UNE Forms a Pipeline to Western Maine to Address Healthcare Shortages

November 10th, 2017 by healthinnovation
A group of ten UNE healthcare students recently participated in a rural health immersion to western Maine, in Oxford County, as part of a pipeline program to alleviate healthcare workforce shortages in rural communities.

A group of ten UNE healthcare students recently participated in a rural health immersion to western Maine, in Oxford County, as part of a pipeline program to alleviate healthcare workforce shortages in rural communities.

Ten healthcare students from UNE’s College of Osteopathic Medicine, College of Pharmacy, College of Dental Medicine, and Westbrook College of Health Professions Physican Assistant and Bachelor of Science in Nursing (BSN) programs recently attended a long weekend rural health immersion in Oxford County of Western Maine and Carroll County of Northern New Hampshire. 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 October immersion experience was the fourth time that a rural health immersion has been offered to UNE students but the first time that a group had gone to Oxford County; last May a weeklong immersion was held in Maine’s midcoast region of Knox and Waldo Counties; last March a weeklong immersion was held in Franklin County; and in May of 2016 the first weeklong immersion was held in Maine’s northern most county, Aroostook County.

“So far, we’ve had over 50 students participate in the immersion experience, and the data that we’ve collected from them suggests that these students are more interested in practicing in a rural or medically underserved area after participating in the immersion” says Karen O’Rourke, Director of the Maine AHEC, located within UNE’s Center for Excellence in Health Innovation. “This corresponds to the literature which shows that early and often exposure to rural health is the most effective strategy to increasing rural provider retention. This is is precisely why we’ve created the rural health immersion, to provide opportunities for our students to get exposed to Maine’s more rural communities, so that they are more likely to become a rural healthcare provider after graduating.”

The students discuss population health initiatives with Sue Ruka, RN, PhD, at Memorial Hopsital, a Critical Access Hospital in Conway, NH.

The students discuss population health initiatives with Sue Ruka, RN, PhD, at Memorial Hopsital, a Critical Access Hospital in Conway, NH.

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. This is a particular problem in Maine where nearly 1/3 of all of Maine’s providers work in Cumberland County, leaving many of Maine’s larger and more rural communities underserved. In order to help alleviate healthcare workforce shortages in Maine’s more rural counties, the Maine AHEC has strategically located three AHEC centers around Maine in Aroostook, Franklin, and Penobscot counties. “Oxford County is one of the Maine’s counties with the fewest healthcare providers in the State, with only about 2% of the providers living in that area. We were able to utilize our western Maine AHEC center, which covers Oxford County, to help connect with area hospitals for this immersion.”, says O’Rourke.

Sue leads the students through one of the Gemba boards at Memorial Hospital.

Sue leads the students through one of the Gemba boards at Memorial Hospital.

Maine and New Hampshire provide a contrasting picture of health and well being, despite neighboring one another. According to the United Health Foundation, New Hampshire ranked 6th in overall health rankings, whereas Maine did not fair as well, ranking 22nd. “These health disparities became apparent to the students rather quickly” said Ian Imbert, MPH, the project coordinator of a prestigious four year Josiah Macy Jr. Foundation grant in UNE’s Center for Excellence in Health Innovation, which aims to enhance team-based care and improve patient outcomes. “The immersion experience provided them an opportunity to see first-hand the effects of healthcare access and funding for prevention programs. In Maine, the decision not to expand Medicaid has created access barriers that have effected the health of our communities, whereas the expansion of Medicaid in New Hampshire has created additional funding to provide much needed services to its underserved populations.” Indeed, the Robert Wood Johnson Foundation’s 2016 county health rankings, for example, show that Carroll County in New Hampshire ranked 4 out of 10 in health outcomes, while Oxford County in Maine did not fair as well, finishing close to the bottom, 14th out of 16.

The first stop of the day was at Saccopee Valley Health Center in Porter, ME, where the students met with Dr. Jeff Ray, DO, Medical Director, and Dr. Israel Adeloye, DMD.

The first stop of the day was at Saccopee Valley Health Center in Porter, ME, where the students met with Dr. Jeff Ray, DO, Medical Director, and Dr. Israel Adeloye, DMD.

It’s predicted that some of the health challenges that Maine’s more disparate Counties face would be improved if there were more providers who lived and worked in those areas. 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. Moreover, the Maine Department of Labor projects a shortage of 170 dentists. 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.

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 Maryland and Pennsylvania while about a third of the students had grown up in New England or had spent time previously in rural Maine, either through extended family or while vacationing. Most students had some experience working with underserved populations in the past but for a few it was their first opportunity to experience rural underserved healthcare. One student from UNE’s College of Dental Medicine, Nicole Caron, from Massachusetts, reflected after the final day of the immersion, “This trip introduced me to a bunch of different rural communities that all had one thing in common, extraordinary healthcare providers who work every day to improve the health of their patients and their communities, despite the obstacles they may face in rural areas. I have been inspired and I hope that I am able to practice dentistry just like the professionals that we interacted with this weekend.”

The students pose for a photo outside of Conway Oral Health with Dr. Eric Heirschfield, DMD.

The students pose for a photo outside of Conway Oral Health with Dr. Eric Heirschfield, DMD.

During the immersion, the students experienced a variety of activities in underserved areas in Oxford and Carroll Counties, such as meeting with providers of Memorial Hospital in Conway, NH, and Bridgton Hospital in Bridgton, ME, for a tour of the hospital facilities; a tour and discussion with providers at Sacopee Valley Health Center, a Federally Qualified Health Center in Porter, ME and at White Mountain Community Health Center, a rural community health center in Conway, NH; a trip to Conway Oral Health in Conway, NH to talk about dentition in rural communities; and a tour of Hannafords pharmacy in Bridgton, ME. “This was the first time that an immersion cradled two states”, said Imbert “which allowed the students to think about health policy, and the effect it can have on populations..”

A pharmacy and an osteopathic medicine student work together to collect a blood pressure from a community member at the Fryeburg Fair.

A pharmacy and an osteopathic medicine student work together to collect a blood pressure from a community member at the Fryeburg Fair.

The students attended the Fryeburg Fair, Maine’s largest agricultural festival, where they helped staff the first aid centers. The students created care kits, consisiting of basic, yet essential health care products, like toothpaste, toothbrush, soap, band aids, and more, to hand out to people at the fair. They also worked along paramedics to take blood pressures and provide basic health education on oral health, exercise, and nutrition. “This event gave me the opportunity to meet and talk with people who live in rural communities in Maine”, said Minh Tam Hua, a second year pharmacy student. “I feel that we as health professional students should create more health screenings in rural areas to educate the community about many of the diseases that we saw. If we all stand together and contribute our part, we will be able to help reduce the number of chronic diseases that are taking place in these rural areas.”

Students conducted a Worksite Health ScoreCard at the fair to assess it's performance in several categories like Animal areas, Nutrition, Tobacco, and more.

Students conducted a Worksite Health ScoreCard at the fair to assess it’s performance in several categories like Animal areas, Nutrition, Tobacco, and more.

Jen Van Deusen, MEd, Director of Curriculum in UNE’s College of Osteopathic Medicine, has participated in all four immersions and once again helped to lead the western Maine immersion. “It’s amazing to see the students perceptions of rural health change throughout the trip. And when they return to the classroom I see how excited they are to share what they’ve learned with their peers, creating a ripple effect.”

The full team of students who attended the Midcoast Maine immersion included two medical students from UNE’s College of Ostepathic Medicine Taylor Ouellette and Rodger Carter; two pharmacy students from UNE’s College of Pharmacy Kelly Banks and Minh Tam Hua; two students from UNE’s Nursing Department Katherine Clark and Lesley Lafland; three students from UNE’s College of Dental Medicine Nicole Caron, Brittany Malia, and Kimberlee Sell; and one student from UNE’s Physician Assistant Department Rachel Moore. You can read more on each students experience here.

The group roasts marshmallows on their last night together in Oxford County.

The group roasts marshmallows on their last night together in Oxford County.

The trip was graciously supported by Maine’s Area Health Education Center (AHEC), the Josiah Macy Jr. Foundation, and UNE’s Center for Excellence in Health Innovation. 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. 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. Dora Anne Mills, MD, MPH, FAAP, Director of UNE’s Center for Excellence in Health Innovation, helped create the immersion experience.

 

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

 

University of New England Works with State and Community Partners for Public Health Emergency Preparedness Exercises

November 8th, 2017 by healthinnovation
UNE osteopathic medicine student adminsters a flu vaccine at the October 20th Alternate Care Site emergency preparedness exercise located at UNE's Biddeford campus center gymnasium.

UNE osteopathic medicine student Justin Doroshenko adminsters a flu vaccine at the October 20th Alternate Care Site (ACS) emergency preparedness exercise located at UNE’s Biddeford campus center gymnasium.  This was the first time that an ACS exercise had been conducted in Maine.

The University of New England recently hosted two public health emergency preparedness training exercises in collaboration with state and community partners, offering free influenza vaccinations to the UNE community and public as part of the events. This is the second year in a row that UNE has partnered with local and state public health agencies to conduct a public health emergency preparedness exercise in order to be better prepared in the event of a real public health emergency. “For several years UNE has registered to be part of a volunteer network of Points of Distribution, or PODs, that will serve as centers for administering medicines, vaccines, and/or necessary supplies for the public in the event of a large-scale emergency”, explained Dora Anne Mills, M.D., M.P.H., FAAP, vice president for Clinical Affairs and director of UNE’s Center for Health Innovation. “To fully prepare for such an event, UNE faculty, staff, and students work in collaboration with state and community partners to simulate such an event, and offer free influenza vaccines to the public as part of the exercise.”

On October 20th, 2017, the UNE Biddeford Campus Center gymnasium was converted into an Alternate Care Site (ACS), a temporary medical system that is established to provide low-acuity care during a public health emergency. UNE students from four of UNE’s six colleges participated in the exercise to learn some of the principles of emergency preparedness planning from State officials.  A large turnout of people looking to receive their flu vaccine allowed medical and pharmacy students to administer vaccines to more than 225 UNE students, faculty, and staff.  Jessica Rehrig, a second year osteopathic medical student in UNE’s College of Osteopathic Medicine said “It is reassuring, both as a student physician and a member of the community, to know that adequate policies and procedures are in place to accommodate patients in the event of a medical surge or state-wide emergency.”

ACS exercise overview smaller copy

The UNE campus center gymnasium was converted into a temporary medical system to provide flu vaccines to the public. Several local and state public health agencies participated in the exercise, including the Maine DOT who delivered the durable medical supplies shown here to Biddeford from a warehouse in Augusta.

The October 20th ACS exercise represents a milestone as the first deployment of a multi agency scenario for the newly established York County Medical Reserve Corps (MRC), a partnership between the greater York County community and UNE.  It was also the first time Maine had implemented a test of the ACS system. “Maine CDC Public Health Emergency Preparedness Program (PHEP) purchased these modules as a way to provide emergency medical assistance in the event of a real response situation. These modules are designed to assist in the immediate response effort, as in help until help arrives, when Federal Medical Systems cache can be deployed”, says Patrick Furey, Maine CDC Public Health Emergency Preparedness Exercise and Training Coordinator. “It was great working with UNE faculty, staff, and students, area Walgreens Pharmacy staff and management, as well as Maine’s Medical Reserve Corps (MRC) volunteers at this exercise.”

One week later, on October 27th, 2017, the newly renovated Innovation Hall at UNE’s Portland Campus was converted to a Point of Dispensing (POD) site where influenza vaccine was once again administered to community members.  Medical, pharmacy, nursing, and public health students helped staff the exercise.  Valerie Bedard, a senior nursing student in UNE’s Westbrook College of Health Professions said “As a student here, it is wonderful to see that UNE is proactively thinking about how it will take care of the community in the event of an emergency. I really enjoyed learning from, with, and about my medical and pharmacy student peers as well as from the local and state public health community.”

A Point of Dispensing (POD) exercise was conducted on October 27th in UNE's newly renovated Innovation Hall.

A Point of Dispensing (POD) exercise was conducted on October 27th 2017 in UNE’s newly renovated Innovation Hall.

Caity Hager, from Maine’s Cities Readiness Initiative based out of the City of Portland, helped coordinate last years POD exercise on the UNE Biddeford campus and was able to use some of the lessons learned from last year to improve upon this years exercise. “Partnering with UNE to conduct similar exercises two years in a row allows the Maine Cities Readiness Initiative to improve and strengthen our plans to respond to this type of emergency”, said Hager. “We have been improving and refining procedures based on feedback from last year’s exercise and it is important for our program to have the opportunity to exercise the changes and evaluate the improvements to our plans.”

Caity Hager from Maine's Cities Readiness Initiative provides a "Just-in-time" orienation training for the staff members who volunteered to operate the exercise.

Caity Hager from Maine’s Cities Readiness Initiative provides a “Just-in-time” orientation training for the staff members who volunteered to help operate the exercise.

In total, more than 350 people receive an influenza vaccine at these exercises. A partnership with Walgreens and UNE’s Health Services ensured that there was enough vaccine supply to dispense to the public at the exercises. Several employees from Walgreens, including seven licensed pharmacists, donated there time to help staff crucial clinical and non-clinical roles at both exercises.  Heather Stewart, an alumnus of UNE’s College of Pharmacy Class of 2014, and current Walgreens pharmacist, says that her time at UNE as a student helped instill the importance of influenza surveillance as a tool to keep the public healthy.  “Influenza is a vaccine preventable virus that has significant public health consequences including decreased productivity, and increased morbidity, mortality, and healthcare expenditures.  Events such as the ACS and POD exercises not only prepare our First Responders for a large scale emergency but they also increase ease of access by creating another public health environment for patients to obtain their influenza immunization.”, said Stewart.

Heather Stewart, PharmD, provides a workshop on proper flu vaccine administration techniques to UNE healthcare students.

Heather Stewart, PharmD, provides a workshop on proper flu vaccine administration techniques to UNE healthcare students.

These exercises are done in collaboration with a number of partners, including: Maine CDC, York and Cumberland District Public Health Councils, Emergency Management Agencys, the City of Portland’s Maine Cities Readiness Initiative, area Walgreens pharmacists and management, and Maine Responds (Maine’s emergency health volunteer system). “As part of this initiative, UNE’s Center for Health Innovation works collaboratively with our health professions programs as well as state and community partners to provide learning experiences for our students. A number of medical, public health, nursing, pharmacy, and other students attend sessions run by emergency preparedness experts and assist in administering vaccines,” said Mills. “As a result, southern Maine will be better prepared for an emergency today, and tomorrow’s health professionals will also be better prepared.”

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

UNE Holds Workshop on Opioid Use Disorder and Medication Assisted Treatment

November 8th, 2017 by healthinnovation
Expert speakers discuss opioid use disorder and medication assisted treatment at the October 28th workshop located on UNE's Portland campus.

Expert speakers discuss opioid use disorder and medication assisted treatment at the October 28th workshop located on UNE’s Portland campus.

On Saturday, October 28, 2017, the University of New England Center for Excellence in Health Innovation hosted an opioid use disorder (OUD) and medication assisted treatment (MAT) Workshop at UNE’s newly renovated Innovation Hall.

More than 150 people registered, and attendees included UNE students from the College of Osteopathic Medicine, College of Pharmacy, Westbrook College of Health Professions and College of Dental Medicine, as well as UNE faculty and clinicians from the community. Experts led presentations and discussions on MAT; screening, brief intervention, and referral to treatment (SBIRT); prescribing laws; public health impact; and stigma.

“As we face a deadly epidemic of opioid addiction, workshops like this are critical to assuring the clinicians of tomorrow as well as today are able to work together with clinicians from other professions and patients to successfully screen people for addiction, help people get into treatment, and keep them in recovery,” said Dora Anne Mills, M.D., M.P.H., director of the Center for Excellence in Health Innovation.

In 2016, 313 Mainers died of an opioid-related overdose, which represents 83 percent of all drug-related deaths in the State. Currently, the demand for MAT in the state still outpaces the supply, especially among those who lack health insurance or live in health professional shortage areas. To address the critical need for health professions education around OUD and MAT, the Center for Excellence in Health Innovation received $80,000 in supplemental funding from its federal Health Resources Services Administration (HRSA) Primary Care Training and Enhancement (PCTE) grant to further increase education around MAT in primary care. The Center for Excellence in Health Innovation plans to hold lunch and learn programs and future events for faculty and students who are looking to learn more about OUD and specifically MAT.

FMI contact Melanie Caldwell, mcaldwell4@une.edu or visit http://www.une.edu/academics/centers-institutes/center-excellence-health-innovation/grants-initiatives/primary-care-training-and-enhancement-grant

UNE Faculty and Staff Present at Collaborating Across Borders VI Conference in Banff, Canada

November 8th, 2017 by healthinnovation
UNE faculty from the Westbrook College of Health Professions present in Banff Alberta at the Collaborating Across Border (CAB) conference (From L-R, Nancy Jo Ross, Sally McCormack Tutt, Kelli Fox, Elizabeth Crampsey, and Kris Hall)

UNE faculty from the Westbrook College of Health Professions present in Banff Alberta at the international Collaborating Across Border (CAB) conference (From L-R, Nancy Jo Ross, Sally McCormack Tutt, Kelli Fox, Elizabeth Crampsey, and Kris Hall)

The University of New England was well represented at the Collaborating Across Borders VI conference in Banff, Canada. Ruth Dufresne, S.M., research associate and evaluator in the Center for Excellence in Health Innovation, gave a presentation focused on evaluation of the Josiah Macy Jr. Foundation and the Health Resource Services Administration (HRSA) funded Primary Care Training an Enhancement (PCTE) Project. She presented on behalf of the PCTE Team which includes Dora Mills, M.D., M.P.H., F.A.A.P., Jennifer Gunderman, M.P.H., Melanie Caldwell, M.S., Ian Imbert, M.P.H., and Toho Soma, M.P.H., as well as clinical partners at Penobscot Community Health Care (PCHC).

Elizabeth Crampsey M.S., OTR/L, BCPR, Kelli S. Fox LCSW, CCS, LADC, Kris Hall M.F.A., Sally McCormack Tutt PT, D.P.T., M.P.H., and Nancy Jo Ross Ph.D., RN, gave an interactive presentation titled, “Parallel Processes in Interprofessional Education (IPE): From Campus to Community.” They described an interprofessional educational (IPE) experience the team has been teaching for the past three summers in collaboration with clinicians from Maine Medical Center. They led participants through activities that simulated student activities in the course. Other UNE faculty contributors include Jan Froehlich M.S., OTR/L, Valerie Jones LMSW, Kira Rodriguez, M.H.S., and Heather McNeil.

Faculty worked to parallel/align the on-campus curriculum with professionals in the field to illustrate the real-world challenges faced by interprofessional teams in clinical practice. The course consisted of two classroom sessions and an assignment for the student groups to work on during the week between the classroom sessions. Students were assigned to interprofessional groups and were guided through activities that provided them the opportunity to learn about two key interprofessional core competencies: teamwork and professional communication. The classroom sessions were evaluated by faculty student feedback. The student feedback was analyzed to determine changes in their comfort level with IPE upon completion of the entire series of activities. The results of this analysis were also presented at the conference.

FMI: Contact Kris Hall of UNE’s IPEC at ipec@une.edu or at (207) 221-4491

LifeWings comes to Bangor, ME, to provide TeamSTEPPS training to area providers and UNE health professional students

July 15th, 2016 by healthinnovation

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On Wednesday, September 14th, the University of New England’s Center for Health Innovation is partnering with LifeWings to provide a training that will help build the necessary team skills to deliver safe, quality care.   The training will be held at Spectacular Events in the Grant Ballroom from 12:00 pm – 4:00 pm, light food and refreshments will be served from 11:00 am – 12:00 pm. The training will offer students, faculty, and area providers an opportunity to earn a Team Strategies and & Tools to Enhance Performance & Patient Safety (TeamSTEPPS) certification and providers will also be eligible to receive CME credits.

The TeamSTEPPS training is an evidence-based framework to optimize team performance across the health care delivery system. It’s based on team structure and has four teachable-learnable skills: Communication, Leadership, Situation Monitoring, and Mutual Support. The interactive LifeWings TeamSTEPPS training will address the U.S. and Canadian IPEC competencies.

LifeWings is a small team of healthcare professionals, military pilots, and healthcare risk managers who have come together to create a sustainable culture of quality. The LifeWings company guarantees that its initiatives will produce measurable outcomes such as creating better teams and teamwork; reducing errors, rework and waste; improving efficiency and reliability; and creating better care and outcomes. The LifeWings team consists of seven different educators who train more than 13,000 healthcare professionals each year at over 150 hospitals worldwide.
Jeff Hill is a LifeWings educator and will be performing the TeamSTEPPS training at the University of New England in September. He brings 30 years of experience in aviation leadership and safety processes to his 15 years of experience as a TeamSTEPPS Master Trainer in healthcare. Prior to joining LifeWings, Jeff was the associate director responsible for TeamSTEPPS trainings at Vanderbilt where he developed safety tools and educational curricula supporting patient safety through teamwork and communication. Jeff has given national presentations at Partners Healthcare, The Joint Commission, and the National Patient Safety Foundation.

The Center for Health Innovation is providing the TeamSTEPPS training to meet the objectives of the five-year $2.5 million grant that it received in conjunction with PCHC in July of 2016 from the Health Resources Service Administration. One of the main goals of the grant is to transform the primary care workforce in rural and underserved Maine and improve health outcomes. The training will provide the necessary tools for UNE’s graduate healthcare students and area providers to have a basic understanding of and exposure to team-based care. It will also encourage students to work interprofessionally before venturing into their professional careers.

For more information on the upcoming TeamSTEPPS event in Bangor please contact Ian Imbert, MPH, Project Coordinator for interprofessional practice and education at iimbert@une.edu.