UNE Interprofessional Community Health Rotations: Training medical students in team-based rural primary care

August 27th, 2017 by healthinnovation

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August 13-19, 2017 was recognized as National Health Center Week, celebrating the work of Federally Qualified Health Centers (FQHCs) in providing comprehensive, coordinated health care to rural and urban underserved communities throughout America. This event drew attention to Maine’s network of mostly rural FQHCs, some of which have begun to serve as training sites for UNE College of Osteopathic Medicine (COM) students as part of an Interprofessional Education Community Health Rotation (IPE CHR) experience.

While UNE COM’s four-week CHR has traditionally addressed not only patients’ clinical needs, but the socioeconomic and cultural factors that shape health outcomes, the IPE CHR was created in 2016 to help COM students apply their on-campus interprofessional training to team-based primary care practice. The IPE CHR includes four to eight hours per week of engagement with non-medical health professionals, providing a profound awareness for COM students of the value of collaborative care. According to Dora Anne Mills, MD, MPH, FAAP, Vice President for Clinical Affairs and Director of UNE’s Center for Excellence in Health Innovation (CEHI), “Maine’s FQHCs are ideal settings for introducing UNE COM students to interprofessional care, as the one-stop shop FQHC care model often includes behavioral health, dentistry, care coordination, and assistance with community resources, effectively meeting patients’ and families’ complex care needs.”

As a foundation for clinical IPE training in rural Maine, the UNE CEHI created the Clinical Interprofessional Curriculum (CIPC) in 2016, which introduces COM students to the national Patient Centered Medical Home (PCMH) model of care now in place at the majority of Maine’s FQHCs. The CIPC’s three-pronged emphasis on team-based care, care management, and population health now guides UNE students in practice-based IPE CHR activities including: student engagement with specialists (podiatrists, optometrists, psychiatrists, etc.) as well as engagement with pharmacists, clinical care managers, behavioral health providers, diabetes educators, case managers (addressing social service needs), dentists, and more. COM students have also worked within interprofessional teams addressing care planning, quality improvement, post-discharge care, and palliative care.


IPE CHR Spotlight: Nasson Health Care, Sanford, Maine

Samuel Wood, OMS-III, UNE College of Medicine

Samuel Wood, OMS-III, UNE College of Medicine

Sam Wood, a third-year COM student and Care for the Underserved Pathway (CUP) scholar with a specific intent to serve vulnerable populations, recently completed his IPE CHR at Nasson Health Care, an FQHC serving rural, low-income communities in southwestern Maine. Following a wide range of team-based care experiences at Nasson including a home visit to a patient with terminal kidney disease, participation in a Cooking Matters nutrition class for food stamp program enrollees, and an unscheduled intake for an opioid-dependent patient, Sam observed that “every link in the chain matters” in meeting patients’ complex needs. At the close of his IPE CHR, Sam reflected that his opioid-dependent patient had “walked in helpless, alone, and without any resources, but roughly one hour later, she emerged with confidence, a plan, and a team to help her implement it.” –Samuel Wood, OMS-III, UNE College of Medicine

Mary Jeralds, RN, Clinical Nurse Manager at Nasson Health Care, also noted at the close of Nasson’s first IPE CHR that her team “feels very fortunate to have had an opportunity to provide a medical student with a rural health rotation. [Sam Wood] was able to participate in providing comprehensive and integrated care in a Patient Centered model of care.”


To date, students have completed IPE CHRs at Nasson Health Care/Sanford, Penobscot Community Health Care/Bangor and Brewer, MDI Hospital/Hancock County* , Swift River Family Medicine/Rumford*, Greater Portland Health/Portland (serving a large refugee/immigrant population). Future IPE CHRs are also planned at Health Access Network/Lincoln, Sacopee Valley Health Center/Porter, Harrington Family Health Center/Harrington, Islands Community Medical Services/Vinalhaven, and DFD Russell Medical Center/Leeds and Monmouth.

* rural practice network; not FQHC

 

FMI: contact MaryFrances Smith, AHEC Clinical Coordinator, msmith4@une.edu or Ian Imbert, Clinical IPE Project Coordinator, iimbert@une.edu

Maine SNAP-Ed Program Manager Testifies in Front of United States Senate Special Committee on Aging Regarding Nutrition for Older Adults

August 26th, 2017 by healthinnovation
Elizabeth Pratt, MPH, Maine SNAP-Ed program manager meets spoke to the Senate Special Committee on Aging in Washington D.C on July 12, 2017

Elizabeth Pratt, MPH, Maine SNAP-Ed Program Manager spoke to the U.S. Senate Special Committee on Aging in Washington D.C. and poses afterwards for a photo with Senator Susan Collins

On Wednesday, July 12th, Maine SNAP-Ed, a program of UNE’s Center for Excellence in Health Innovation, testified in front of the Senate Special Committee on Aging in Washington D.C regarding nutrition for seniors. Maine SNAP-Ed’s Program Manager, Elizabeth Pratt, MPH, was joined by other experts in the field, including Dr. Connie Bales, Duke University School of Medicine and Durham VA Medical Center; Dr. Seth Berkowitz, Harvard University and Massachusetts General Hospital; and Pat Taylor, Retiree from Penn Hills, Pennsylvania. The theme of the hearing was “Nourishing our Golden Years: How Proper and Adequate Nutrition Promotes Healthy Aging and Positive Outcomes.”

SNAP-Ed is the USDA’s nutrition education arm of the Supplemental Nutrition Assistance Program. It offers education, social marketing campaigns, and environmental support in all 50 states. SNAP-Ed uses evidence-based, comprehensive public health approaches to improve the likelihood that low-income families will make healthier food and physical activity choices, consistent with the current Dietary Guidelines for Americans. The purpose of the Maine SNAP-Ed program is to provide low-income Mainers with easy ways to shop, cook, and eat healthy on a limited budget – stretching their limited food dollars.

In Maine, there are 44 highly qualified Nutrition Educators who provide series-based nutrition education and implement policy, systems, and environmental change strategies. They work in every Maine District and are based in local community coalitions and hospitals. They work in eligible community settings and with multiple organizations to reach children in schools, veterans, adults with disabilities, working adults, and seniors.

In her testimony, Ms. Pratt noted that Maine is the “oldest state in the country” with the highest percentage of older adults, and many of them are low-income. She discussed the prevalence of food insecurity, noting that “roughly 203,000 Mainers face hunger every day.” Four out of 10 SNAP participants in Maine (43%) are in families with members who are elderly or have disabilities. Many Maine seniors have to make hard decisions related to their food choices, having to “choose between their prescriptions, feeding the children who live in their households, fuel for heating in the winter, and their own nutrition needs.” Ms. Pratt provided examples from the field, noting the efforts of two Nutrition Educators – one from Downeast and one from Houlton. These stories of success illustrated how seniors benefit from improved nutrition, while highlighting how SNAP-Ed helps address the social isolation of rural seniors by creating social and environmental supports for healthier living.

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After the witnesses presented their testimonies, Senator Collins held up the Maine SNAP-Ed annual report to the page that includes a map with the settings where Nutrition Educators provide education. She praised the program model and said the following:

“I was impressed with your chart on SNAP-Ed in my state of Maine and you show where the Nutrition Educators are located. And in which District or county. But to me what is more significant is how integrated they are into places where people shop, learn, work, play and go to church. That’s what really impressed me. It seems like you’re everywhere…and I congratulate you for that.”

 

For more information about the Maine SNAP-Ed program, visit mainesnap-ed.org or contact mainesnap-ed@une.edu.

To watch the recorded testimony or read the written testimony, visit:

Nourishing our Golden Years: How Proper and Adequate Nutrition Promotes Healthy Aging and Positive Outcomes

Review the Maine SNAP-Ed’s 2016 Annual Report.

UNE’s second cohort of Key to Oral Health Scholars begin dental rotations in Aroostook and Penobscot Counties

August 25th, 2017 by healthinnovation

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University of New England (UNE)’s College of Dental Medicine has selected its second group of Key to Oral Health Scholars (KOHS) to participate in the Key to Oral Health Program, a joint initiative of UNE and KeyBank. The 2017 Key to Oral Health Scholar award recipients are:

Audra Boynton – Windsor, ME
Christopher Casgonguay – Rutland, VT
Hillary Creed – Etna, ME
Nicholas Guy – Hollywood, MD
Molly Kalish – Beaumont, PA
Anthony Preissler – Dudley, MA

The KOHS are fourth-year dental students who have been selected to complete a 12-week clinical rotation in northern New England in Maine’s Aroostook and Penobscot Counties. The Key to Oral Health program is designed to address the shortage of dental health providers in Aroostook and Penobscot Counties, two geographic areas of demonstrated oral health need.

With 15 of 16 counties identified as dental health shortage areas and a high percentage of practicing dentists reaching retirement age within the next five to 10 years, increasing Maine’s dental workforce pipeline has heightened in importance. Through generous funding from KeyBank of Maine and the KeyBank Foundation, a select group of 12 UNE dental students have been chosen to represent the University and provide patient care at clinical sites in Aroostook and Penobscot Counties which began in June 2016 and will continue through May of 2018. The university projects that the scholars will deliver a total of 4,000 to 5,000 oral health care patient visits by the conclusion of the program on May 31, 2018.

The Key Oral Health Scholars were chosen for their commitment to serving rural and underserved areas of Maine and their residents. The selected students demonstrated a strong history of community service, had a meaningful vision for addressing critical oral health problems in Maine, and outlined an engaging service learning project that they plan to implement. Each awardee receives a comprehensive package that includes scholarship support, housing stipends, travel assistance and dedicated funding to engage the community in a robust service project. The program’s long-term goal is to encourage UNE dental students to return and build practices in these underserved areas upon graduation.

In addition to bolstering the dental workforce in these counties, the program provides a unique learning opportunity for the students. During their rotation in Federally Qualified and other health centers, they will work with the public, providing oral health education in area schools and senior centers. The program will also connect students with business leaders and local dental professionals, facilitating the development of relationships with community members. The service learning projects for the first group of KOHS included:

  • Providing oral health education during a Community Wellness Fair in Lincoln, Maine
  • Providing oral health education to students at Enfield Station School in Enfield, Maine
  • Conducting a survey and oral health exam to indentify the most prevalent oral conditions
  • Providing fluoride sealants to K-4 school children
  • Introducing students to dentistry as a career by providing simulated dental training to middle school children

The 2016 Key Oral Health Scholar award recipients were:

Thanh Huynh – Da Nang, Vietnam
Adam L’Italien – Enfield, Maine
Dustin Nadeau – Brunswick, Maine
Nathan O’Neill – Calais, Maine
Dzhuliya Servetnik – Westfield, Massachusetts
Chelsea Toussaint – Madawaska, Maine

As of May of 2017, two of the 2016-2017 KeyBank Oral Health Scholars have returned to practice in Penobscot County. One student is employed at Health Access Network in Lincoln and another student is employed at a private practice in Newport.

This program was made possible by a lead gift from KeyBank, which encouraged generous additional funding from the Stephen and Tabitha King Foundation, the Fisher Charitable Foundation, and the PD Merrill Charitable Trust.

To learn more about UNE’s College of Dental Medicine, visit http://www.une.edu/dentalmedicine

To apply, visit http://www.une.edu/admissions

UNE Faculty Champions Interprofessional Collaboration – From Campus to Community

August 24th, 2017 by healthinnovation

 

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150 UNE students from nursing, social work, occupational therapy and physical therapy learn with, from and about each other while discussing a patient case.

This summer, faculty from nursing, social work, occupational therapy, and physical therapy collaborated on a three-part event series for 150 of their students called “Parallel Processes in IPE: from Campus to Community”.  These sessions were designed to provide student teams with the opportunity to learn about the core values of IPE from a team of practicing clinicians.

Developed jointly by UNE faculty and practitioners from Maine Medical Center, these sessions centered around an interactive team building experience that addressed the medical needs of two complex medical health care cases. Medical practitioners included Danalyn Adams,, LMSW-cc, Social Work Care Manager, Special Care Unit,  Sonja Orff, RN, MS, CNL, Maine Medical Center Clinical Nurse Leader Special Care Unit (SCU)and Kelley Crawford PT, DPT, MS, CCS, Maine Medical Center Level IV Physical Therapist, Primary in Special Care Unit (SCU), and Adjunct Faculty UNE PT Department. One student indicated, “This session has shown me what working with other professionals is like. It was refreshing and I feel one step closer to being prepared for future practice.”

The students worked within their teams to determine a problem list and identify a potential plan of care for each patient case. Each team presented their findings to the practitioners from Maine Medical Center. The students were given the opportunity to ask questions of the team related to the patient, with a focus on teamwork strategies. “I have greater respect and understanding of my fellow allied health professionals, and I will be able to better communicate and get help with patients to better give holistic, patient-centered care.”

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UNE Faculty members from four different professions are available to facilitate discussion and answer questions during interactive case-based learning.

Participating faculty included Jan Froehlich, M.S., OTR/L, Associate Professor of Occupational Therapy, Kelli Fox, LCSW, Director of Field Education and Assistant Clinical Professor of Social Work (Kelli is also an SBIRT Faculty Champion), Elizabeth Crampsey, M.S., OTR/L, BCPR, Assistant Clinical Professor of Occupational Therapy and Coordinator of the Community Therapy Center (CTC), Nancy Jo Ross, PhD RN, Assistant Professor of Nursing, and Sally McCormack Tutt, PT, D.P.T., M.P.H., Associate Clinical Professor and Director of Clinical Education for the Physical Therapy Program.

The primary goal of the educational series was for students to learn about, from, and with each other within their program specific curriculum. Case-based learning allows them to practice teamwork, communication, as well as provides an opportunity for exposure to the different roles and responsibilities of these four health care professions. Several of the faculty designers of this strategy for improving health professions education outcomes have been accepted to present their model at Collaborating Across Borders (CAB http://www.cabvibanff.org/) North America’s premier interprofessional healthcare education and collaborative practice conference in October. CAB is an internationally recognized venue that brings educators, researchers, practitioners, students and patients from Canada and the United States together for essential discussions around interprofessional healthcare education, practice, leadership and policy in North America.

IPEC recognizes the vital importance of providing students with IPE activities on campus to build the skills to practice collaboratively in their clinical placements and career.

 

FMI on UNE’s IPEC: http://www.une.edu/wchp/ipec