POST-ACUTE AND LONG-TERM CARE IN THE TIME OF COVID-19
By Laurie Archbald-Pannone
In March 2020, our geriatric team, led by Dr. Archbald-Pannone and including Dr. Mutter and Dr. Harris (Pulmonary/ Critical Care), was tasked by the health system to work closely with our regional post-acute and long-term care (PA/LTC) facilities in COVID-19 preparations. From this initiative, we have developed the UVA Geriatric engagement and resource integration for post-acute and long-term care facilities (GERI-PaL) team with COVID-19 prevention and response arms with an excellent inter-professional team. We have already have been successful in the creation, implementation, and publication of this initiative.
COVID-19 Collaborative Model for an Academic Hospital and Long-Term Care Facilities
Rapid Telehealth-Centered Response to COVID-19 Outbreaks in Postacute and Long-Term Care Facilities
Does forgetting a name or word mean that I have dementia?
Although the team is newly formed, we have already shown a record of excellent collaboration and dedication to the early dissemination of our work through the publication of our model and partnership with our state health department to serve as a model for the Commonwealth of Virginia.
Dr. Archbald-Pannone serves as Clinical Champion and Faculty Lead for the development and implementation of telemedicine consultation for residents in post-acute and long-term care facilities in response to the COIVD-19 pandemic. We have implemented telemedicine consultation subspecialty services in eight of our local PA/LTC facilities and actively responded to multiple COVID-19 outbreaks, as well as shown decreased mortality and hospitalization rates among these vulnerable patients.
By Leslie Blackhall
Palliative Medicine has been working with Medical Center and SOM leadership in expanding inpatient hospice conversions as part of an effort to improve end of life care at UVA. This initiative seeks to provide increased support to patients and their family members in situations where death is imminent, and the patient is too unstable for transfer to home or another hospice facility.
Tammy Schlag and Jon Bartels have taken the lead as guides to ensure smooth transitions for these patients. More than 30 patients have been converted to hospice while inpatient since June in addition to patients who are transferred to the Center for Acute Hospice Care at the TCH or discharged home with hospice. Areas eligible for conversion have been expanded to include the medical, cardiac, neurosurgical, surgical ICUs, and the entire 3rd floor. Expansion to include Heme-Onc is expected mid-October, with expansion to include the entire medical center by 2021. On July 29, a hospice unit was opened on 3S, and palliative care will officially take over the medical directorship of that unit in November. Two new palliative care NPs, Scott Owens and Nicole Meicke, will be starting in October to help run this unit and facilitate hospice discharges and conversions.
HEPATITIS C SCREENING AND TREATMENT PROGRAM – UNIVERSITY PHYSICIANS ORANGE
By Brittany Cavanaugh
Faculty member, Brittany Cavanaugh D.O., is heading the new Hepatitis C screening and treatment program at University Physicians Orange. Brittany’s interest in hepatology led her to complete the conference ‘Hepatitis C treatment for Primary Care Providers’ by the Virginia Department of Health, Rebecca Dillingham, MD, and Terry Knick, RN. She is working on a quality improvement project to analyze and improve Hepatitis C screening rates. Additionally, she is actively treating patients with Hepatitis C. When patients do not meet the criteria for primary care treatment, usually in cases of cirrhosis or complicated medical history, they are referred to hepatology for treatment. She is looking forward to expanding the referrals for Hepatitis C treatment but is currently only working with internal University Physicians Orange referrals.
YOU CAN HAVE BOTH: COACHING TO PROMOTE CLINICAL COMPETENCY AND PROFESSIONAL IDENTITY FORMATION
By Rachel Kon
Applying a coaching model to undergraduate medical education is growing in popularity. Medical schools traditionally try to assign mentors and advisors to students to help with career development separate from the faculty that evaluate them in the curriculum, but this doesn’t necessarily improve the performance of clinical skills. As part of their leadership roles in UME at UVA, Dr. Parsons, Dr. Plews-Ogan, and Dr. Kon have been applying a coaching model to their curriculum reform. They recently published their work to disseminate to others their model for applying coaching to professional identity formation and clinical skills development.
In this paper, the authors begin by distinguishing coaching from other supervisory roles in medical education and argue that coaching is a critical tool to guide student development of clinical competency and professional identity. For example, they describe the novel, comprehensive clinical coaching program designed and implemented here at UVA: Foundations of Clinical Medicine (FCM). Dedicated physician coaches, many from the Division of General, Geriatric, Palliative, and Hospital Medicine, make up the core of FCM. These coaches work longitudinally with students, and through reflective dialogue, guide students to explore their emerging identity as physicians and to create meaningful learning plans using data from clinical assessments. The paper outlines how the structure of their curriculum has faculty coaches at the center of achieving professional identity formation and clinical competency goals.
COMMUNITY OUTREACH FOR COVID TESTING FOR VULNERABLE POPULATIONS
By Mo Nadkarni
Led by Drs. Amy Salerno (hospital medicine), Mo Nadkarni (General Internal Medicine), and Max Luna (Cardiology), the UVA health system, has initiated a program of community COVID testing designed to address health equity issues by improving access to COVID testing to vulnerable populations and communities of color. Staffed by volunteer M.D.’s, Nurses, Access staff, and others, over 3000 COVID tests have been provided to community members, many who face barriers to receiving testing and care on UVA grounds.
Community testing events occur four evenings per week via outdoor drive-through access. Two events are at fixed sites. Monday’s at Church of the Incarnation is serving a Latinx population. And Tuesdays at Mt Zion First African Baptist Church is serving a primarily African American population.
Community requests and hotspots determine other events. Wrap around social services such as food, sanitizers, rent assistance, and education is provided as well in conjunction with multiple community partners. The positivity rates at events have varied from 3% to over 45%, with the Latinx population with the highest rates.
Volunteers for testing and results callbacks are still needed. Contact Mo Nadkarni for further details. Many thanks to so many who have already volunteered to provide this vital service to the community.
If you are able to volunteer, please visit the sign-up link here.
HEARR: HEALTH EQUITY AND ACCESS IN RURAL REGIONS
By Preston Reynolds
HEARR, an acronym for Health Equity and Access in Rural Regions, is a community-based group that promotes access to medical care and infrastructure to achieve health equity for some 15,000 residents in the area connecting Southern Albemarle, Buckingham, Fluvanna, and Nelson counties.
HEARR was established over the past two years under the leadership of former Mayor Nancy Gill. As a founding member of the steering committee, it is exciting to share the work of our group. We have completed a regional health assessment under the direction of consultants, created a website, hosted several local health events, and launched a clean water initiative. Recently with funding from the GIDI (Global Infectious Disease Institute), we are conducting a 40-question survey to explore the impact of COVID and determine how to best address the health needs of the region, in collaboration with the local and state health departments and other regional partners, including the University of Virginia.
With funding from iThrive, we are expanding our work on access to clean water with testing of wells for lead and other contaminants in collaboration with faculty at UVA and Virginia Tech.
With the constraints of COVID, we are planning upcoming events that include community education about COVID, with testing, distribution of masks, and installation of sanitizing solution dispensers around Scottsville and at key businesses. Also, we are organizing events as part of the national take-a-hike month of November. Watch for more as HEARR is up and running!
You can take the survey here.
Filed Under: News and Notes
Tags: GENERAL MEDICINE, medicine matters, October 2020, October 2020 Newsletter, October Medicine Matters Newsletter, Palliative Medicine, Research