to recently discharged complex patients. The session was presented through in-person sharing, dialogue with the audience, and video. Participants were then asked to discuss several questions at their table, followed by a whole group discussion. A lively and engaging discussion wrapped up the session.

Dora Anne Mills, M.D., M.P.H.; Felix Hernandez, M.D., and Frank Bailey, talk about implementing a model of collaborative practice at the 2017 Maine Quality Counts Conference.

Dora Anne Mills, M.D., M.P.H.; Felix Hernandez, M.D., and Frank Bailey, talk about implementing a model of collaborative practice at the 2017 Maine Quality Counts Conference.

The UNE team included: Dora Anne Mills, M.D., M.P.H.; Ruth Dufresne, SM; Ruby Spicer, RN, M.P.H.; Toho Soma, M.P.H.; Melanie Caldwell, M.S.; Ian Imbert, M.P.H. They were joined at the session by Dean of the College of Pharmacy, Gayle Brazeau, Ph.D.

To learn more about the Center for Excellence in Health Innovation, visit: http://www.une.edu/academics/centers-institutes/center-excellence-health-innovation

 

Multiple Stakeholders Partner to Build Multidimensional Interprofessional Training Series

April 29th, 2017 by healthinnovation

UNE’s Interprofessional Education Collaborative (IPEC) and the School of Social Work partnered with Maine Quality Counts and the Northern New England Practice Transformation Network (NNE-PTN) to build a multidimensional interprofessional training series. NNE-PTN is a multi-million-dollar grant project spanning Maine, Vermont, and New Hampshire designed to raise awareness of the Institute for Health Care Improvement’s (IHI) Quadruple Aim goals leading to improved and coordinated healthcare. Tenets of the Quadruple Aim include improving the patient experience of care, improving population health, reducing healthcare costs, and increasing provider satisfaction.

The first of the three-part series was an in-person workshop that introduced providers and healthcare administrators to concepts of seamless care, medical neighborhoods and collaborative practice. The primary site of the half-day training took place on March 9th at Maple Hill Farm and Conference Center in Hallowell Maine, and was livestreamed to the University of New Hampshire School of Law in Concord, New Hampshire.

A captive audience of diverse health professionals watches Pat’s story at the NNE-PTN live learning session on March 9th.

An audience of diverse health professionals watch Pat’s story at the NNE-PTN live learning session on March 9th.

The second training for Quality Counts NNE-PTN was an interactive webinar on March 28th (Find the link here:https://www.mainequalitycounts.org/articles/161-1565/march-28th-webinar-seamless-care/3). The webinar built upon concepts of seamless care and collaborative practice, adding community-based exemplars to demonstrate how these concepts reduce costs in care. Jaclyn Chadbourne, Research and Development Principal of MedTech™ and MedGym and Victoria Hynes, Clinical Outreach and Implementation Coordinator of Maine Behavioral Health’s PRIDE Program, joined Shelley Cohen Konrad, UNE-IPEC and School of Social Work Director, to present the business case for successful seamless care implementation exemplified in their respective programs.

The final tier of the training collaboration will be educational modules that draw upon UNE-IPEC’s COMPtime series of interactive online modules (http://www.une.edu/wchp/ipec/comptime) designed to demonstrate real world use of interprofessional competencies (https://ipecollaborative.org/uploads/IPEC-2016-Updated-Core-Competencies-Report__final_release_.PDF) through a patient story. The development of COMPtime was funded by an Arthur Vining Davis Foundation grant received by UNE-IPEC in 2012. The educational modules will be posted on the Quality Counts website in mid-May 2017.

Faculty members Arabella Perez and Kelli Fox are filmed discussing seamless care for the NNE-PTN online modules.

Faculty members Arabella Perez and Kelli Fox are filmed discussing seamless care for the NNE-PTN online modules.

The successful execution of this training series brought together collaborators from a host of organizations, proving that tenets of seamless care exist both within and outside the halls of healthcare. Partners in the NNE-PTN training series include Maine Quality Counts, Maine Behavioral Health, Jaclyn Chadbourne from MedTech™ and MedGym™, Sylvie Demers, Project Manager, Alyssa Wyman, UNE graduate assistant, instructional designers Anne Fensie and Shiva Darbandi, Kelli Fox and Arabella Pérez, School of Social Work content experts, and UNE-IPEC’s Kris Hall, and Shelley Cohen Konrad. Those wishing to view the NNE-PTN trainings can find them on the Quality Count website.

 

Holding Effective Meetings, the Latest New England Public Health Training Center Course

April 27th, 2017 by healthinnovation

PHT - Module 2 Holding Effective Meetings

If you manage a team, you may have asked yourself the following question; How can I make the best use of my employee’s time in meetings? Or, better yet, have you ever attended a meeting that was disorganized, took much longer than it should have, and ended with nothing to show for it? If you have, you may want to consider the New England Public Health Training Center at the University of New England and it’s newest course, Holding Effective Meetings, where we’ll look at how to put an end to these “time-wasters” and instead offer strategies on how to execute an effective meeting. We’ve all been made to sit through ineffective meetings at some point in our careers and most of us agree that not only are these meetings annoying to the attendees, but they can also be a waste of one of our most valuable resources: time.

By participating in the course Holding Effective Meetings you will learn how to:

  • optimize your time by identifying the need for a meeting and the benefits of planning for a successful outcome;
  • find better ways to engage staff at crucial steps throughout the meeting process;
  • properly execute meetings by improving your facilitation skills to help you manage your team more efficiently; and
  • review the key components to running a successful meeting and learning the basics of meeting setting and facilitation skills.

The Public Health Training site is supported by The New England Public Health Training Center at the University of New England through funding from HRSA, offering free professional and workforce development modules for public health professionals. To access our latest module, Holding Effective Meetings, visit our website at Maine.gov/PHT. Once on the site, you can quickly and easily set up an account and choose at least one course from the several that are available based on which course is more relevant for you and your teams’ professional development goals. Courses are typically an hour long and can easily fit into your workday

FMI: Contact Nicole O’Brien, M.A., Research Assistant in UNE’s Center for Excellence in Health Innovation and Project Manager, Community Access to Child Health in Maine (CATCH-ME) grant at nobrien1@une.edu

Upcoming Training for Maine providers, Taking It To The Next Level: Meaningful Use of IPE in Clinical Settings

March 28th, 2017 by healthinnovation
Flyer for the April 28th IPE training held on the UNE Portland Campus rom 8:45 a.m. - 3:00 p.m.

Flyer for the April 28th IPE training held on the UNE Portland Campus from 8:45 a.m. – 3:00 p.m.

The University of New England is pleased to invite UNE clinical affiliates and providers to attend an interprofessional education (IPE) training with two nationally recognized IPE experts, Brenda Zierler, Ph.D., RN, RVT, and Sarah Shrader, PharmD, BCPS, CDE. The training will be held on Friday, April 28th, from 8:45 a.m. – 3:00 p.m. on the University of New England’s Portland Campus located at 716 Stevens Avenue and will feature two training sessions, one on interprofessional facilitation and one on collaborative community practice. The training is offered through the four year Josiah Macy Jr. Foundation grant that was awarded to UNE in 2015 which aims to improve healthcare outcomes through collaborative practice. The goal of the training is to help clinical preceptors, IPE facilitators, and practice leaders build skills to guide students in delivering collaborative and effective team-based patient care.

The objectives for the training are:

  • Demonstrate an understanding of the value of interprofessional principles and their meaningful use in campus and clinical practice and education.
  • Describe how IP facilitation is similar to and different from traditional teaching and learning.
  • Analyze the core elements of IPE facilitation.
  • Identify areas of where and how to apply these in your curriculum and activities.
  • Identify and overcome barriers to implementing IP learning and facilitation.
  • Demonstrate IP facilitation skills that can be implemented in classroom and clinical settings.
  • Discuss the range of venues in which IP facilitation skills can be operationalized.

Interested participants can register here: www.surveymonkey.com/r/3PK9XLY .

Dr. Brenda Zierler is the Associate Director for the Institute for Simulation and Interprofessional Studies at the University of Washington School of Nursing and Health Systems. As the co-principal investigator of a Macy Foundation-funded study (with Brian Ross MD, PhD). Dr. Zierler led a group of interprofessional faculty and students in the development of a simulation-based, team training program it improve collaborative interprofessional communication both within teams and with patients. In addition, Dr. Zierler is a fellow in the RWJ Nurse Executive Program (2008 cohort).

Dr Sarah Shrader is a Clinical Associate Professor at University of Kansas School of Pharmacy. She has a clinical practice site in the Interprofessional Teaching Clinic in Family Medicine. Her areas of interest are Interprofessional Education, Preceptor and Experiential Learning/Site Development, and Primary Care.

FMI on UNE’s Center for Excellence in Health Innovation: http://www.une.edu/academics/centers-institutes/center-excellence-health-innovation

FMI on UNE’s Interprofessional Education Collaborative: http://www.une.edu/wchp/ipec

FMI on the Josiah Macy Jr. Foundation: http://macyfoundation.org/

 

UNE’s Center for Health Innovation Forms a Pipeline to Franklin County to Address Healthcare Shortages

March 27th, 2017 by healthinnovation
Students from the Franklin County rural health immersion pose for a photo on Wilson Lake the day after a Nor'Easter hits Maine and most of New England.

Students from the Franklin County rural health immersion pose for a photo on Wilson Lake the day after a Nor’Easter hits Maine and most of New England.

Fifteen healthcare students from UNE’s College of Osteopathic Medicine and Westbrook College of Health Professions Accelerated Bachelor of Science in Nursing (ABSN) program recently attended a weeklong rural health immersion in Franklin County. The experience, which is coordinated and funded by UNE’s Center for Excellence in Health Innovation and the Maine Area Health Education Center (AHEC), is a pipeline activity created to reduce healthcare provider shortages in rural Maine and to strengthen UNE’s relationships with healthcare centers around Maine. The weeklong rural health immersion experience was the second time that it has been offered to UNE students; last May a weeklong immersion was held in Maine’s northern most county, Aroostook County. The enormous amount of positive feedback from students and community members of last years 2016 immersion spurred two more immersions to be scheduled for 2017.

Attracting healthcare professionals to rural and underserved communities has been a national priority for several years and a particular issue for Maine partly due to the fact that, according to the 2010 Census Data, Maine was the most rural state in the United States. Rural terrain can lead to long commutes for patients seeking basic healthcare services and can exacerbate provider shortages, leading to poorer health outcomes. The locations for the immersion experiences are chosen based on the three AHEC centers strategically located around Maine in Aroostook, Franklin, and Penobscot counties, three of Maine’s most rural counties.

Franklin County, which ranked middle of the pack among Maine’s sixteen counties for health factors (8th) and health outcomes (7th), has been given less favorable ratings in quality of life (12th) and social & economic factors (10th), according to the Robert Wood Johnson Foundation’s 2016 county health rankings. It’s predicted that some of the health challenges that Franklin County faces would be improved if there were more providers in that area. According to the Robert Graham Center and the Nursing Workforce Forecast, Maine will need an additional 120 primary care physicians and 3,200 nurses in the next decade in order to maintain current rates of healthcare utilization. Research shows that students are more likely to practice rural medicine if they have a personal connection to a rural area, so, the rural health immersions aim to provide opportunities for students to connect to rural Maine and hopefully alleviate healthcare provider shortages.

Brad Gilbert, RN, talks to the students about his career path as a nurse and how he ended up in rural medicine

Brad Gilbert, RN, of Franklin Memorial Hospital in Farmington, ME, talks to the students about his career path as a nurse and how he ended up in rural medicine

The students who participated in the western Maine rural health immersion came from a broad array of backgrounds, some growing up throughout the country in areas like California and Oklahoma while about a third of the students had grown up in Maine or had spent time previously in rural Maine. Most students had some experience working with underserved populations in the past but, for some it was their first opportunity to experience rural underserved healthcare. One ABSN student, originally from Taiwan, Feng Cherng (Alex) Hsu, who was an economist before enrolling in UNE’s ABSN program, said he is already considering returning to Franklin County after graduating It would be my honor to be able to become one of the colleagues of Franklin Memorial Hospital because they have many professionals who contributed so many years in such working environment without many support and resources…We were constantly informed that [Franklin County] is and will be a great [place to] work under such a beautiful area. The working environment in Franklin County is great, people of Maine are very nice, and workers can enjoy all kinds of outdoor recreational activities all year long.”

The students experienced a variety of activities in underserved areas in Franklin County, such as meeting with providers of Franklin Memorial Hospital for a tour of the facility, meeting with a local pediatrician and nurse to discuss current strategies used to address population health, and meeting with a local EMS agency to discuss emergency medicine in rural Maine. There was also an overarching behavioral health theme during the trip and all of the students were exposed to topics within that field on multiple occasions, such as a panel discussion on the opioid epidemic in rural Maine with a public health professional, maternal child health nurse, and nurse practitioner who work in Franklin County. Later, they also attended a three-hour public seminar to discuss suicide prevention and strategies, which featured a well-known expert from Maine General and the director of the Maine Chapter of the National Alliance on Mental Illness. “There was great depth and breadth of exposures during the immersion that the students will be able to bring to future courses and clinical experiences”, says UNE clinical assistant professor, Judith Metcalf, APRN, BC, MS, FMGS, one of the faculty members who also attended the immersion.

The students also enjoyed having time to take in the natural beauty of the area, such as when they went snowshoeing under a full moon on Wilson Lake. They also got a taste of the local culture when they met with with Bill Roorbach and Tom Saviello. Roorbach, a nationally known author from Farmington, had lunch with the students and gave each of them a signed copy of one of his books. The next morning, Saviello, a Maine state Senator, talked with the students about economics and health policy in rural Maine.

Students wake up early to meet for breakfast and talk health policy with Maine state senator Tom Saviello

Students wake up early to meet for breakfast and talk health policy with Maine state senator Tom Saviello

Some of the week’s activities were canceled due to the March 14th blizzard that hit most of Maine and New England. There were a variety of clinical skills activities that were scheduled but had to be canceled due to the storm such as conducting health screenings at a senior citizens center in Farmington and Rangeley; collecting vitals and providing patient education at Edgewood Rehab in Farmington, and doing home visits with Androscoggin Home Health. Despite the wintery conditions, the students were determined to make the most of their rural health experience, and, after making a trip to the local Hannafords to stock up on food and water for the storm, the group hunkered down at the motel in Wilton to work on team-building exercises, as they collectively decided to cook dinner together and then self-facilitate an evening debrief.

Dora Anne Mills, MD, MPH, FAAP, and Vice President for Clinical Affairs and director of UNE’s Center for Health Innovation attended the immersion and had this to say of the students experiences “It’s been very exciting to see medical and nursing students learn from, with, and about each other, and I found it very inspiring to learn from them.  They are truly an interprofessional team, as partly evidenced by how I couldn’t tell who is which profession.” Another UNE faculty member who participated in the immersion, Jen Van Deusen, Director of Curriculum in UNE’s College of Osteopathic Medicine, saw the tight bonds that had formed among the students as an opportunity to continue the interprofessional learning and extended an invitation to the nine nursing students to attend a panel session on addiction and substance use with the first year medical students the week after they returned from the immersion. “The rural health immersion leads to longstanding friendships and increases students’ value of interprofessional learning experiences, which is why I invited the nursing students to join our medical students in the March 24th training session”, says Van Deusen.

The full team of students who attended the Franklin County immersion included six medical students from UNE’s College of Ostepathic Medicine, Sean Bilodeau, Jessica Brancely, Kristina Carlson, Stephanie Czajkowski, Kristin Frisby, and Zachary Lane and nine nursing students from UNE’s Westbrook College of Health Professions Accelerated Bachelor of Science in Nursing program, Sheridan Aspinwall, Valerie Bedard, Ilija Bratina, Anika Gannon, Feng (Alex) Hsu, Kane Kunst, Cynthia Mosher, Sarah Rafferty, and Kali Waters. You can read more on each students experience here.

Lorri Brown and Tania Dawson, RN, talk to the students about substance misuse in Franklin County.

Lorri Brown and Tania Dawson, RN, talk to the students about substance misuse in Franklin County.

The majority of the planning and coordination for the trip was provided by Ian Imbert, MPH, project coordinator of a four year Josiah Macy Jr. Foundation grant and staff member in UNE’s Center for Excellence in Health Innovation. Jen Van Deusen, M.Ed., Director of Curriculum for UNE’s College of Osteopathic Medicine, and Judith Metcalf, APRN, BC, MS, FMGS, clinical assistant professor of nursing and coordinator, Upstream Practicums in Nursing Program, both attended and provided expertise and mentorship during the trip. Dora Anne Mills, MD, MPH, FAAP, Vice President of Clinical Affairs at UNE and director of UNE’s Center for Health Innovation also attended the immersion.

The next weeklong immersion is scheduled for May 21st – 26th 2017 in the Midcoast region and will involve students from UNE’s College of Osteopathic Medicine, College of Dental Medicine, and College of Pharmacy.

The trip was graciously supported by Maine’s Area Health Education Center (AHEC) and the Josiah Macy Jr. Foundation. The Maine AHEC has continued to prioritize experiential learning in rural communities for graduate healthcare students and their commitment to the rural health immersion proved to be invaluable for the success of the trip. Tania Dawson, director of the Western Maine AHEC was an essential resource in setting up connections with providers, community members, and hospitals in Franklin County. The Josiah Macy Jr. Foundation grant that also helped fund the experience is a four-year grant awarded to UNE in 2015 from the Josiah Macy Jr. Foundation and aims to improve health care and education in rural areas.

FMI: Contact Ian Imbert, MPH, (207-221-4625 or iimbert@une.edu)