Medicine and Health Sciences Commons^™

Quality Of Care Assessment At A Resident-Based Primary Care Hiv Clinic, Amanda Lacue, Marshall Miller, Md

CwiC Posters

A quality improvement study based in a primary care resident-based HIV clinic, the Kendig Clinic, was conducted within Jefferson Family Medicine Associates. The study objectives were to

• Determine the percentage of the clinic patients meeting each quality measure

• Compare these calculated clinic measures to known national averages

• Use the data to determine areas to target for future quality improvement initiatives.

Barriers And Facilitators To Cervical Cancer Screening Among Iraqi Refugees Resettled In Philadelphia: A Qualitative Analysis Of Patient And Provider Perceptions, Colleen Payton, Mph, Ches, Laura Parente, Md, Dalea Al-Hawarri, Md, Philip Manasseh, Mph, Kevin Scott, Md, Marc Altshuler, Md

Department of Family & Community Medicine Presentations and Grand Rounds

Oral presentation at the 6^th Annual North American Refugee Health Conference, Niagara Falls, New York.

Research Questions:

1. What is the prevalence of cervical cancer and cervical cancer screening among recently resettled refugees seen at Jefferson's Center for Refugee Health?

2. Are patient-and provider-identified barriers to cervical cancer screening at CRH consistent with those identified in previous research efforts?

3. What are patient-and provider identified facilitators to cervical cancer screening for Iraqi refugee women?

Literature Review On Hospital Costs For Patients Undergoing Colectomy, Brian P.H. Chen, Scm, Hang Cheng, Martha Romney, Rn, Ms, Jd, Mph, Carine Chia-Wen Hsiao

College of Population Health Posters

Objective:

This study aims to identify the range of direct hospital costs associated with a minimally invasive or open colectomy procedure across different countries.

Poster presented at 2016 ISPOR conference in Washington DC.

Factors Influencing Resection In Locoregional Pancreatic Cancer Patients, Amy Cunningham, Mph, Phd(C), Brian P.H. Chen, Scm, Pharmd, David Delgado, Phd

College of Population Health Posters

Objective:

Identify factors associated with resection in a national sample of locoregional pancreatic cancer patients.

Poster presented at ISPOR conference in Washington DC.

Did A Physician-Targeted Intervention That Reduced Potentially Inappropriate Prescribing To Elderly Patients Also Reduce Related Hospitalizations?, Jacquelyn Mcrae, Pharmd, Sarah E. Hegarty, Pharmd, M. Alcusky, A. Vegesna, S. Varga, S. W. Keith, S. Del Canale, M. Lombardi, Vittorio Maio, Pharmd, Msph

College of Population Health Posters

Objectives:

To determine whether a general practitioner focused intervention aimed at decreasing PIM prescribing in the elderly can decrease the risk of PIM-related hospitalizations.

Poster presented at 2016 ISPOR conference in Washington DC.

Literature Review On Hospital Costs For Patients Undergoing Hysterectomy, Brian P.H. Chen, Scm, Pharmd, Hang Cheng, Martha Romney, Rn, Ms, Jd, Mph, Carine Chia-Wen Hsiao

College of Population Health Posters

Objective:

This study aims to identify the range of direct hospital costs associated with a minimally invasive or abdonimal hysterectomy procedure across different countries.

Poster presented at 2016 ISPOR conference in Washington DC.

A Review Of Current Quality Metrics For Evaluating Patient-Centered Medical Homes, Stefan Varga, M. Lombardi, Vittorio Maio, Pharmd, Msph

College of Population Health Posters

Objectives:

This review sought to explore the quality metrics that are currently utilized to assess PCMHs

Poster presented at 2016 ISPOR conference in Washington DC.

Erosion Of Empathy In Primary Care Trainees, Jacquelyn Mcrae, Pharmd, G. Calusi, Mengdan Liu, V. Scognamiglio, E. Messina, L. Polenzani, Vittorio Maio, Pharmd, Msph

College of Population Health Posters

Objective:

To evaluate if empathy among physician residents (trainees) differs dependent on training year and to assess trainees' characteristics associated with higher empathy scores.

Poster presented at 2016 ISPOR conference in Washington DC.

The Pennsylvania Emergency Department Geriatric Readiness Project, Adam Perry, Md, Alyssa Sipes, Bs

College of Population Health Posters

BE THE ED DOC – Illustrating Geriatric Readiness

An independent, right handed 81 year old who lives alone trips and falls while walking with her walker. A thorough evaluation at her local ED reveals only a nonoperative right proximal humeral fracture. Her pain is well controlled with immobilization and oral analgesics.

What is her disposition?

• Discharge home with shoulder immobilizer and instructions to call orthopedics in the morning.
• Admit to Telemetry Bed for “Syncope” with orthopedics and cardiology consultations, with subsequent SubAcute Rehabilitation stay.
• Admit to Observation Status for “Ambulatory Dysfunction”.
• Discharge home with her daughter, who lives locally, with …

An Evaluation Of A Sexual Health Education Program For Adolescents In A Residential Treatment Program In The Philadelphia Area, Rachel Powell (Student), P. Smith, Amy Leader

College of Population Health Posters

BACKGROUND

The US is currently experiencing an epidemic; millions of American adolescents are affected by sexually transmitted diseases (STDs), teen pregnancy and intimate partner violence (IPV), costing the country both socially and economically:

• Adolescents 15-24 years of age account for 50% of the 20 million new STD cases each year
• US birth rates are significantly higher than countries in Europe
  • 6.8 times higher than teens living in the UK
  • 13.9 times higher than teens living the EU
• In 2010 18.7% of adolescents ages 11-17 experienced IPV for the first time
• Adolescents who are diagnosed with an STD, are teen parents …

Evaluating The Decision Making Process Of Pediatricians' Recommendations For First Complementary Foods In Infants, Gretchen Schmoyer

Master of Public Health Capstone Presentations

The purpose of this research study was to document the feeding guidelines from medical associations, understand what pediatricians are recommending to new mothers, and to capture the response from mothers regarding their understanding and personal practices in feeding. Previous studies have found that mothers were not following feeding recommendations by the American Academy of Pediatrics (AAP). Furthermore, the role of infant rice cereal as an early first food is currently under debate. Qualitative research was conducted through interviews with five mothers of children under 2 years, five healthcare providers in pediatric settings, and three policy experts. The Theory of Reasoned …

Health Care Providers Advice Not To Smoke And Quit Attempts Among Mid-Adolescent Smokers, Russell K. Mcintire, Phd, Mph

College of Population Health Posters

Background

• Nearly 1 out of 7 U.S. adolescents is a current cigarette smoker by the time they leave high school. ¹
• Although almost one third of adolescents who saw a healthcare provider in the past month were advised to quit or avoid tobacco,² research on the influence of provider advice on quit attempts among adolescent smokers has shown mixed results. ³
• These results may be due to selection bias—adolescent smokers who get advice may be different from those who do not on a range of factors including age of initiation, smoking frequency, attitudes toward smoking, exposure to other anti-tobacco …

Jeffhealth Medical Student Exchange In Rwanda, Amanda Nemecz, Alexander Rowan, Talia Stark

CwiC Posters

Teaching Community Health Workers

In rural Rwandan villages, the communities are linked to healthcare through Community Health Workers (CHW). CHW are appointed based on village election and the requirement that they can read and write. The Rwandan Ministry of Health provides general health training to the CHW so that they can educate and advise the village on health related matters. CHW administer educational sessions at village meetings about prevalent health issues, and advise members of the village when they should go to the Health Center. JeffHEALTH’s teaching aims to supplement the Ministry of Health training. Topics are chosen and approved …

The Public Health Of Youth And High School Athletics, Michael Haines

CwiC Posters

The Problem

• The number of participants in high school sports has increased since 1989 (National Federation of State HS Association).
• From 2000-2010 7% of public schools cut athletic programs while less than 1% added them (Sharp Center Univ. Michigan).
• Some estimates predict 27% of public high schools will not offer varsity athletics by 2020 (Sharp Center Univ. Michigan).
• School’s are dropping athletic programs (as well as music and theater programs) due to budget cuts.
• Alternative approaches schools are taking include “pay to play” which increases the financial burden on students and families.
• In 2011, 3 out of 4 school districts …

School Wellness Assessment: Creating A Culture Of Health, Kaitlyn Petruccelli, Bs, Rickie Brawer, Mph, Phd

CwiC Posters

Introduction

The Center for Urban Health (CUH) and the Office for Student Life and Engagement at Thomas Jefferson University (TJU) are working with two public elementary schools in Philadelphia – Southwark School and Independence Charter School – to create a culture of health in the schools. Both schools wish to establish an environment that promotes health and safety and assists children in developing life-long healthy habits. The offices at TJU set out a plan to

(1) Assess the current policies and climate at the schools,

(2) Identify priority weaknesses to address,

(3) Connect TJU’s various health professional schools and student …

The Intersection Between Medication Tablets And Electronic Tablets: Determining The Usability And Acceptability Of A Patient-Centered Cardiovascular Risk Assessment (Pccra) Ios App, Nisha Patel, Ms2, Geoffrey Mills, Md, Phd, Marianna Lanoue, Phd, Amy Cunningham, Mph

CwiC Posters

Background

One American dies from cardiovascular disease (CVD) every 40 seconds. Risk factor awareness, assessment, and communication has been shown to improve efficacy of patient treatment and also decline overall risk in the population over time. Traditional cardiac risk assessment tools (e.g. Framingham risk assessment, FRA) generate a risk score in a format that may not appreciated or easily understood by all patients. A new patient-centered approach, in which the patient becomes an active participant in the decision-making process, has shown significant increase in patient-provider communication and diagnosis/management.

Clinical Experience At Pasteur Clinic Đà Lạt, Vietnam, Emma Howard-Young, Jordan Howard-Young, Ma

CwiC Posters

History of the Pasteur Clinic Đà Lạt

The Pasteur Clinic is associated with the Institut Pasteur, part of the international network of research institutes dedicated to the prevention and treatment of infectious diseases. The Đà Lạt branch of Vietnam’s Institut Pasteur was built between 1930 and 1936 under the direction of Dr. Alexandre Yersin, a physician remembered for identifying Yersinia pestis as the causative agent of Plague and a student of the eponymous French chemist and microbiologist Louis Pasteur. While many overt references to the French colonial tradition have been supplanted in Vietnam by nationalist sentiments, the Institut Pasteur …

Improving Rural Community Health Through Care Coordination, Alexander Miller

CwiC Posters

DEMOGRAPHICS OF CRAWFORD COUNTY^1,2

• Population – 87,600
• Population density – 86.5 per mi²
• Ratio of patients to PCPs – 1,685:1
• Number of hospitals – 2
• Population 65 and older – 17.4%
• Overweight – 65% Obesity – 32%
• Population with Diabetes – 12%
• Heart disease death rate – 200 deaths per 100,000 people.

The above percentages and rates of disease are either equal to or higher than the averages for the state of Pennsylvania.

Virtual Rounds: Improving Family Participation In Multidisciplinary Rounds Via Telehealth, Gerald Durkan

CwiC Posters

Background

What Are Multidisciplinary Care Rounds (MDR’s)?

MDRs are defined by the unique characteristic of incorporating a multitude of both physician and non-physician specialties into the conversation with the patient for the coordination of their care.

What is Discussed During an MDR?

Activities relating to the care of the patient that may be incorporated into the MDR include summarizing the treatment that the patient has undergone, discussing the treatment approach that is planned for the patient, working through potential issues that may arise from the treatments, and discussing the potential future therapy.

What is Telehealth?

Telehealth is the delivery of …

How A Civil War Surgeon’S Population Health Initiatives Helped Save The Union, 2lt Tyler Walker

CwiC Posters

Introduction

Dr. Jonathan Letterman was the medical director for the Army of the Potomac during the American Civil War. Dr. Letterman graduated from Jefferson Medical College in Philadelphia in 1849. With his appointment to the largest portion of the Union Army, Dr. Letterman was tasked with improving what would today be called a population health nightmare. Soldiers lived in filth, ate food devoid of nutrition, were forced to train beyond what was necessary no matter the conditions, and worst of all, were not provided with an organized medical department to treat them if they were wounded or became ill. He …

Developing Maternal And Child Health Curriculum In Rural Uganda, Rebecca Newbrander, Md Candidate

CwiC Posters

Maternal and Child Health in Iganga District Uganda

Maternal and child health outcomes in the East Central Region of Uganda are especially poor compared to the rest of Uganda [1]:

• Only 32% of women (50.7% nationally) informed about signs of pregnancy or delivery complications
• Only 12% of women (62% nationally) received malaria prophylaxis during pregnancy

The “Three Delays Model” of barriers to care[3]:

• Knowing when to seek care and making the decision to do so
• Access to care once decision is reached to seek it
• Receiving quality care at a health center or hospital

Maternal and Child Heath Care in …

Housing First: A Solution To Urban Homelessness, Kelsey L. Capron, Lara C. Weinstein, Md

CwiC Posters

Homelessness in the United States

• 630,000 homeless in the US in 2012, thousands in Philadelphia
• Over 3% of the US population has been homeless during the past 5 years
• Homeless = no stable residence

Temporary shelters, unsheltered locations (the street, transit stations, parked cars), etc.

• High rates of legal issues, substance abuse/dependency, & lack of stable employment

Severe mental illness = overrepresented & linked to severe health disparities

• Higher risk for all-cause mortality (primarily due to injuries, overdose, CV disease)

Mortality rates 3-4x higher than the general population

Chronic & acute mental & physical health conditions

HIV, tuberculosis, hypertension, diabetes …

The Global Health "Interactive Curricula Experience (Ice) Platform & App": Technology That Enables Inter-Professional Innovation, James Plumb, Md, Mph, Nicholas Leon, Pharmd, Louis N. Hunter, Pt, Dpt, Martha Langley Ankeny, M.Ed, Ellen Plumb, Md, Lucille B. Pilling, Edd, Mph, Rn

College of Population Health Lectures, Presentations, Workshops

17 slide PowerPoint presentation.

Presented at APHA in Chicago Illinois.

Healthy Corner Store Network "Heart Smarts" Program, Nyssa Entrekin, Sandra Sherman, Edd, Rickie Brawer, Mph, Phd, Mches, James D. Plumb, Md, Mph

College of Population Health Lectures, Presentations, Workshops

Objectives:

1. Identify corner stores for nutrition education and health screenings based on criteria presented.

2. Identify education strategies appropriate for a corner store setting when integrating health screenings, nutrition education and food access.

3. List at least two store owner training topics for use in a corner store setting that reinforce nutrition education and disease prevention in the store.

4. Understand methods for evaluating outcomes of an integrated educational effort.

Presented at APHA in Chicago, Illinois.

Purchase Of Loose Cigarettes By Adult Smokers In Philadelphia: Individual-Level Correlates And Neighborhood Characteristics, Russell K. Mcintire, Phd, Mph

College of Population Health Posters

Background

• Philadelphia has the highest adult smoking rate1 and the highest rate of tobacco retailers2 among the 10 largest U.S. cities.

• Governmental reports have identified high rates of illegal sale of cigarettes in Philadelphia2.

• Studies have found that a main source of cigarette use in low income communities is single (loose) cigarettes purchased at tobacco retailers or from unregulated street vendors3,4.

• While studies have shown that loose cigarette use is a problem among urban youth who reside in disadvantaged neighborhoods, less research has been performed among adults on this topic5,6, and no studies focus on Philadelphia. …

Low-Income African American Women's Perceptions Of Primary Care Physician Weight Loss Counseling: A Positive Deviance Study, Elaine Seaton Banerjee, Md

Master of Public Health Capstone Presentations

The purpose of this study was to qualitatively and quantitatively evaluate the interactions between low-income, African American women who successfully lost weight and the healthcare system. This mixed methods study followed a positive deviance approach, identifying a population at high risk for obesity and then identifying positive deviants within this population. In this case, positive deviants were low-income, African American women who had been obese, and had successfully lost at least 10% of their weight and maintained this loss for at least six months. We collected data from electronic medical records (EMR) and participant surveys of both positive deviant cases, …

Whole Person Orientation In Primary Care: Understanding Priorities And Assessing Performance, Shannon Doyle

Master of Public Health Capstone Presentations

The purpose of this project was to use a participatory research methodology to develop a framework for understanding the concept of whole person orientation in primary care delivery. Whole person orientation is one of the seven Joint Principles of the Patient Centered Medical Home (PCMH) authored by the American Academy of Family Physicians in partnership with several other physician organizations. Although the PCMH model of primary care has been touted as part of the solution to the U.S. healthcare system’s cost and quality issues, there are few tools available to evaluate implementation of the essential components and none at all …

Identification And Linkage To Care Of Hcv-Infected Persons In Five Health Centers-Philadelphia, Pennsylvania, 2012-2014, Catelyn Coyle, Mph

JCPH Alumni

Approximately three million persons in the United States are infected with hepatitis C virus (HCV), a blood-borne pathogen that is an increasing cause of liver disease and mortality in the United States (1,2). Treatments for HCV are curative, of short duration, and have few associated side effects (3), increasing the importance of identifying HCV-infected persons. Many persons with HCV infection were infected decades ago, before implementation of prevention measures and most are unaware of their infection, regardless of when it occurred (4). Most newly diagnosed cases are associated with injection drug use (5). Persons born during 1945–1965 have a fivefold …

Experiential Global Health Education For The Health Professions: Lessons Learned From Experience-Based Learning For Students And Healthcare And Population Health Professionals, Rob Simmons, Drph, Mph, Mches, Cph, James Plumb, Md, Mph, Lucille Pilling, Edd, Mph, Rn, Ellen Plumb, Md

College of Population Health Lectures, Presentations, Workshops

Purpose:

• Describe key components of developing and sustaining a global health experiential learning experience

• Global Health Education for the Health Professions
• An area for multi-disciplinary study, research, and practice that places priority on achieving equity in health for all people worldwide
• Emphasizes transnational health issues, determinants, and solutions that promote interdisciplinary collaboration providing a synthesis of population based prevention, often including individual-level education and healthcare

Innovating At Jefferson: Developing The Patient-Centered Medical Home (Pcmh) Cost Tool, Robert D. Lieberthal, Phd

College of Population Health Lectures, Presentations, Workshops

Presented at Jefferson School of Population Health Faculty Research Seminar.

Objectives:

Describe the cost-collection tool we created for the PCMH Model

Propose improvements to our tool in order to enhance the response rate

Determine our next steps in terms of research and innovation for PCMH at Jefferson

21 slides