1. health and fitness

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