Reducing hospital bed time 4 Executive changes 11
A COMMITMENT TO COMMUNITY
Essentia
Health’s
Resourceful platform connects people to social services
By LISA EISENHAUER
In its less than three years of existence, Essentia Health’s public resource directory has been the conduit for 19,000 referrals to social services with more than one-third of those referrals resulting in services being accessed.
The directory, Resourceful, is available online at weareresourceful.org. It is used on average 500 times per month to make connections to services such as food banks and housing assistance across the Duluth, Minnesota-based health system’s footprint in Minnesota, Wisconsin and North Dakota. The platform tracks referrals so Essentia knows when a person or organization “closes the loop” by accessing or providing services.
The directory recently earned Essentia the Dick Davidson NOVA Award from the American Hospital Association. The annual award honors hospital-led collaborative efforts that improve community health.
Emily Kuenstler, Essentia’s community health director, says the health system developed Resourceful with Findhelp, a company that builds branded social
Continued on 9
New Hampshire hospital, church partner to run preventative food pantry
By VALERIE SCHREMP HAHN
To find out if patients at Catholic Medical Center in Manchester, New Hampshire, are struggling with food insecurity, nurses ask them:
In the past 12 months, have you worried
whether your food would run out before you got money to buy more?
In the past 12 months, has the food you bought not lasted, and you didn’t have money to buy more?
To someone who can easily afford healthy food, the questions are striking,
Research builds case for spirituality as
social determinant of health
By VALERIE SCHREMP HAHN
Should public health explicitly consider spirituality as a social determinant of health?
A group of researchers say yes, based on their review and analysis of thousands of articles and studies about the topic. One of those researchers said the findings and recommendations should be particularly relevant for Catholic health care providers.
The research was published in the July 12, 2022, issue of JAMA and analyzed in the June 2024 issue of Health Affairs. Katelyn Long, a coauthor on both articles, and Xavier Symons, a co-author on the Health
said Marc Guillemette, the director of the Office of Catholic Identity for the hospital.
“We’re trying to help folks where that’s a worry,” he said.
For the past six years, Catholic Medical Center has partnered with a food pantry Continued on 8
“For many of us Black women, there is generational trauma that can affect us. A program like JUST Birth is needed because we often feel we are not heard, not advocated for, not represented, not seen (by providers).”
— Natasha Blanchard
Providence Swedish initiative offers culturally competent doulas
and support to Black moms-to-be
By JULIE MINDA
Providence Swedish is addressing the especially high rate of maternal mortality for Black women through an initiative with doulas, navigators and other resources focused on improving birth experiences and outcomes for women of color.
Maternal mortality rates have been rising in the United States for the past decade. According to data curated by Seattle-based Providence Swedish, a nine-hospital system within Providence St. Joseph Health, between 800 and 900 women die annually nationwide from childbirth complications. In the U.S. Black women are up to four times more likely as white women to die during or because of childbirth.
Providence Swedish is taking on this disparity through the Justice Unity Support Trust, or JUST, Birth Network, which it launched in 2022.
The initiative provides women with a
Continued on 9
Revised equation moves Black Americans higher on kidney transplant waitlist
By LISA EISENHAUER
When Mario Hicks was put on the waitlist for a kidney transplant in 2019, his doctors told him that it probably would be 10 years before his turn would come. In the meantime, his life revolved around being hooked up to an at-home dialysis machine for nine hours a day.
Four years later, after a race-based factor was removed from a formula used to determine kidney function, Hicks, 43, and
thousands of other Black Americans got moved up on the long transplant waitlist. Last fall, the truck driver for the city of Chicago underwent a successful transplant at Loyola University Medical Center, a Trinity Health hospital in suburban Chicago. Since his transplant, Hicks no longer must spend more than a third of his day tethered to a device. “I actually have time to enjoy life with my wife, with the kids,” says Hicks, the father of two adult children.
LaShaye Stanton-Phillips, a certified medical assistant and doula, cradles a baby whose mother was a client of hers in the Justice Unity Support Trust, or JUST, Birth Network. Providence St. Joseph Health’s Providence Swedish subsystem launched the network two years ago to provide support to pregnant women of color.
Long Symons
High-caliber corps
HSHS expands continuing education offerings to help fill needed job roles
By VALERIE SCHREMP HAHN
Tom Ahr has seen a dramatic shift in the last five years in his work in human resources: Health care providers now are becoming education providers.
“The hospitals and clinics need to be much more active in the space to ensure that their workforce is getting the education they need because the jobs are changing, pretty quickly, pretty rapidly,” said Ahr, who is the senior vice president and chief human resources officer at Hospital Sisters Health System of Springfield, Illinois. “And so we need to play a bigger role than we did in the past.”
HSHS recently announced a new upfront tuition program for employees called REACH, short for Resources and Education for the Advancement of Colleagues at HSHS. The system put REACH together in partnership with InStride, which describes itself as a “workforce education solutions provider.” InStride provides a platform that connects workers with educational programs.
Through its REACH program, HSHS will provide up to $4,000 toward tuition each year for its more than 11,000 employees in Illinois and Wisconsin.
Workers can choose from more than 1,000 courses toward earning clinical certificates, associate’s, bachelor’s and graduate degrees, skills certificates and high school diplomas. The program is available to fulltime and part-time employees from the first day of employment.
Other Catholic health care systems and hospitals offer training and education programs in partnership with InStride, including Ascension, Intermountain Health, PeaceHealth, Saint Peter’s Healthcare System, and SSM Health.
SSM Health announced its partnership in November with a new professional development program called FlexPath Funded. Eligible employees can get up to $5,250 per year in tuition toward online programs.
“While it’s early, our initial results with FlexPath Funded have been overwhelmingly positive,” Janet Smith-Hill, SSM Health’s chief human resources officer, said in a statement. “Our team members say they appreciate the growth opportunities and the broad variety of options without having to incur up-front, out-of-pocket costs. The flexibility and self-paced learning also appeal to our team. It’s been an essential complement to the many professional development opportunities we offer at SSM Health.”
Intermountain Health offers a program called Intermountain’s Pathway to Edu-
cation, Advancement and Knowledge, or PEAK, for caregivers in Colorado and Montana. The program has been administered by InStride since June 2023.
“This program is more than just a tuition benefit for the hundreds of caregivers taking advantage of this unique program; it is a way of empowering our caregivers to realize their full potential, enhance their skills and knowledge, and advance their careers in health care,” Marguerite Samms, chief learning officer of Intermountain Health, said in a statement.
The InStride partnerships complement existing tuition reimbursement policies at Intermountain Health, HSHS and SSM Health.
Ahr, of HSHS, said the partnership allows employees to see a clear path as to how they can grow and what is required to earn a certain certification or pursue a certain career path.
“How does it align with what we’re trying to do as a mission, what might be different?” asked Ahr. “It’s getting access to education providers that may not be local.”
While HSHS already works with local institutions for education and training, InStride has the capacity to provide more training options for different jobs, such as phlebotomy technicians. That’s one job
category HSHS is challenged to fill, along with pharmacy technicians, surgical technicians and medical assistants. While most of the learning accessed through InStride is online, HSHS is working on ways to provide clinical components in person.
HSHS is building some online classes that will include that system’s employees in one virtual classroom, but other classes may include students from all over the world. Ahr said HSHS would like to build cohorts of specialty areas with other Catholic health care systems who use InStride.
Ahr is hopeful that InStride will sharpen the focus of HSHS’ training efforts and reduce turnover. “If we get more folks to stay because they feel that we’ve demonstrated that we value them and it lowers a lot of immediate costs for them, then we are better as a whole in building a strong, engaged workforce,” he said.
He said that people already are signing up for REACH. “It’s really just a great opportunity to share that we’re interested in the growth of our colleagues,” he said. “We’re more in the driver’s seat now by saying we can provide this. Now, it’s incumbent upon us to deliver on that and make it a good experience.”
vhahn@chausa.org
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Students attend a high school boot camp at HSHS St. Elizabeth’s Hospital in O’Fallon, Illinois, in December. Hosting the boot camp and providing educational assistance are among the ways Hospital Sisters Health System works to build and upskill its workforce.
Ahr
CHI Health takes holistic approach to training with nurse residency program
By DALE SINGER
In her dual roles in the new nurse residency program at CHI Health Nebraska in Lincoln, Tayler Hansen can do her job on the hospital floor or in a coffee shop.
In one role, Hansen is a teacher, helping to train fledgling nurses in the techniques and knowledge they will need to care for patients. In the other, she mentors a protégé through the ups and downs of nursing when they are off the floor.
“As a preceptor, I am training somebody how to care for patients,” Hansen says. “But when I’m a mentor, I’m someone they can lean on if they’re having a hard time. Investing in such programs like this, we are not only supporting our new nurses, we are also strengthening the entire health care system for better patient care and outcomes.”
Tim Plante, the chief nursing officer over the central region of CommonSpirit Health, says the residency program began last year as part of an effort across the system to address a lack of qualified personnel. CHI Health, based in Omaha, Nebraska, is part of CommonSpirit’s central region. CHI Health operates 26 hospitals.
The residency program at CHI Health is done in cohorts so new nurses build relationships with peers and their preceptors and mentors. The first cohort session ended in June with 104 graduates. As of late July, over 180 nurses had graduated and the sixth cohort session had begun. Another group will start the program in October.
One of the June graduates is Josiah Oyebefun, a Nigerian native who came to Nebraska via the Caribbean. He says the new setup helped him learn firsthand.
“If you ever have any questions or need help with anything, there’s always a nurse around with more experience who knows what’s going on and can assist you,” Oyebefun says. “But also, whenever you have some downtime or whatever, you learn and start to get exposure to the more critical patients.”
Evidence-based model
Plante says in developing the yearlong residency program, CommonSpirit nursing leaders did a deep dive into the latest research on how nurses learn and what they retain from training.
“They put together actually a whole department that manages this from the national standpoint,” he says. “We were one of the first regions to go up with it. Our national team came up with the theory behind it, but they engaged our local educators, and it’s managed and operated locally.”
CHI Health has given special attention to what’s needed both by the preceptors and
by the residents they are helping to guide.
“Number one, we were very deliberate in seeking out the people who wanted to teach, but we gave them extra training before they could teach our newer nurses,” Plante says. “And we also extended the orientation time (for the trainees), so rather than 12 weeks, we offer up to six months of one-on-one training so that we’re not pushing the nurses out of the nest. They tell us they’re ready versus us assuming or really pushing to get them off orientation, which was a practice that we have had before.”
The residency program includes clinical training and didactic education. Plante says the nonclinical portion was specifically designed to expand on what the resident nurses have covered in school. “We increased the difficulty of our didactic classes to make sure that they were find-
ing value and that they were leaving with a higher skill set,” he says.
In some cases, Plante adds, the training has been described as too hard — a gripe that he says showed that CommonSpirit was on the right track. “That was music to my ears, right? Because nursing is not easy. Nursing is hard, and patients are sicker than they’ve ever been,” Plante says. “So we need to prepare these nurses.”
In addition to working with preceptors on the job, the nurse residents get a mentor who meets with them regularly away from the workplace. Some of those mentors volunteer, others are recruited.
High retention
Plante says the retention rate for nurses who are in or who have graduated from the residency program is about 95%. That rate stands out among the current generation of nurses, he says.
“For Gen Z, changing jobs is literally part of their identity,” he notes. “Things like job anxiety and stress are just a catalyst when you’re talking about nurse training.”
During the COVID pandemic, Plante says, a troubling trend of high turnover among nurses worsened.
“A lot of hospitals moved to more simulation using manikins,” he says. “There’s some really high-fidelity, lifelike manikins, but it’s very different than having a real clinical experience with live patients in the acute care setting. Also, during COVID, a lot of health systems limited the access that students had to these clinical experiences because of exposure and because of supplies.”
Firsthand relationships
Oyebefun appreciated the residency program’s person-to-person approach. He notes that with a mother who is a nurse and a father who is a microbiologist, he grew up around science. But to master the skills he needed on the patient floor, the nurse resi-
dency program was a big step forward.
“I like having the relationship with people rather than being in a lab more secluded,” he says. “You learn a lot about the science of caring for people, the physiology behind it all. But I’m also getting to relate to people on a regular basis, just learning about them. Every patient that comes through has a unique story. We’re able to take them from point A to point B where they come with an issue, and then we’re able to see them leave improved in health. You get to be a little piece of that.
“The job gets more complex with the more skills you learn because you get introduced to a new role. But you’re trained well and prepared for it. The preceptors make sure you’re learning and prepared,” he says.
Hansen, who works on cardiac units, recalls how her own training was different from the preceptor relationship she has been able to establish under the CHI program.
“I was paired with a nurse for about six weeks and followed them,” she says. “I feel like this nurse residency program definitely has a stronger impact on our newer nurses.”
Smoothing the transition
And the support mentors provide off the hospital floor is valuable in a reinforcing way, Hansen adds.
“We meet with these mentees once a month and we say, ‘Hey, what are you having trouble with understanding? Do you want to go over heart rhythms? Do you want to go over how to run a code? Do you want to learn how to appropriately manage your time at work? How are you handling working night shift? How are you emotionally and mentally?’” she says. “Night shift could be draining for our rotating nurses. So this mentorship program provides mental and knowledge support.”
It’s all about taking care of the whole person, she says, in all their roles.
“We understand that the transition from the classroom to the bedside can be challenging,” Hansen says, “and the program that we offer aims to bridge that gap effectively. If they’re having problems with learning heart rhythms or recovering hearts, or they want to learn how to change a wound dressing, we can go over that. Or if they just wanna talk about life, see if anything’s bothering them, we can do that.”
From the mentee point of view, Oyebefun says, the holistic approach has been a key to success.
“You can start with a leg up and be at a better starting point,” he says. “That’s what I’ve really appreciated about it. It’s also created a resource of someone you can lean on, whether it’s a quick check about a difficult situation you dealt with or learning about something you’re unsure about. It just gives you a direct line of support.”
Mercy Health Services President and CEO Dr. David Maine threw out the first pitch at an August Orioles game as part of a series of events to mark the 150th anniversary of that health system’s sole hospital, Mercy Medical Center.
Additionally at the Aug. 15 home game at Baltimore’s Camden Yards, Sr. Helen Amos, RSM, received the Orioles Heavy Hitter Award in recognition of the 800-plus Mercy employees who attended the game that evening. Sr. Amos, who is executive chair of the Mercy board, appeared on the Orioles scoreboard as she accepted a game ball autographed by Orioles players.
The Orioles game festivities were part of “We Are 150,” the anniversary year campaign that so far has included a volunteerism
event for employees at Port Discovery Children’s Museum, a St. Patrick’s Day event, a volunteerism opportunity at the Our Daily Bread nonprofit, and an employee picnic. More activities are planned in the coming months for staff, clinicians and donors.
On Nov. 11, the anniversary of the Sisters of Mercy’s arrival in Baltimore, Mercy is hosting a live videoconference featuring Maine, Sr. Amos and an audience.
Mercy’s origin as a ministry of the sisters was on Nov. 11, 1874, when at the request of local doctors six Sisters of Mercy took charge of a small health dispensary in Baltimore. Mercy Health Services — including Mercy Medical Center, its related outpatients sites and its long-term care facility — has 5,760 employees.
Dr. David Maine, president and CEO of Mercy Health Services of Baltimore, gets ready to throw out the ceremonial first pitch at the Aug. 15 Baltimore Orioles home game. His appearance was connected with the celebration of the 150th anniversary of Mercy Medical Center, which is part of Mercy Health Services.
Nurses in the yearlong residency program at CHI Health get both clinical training and didactic education.
Josiah Oyebefun was among the nurse residency program’s first graduates. Tayler Hansen is a trainer and mentor in the program.
Plante
How one facility reduced time in a hospital bed
Bon Secours — St. Mary’s Hospital is sharing its approach, which improved care and efficiency, and lowered costs
By LORI ROSE
Faced with increasing delays in patient discharges, leaders at one Bon Secours Mercy Health hospital in Virginia took a hard look at ways to address the challenge.
The changes developed at Bon Secours — St. Mary’s Hospital in Richmond resulted in a significant drop in the amount of time patients admitted through the emergency department were hospitalized. They led to a renewed focus on sending more patients who require additional care to their own homes to recover, rather than to skilled nursing facilities.
“It’s all about serving all patients to the best of our ability,” said Dr. Leanne Yanni, chief medical officer at St. Mary’s Hospital.
“We have to address those efficiency issues that may impact the quality of care,” she added. “We have to be good stewards of our resources and make sure that when home is possible we make that a reality, especially when that’s the goal of our patients and families. We want to make sure our care is aligned with their goals.”
Delays in patient discharges create bottlenecks throughout the health care system, affecting both efficiency and quality of care, she said. Logjams put a strain on caregivers, reducing their ability to care for others and leaving fewer beds available for other patients who need them. Plus, longer stays in the hospital can result in lengthier recovery periods for patients and higher chances for developing a complicating infection.
A national issue
According to the American Hospital Association, the average hospital stay increased 19% overall in 2022 compared with pre-pandemic levels, and increased 24% for patients discharged to post-acute care, such as skilled nursing or rehabilitation facilities.
Staffing shortages at nursing homes and other long-term care facilities, delays in insurance approval, and other factors exacerbate the problem, Yanni said.
Yanni was instrumental in developing
and implementing the changes at St. Mary’s and sharing the results with other hospitals within and outside the Bon Secours Mercy Health system. The Cincinnati-based system is the fifth largest Catholic health care system in the nation, with 48 hospitals and more than 60,000 employees.
Yanni worked on the discharge project in conjunction with earning her master’s degree in health care management from Harvard T.H. Chan School of Public Health. She said discharge delays meant patients ready for release from St. Mary’s to skilled nursing care ended up staying in the hospital for two to seven days longer than was medically necessary.
“It was clear we had a high percentage of patients going to skilled nursing facilities and their length of stay in the hospital was twice as high” as those who weren’t, Yanni said. Because of those high numbers, it seemed like tackling that specific bottleneck would have the greatest impact hospital-wide.
A unified approach
Creating an interdisciplinary team of
frontline workers helped hospital leadership identify three ways to improve patient outcomes and promote quicker discharges.
The first was early evaluation of patients’ functional status and mobility, a key to understanding whether they could be discharged home with in-home nursing and therapy services.
Second was a widespread educational effort among staff to help remove barriers to home discharge, such as mixed messaging from caregivers, and to eliminate skilled nursing as the default next step. Discharging to skilled nursing facilities is a multistep process, including insurance authorizations, that commonly results in discharge delays.
Third was standardizing the discharge process, by creating a centralized report so that a care management leader could remove barriers and ensure progression through the multistep process. A discharge disposition tool also was created to support team collaboration and decision-making in daily interdisciplinary rounds. The tool provides a guide for the team — physicians, nurses, therapists, care managers — to
Discharge delays
Harm patient’s quality of life by slowing recovery.
Put additional pressure on an already overwhelmed workforce and can put access to care at risk for the wider community.
Put a financial strain on hospitals as they must bear the cost of caring for patients during those excess days without appropriate reimbursement.
Source: American Hospital Association, December 2022 IN 2022, THE AVERAGE LENGTH OF STAY IN HOSPITALS INCREASED BY 19% COMPARED TO PRE-PANDEMIC LEVELS, WITH SOME TYPES OF PATIENTS SEEING EVEN LARGER INCREASES.
align on the safest and most productive discharge recommendation for patients and their family.
The changes have reduced the percentage of patients discharging to skilled nursing from more than 14% to less than 11%, Yanni said, and significantly decreased the number of medically unnecessary days in a hospital bed.
Many moving parts
Yanni said sending a patient home to a familiar environment, with the appropriate resources such as physical therapy, is not only better for the patient, it saves thousands of dollars.
Coordinated discharge planning is key, she said. And if a safe discharge and effective home care is not possible, only then should caregivers look to a discharge facility.
“It’s a complicated process with many moving parts,” she said.
“Our goal here is to achieve high-quality care for the patients and families we serve, especially in transitions out of the hospital, while serving as good stewards of very limited health care resources.”
Truveta optimizes use of data, AI and human ingenuity to fuel medical research
By JULIE MINDA
Countless advancements in health care data collection and the use of artificial intelligence to analyze that data are opening up virtually limitless possibilities for mining patient information for new clinical insights. But the process remains very difficult.
A data aggregation and analytics company affiliated with multiple Catholic health systems has taken on this challenge and is helping to produce vital research on health outcomes. In the four years since its founding, the for-profit Truveta has amassed a dataset of more than 100 million patient records. The company has been using quickly evolving artificial intelligence tools to process that data and make it usable for researchers.
Dr. Michael Simonov, Truveta vice president of product, says, “It used to take about two decades for research to impact patient care, and that was deplorable. We are shrinking down that timeframe, and we also are expanding the type of data used.”
“We are changing the way researchers study and analyze data,” he says.
Born at Providence
Truveta was the brainchild of leaders at Providence St. Joseph Health, who started exploring around 2018 how best to
use the power of big data to answer pressing questions about health care delivery and outcomes. Providence, Trinity Health, Advocate Health and Tenet Health together launched Truveta as an independent company in September 2020.
Truveta’s collective membership has grown to 30 health systems that provide 18% of the daily clinical care across all 50 states from 800 hospitals and 20,000 clinics. Catholic systems that are members of Truveta are Bon Secours Mercy Health, CommonSpirit Health, Providence and Trinity Health.
Truveta member systems participate at various levels, with some serving on the Truveta board, some contributing as investors in Truveta, and all contributing data to Truveta’s dataset and getting access to the data for use in research. They get access to that data as part of their paid membership.
Daily updates
The member health systems provide data from patient medical records to populate Truveta’s dataset. According to information from Truveta, this “daily updated data delivers the most complete, timely, and clean data on U.S. health.”
Simonov says that Truveta has been evolving its processes of using artificial intelligence tools and other technologies to de-identify the patient data, clean it and organize it for optimal use. Simonov says the methods are so advanced that researchers can use the de-identified data to conduct longitudinal studies, correlate maternal
health to fetal health, track trends in public health, and conduct other types of analysis.
He says Truveta also has greatly expanded the types of medical record data that it can pull and use in its dataset. This now includes genomic information, clinician notes on patients, and data from electrocardiograms, CT scans, PET scans and other imaging. It also can include information relating to the social determinants of health, which can allow researchers to study the connection between health disparities and social determinants.
Researchers at life science and pharmaceutical companies, government agencies and academic institutions can buy access to Truveta’s dataset.
‘Juicy’ findings
Simonov, who was a medical researcher in academia before he joined Truveta, says the richness of Truveta’s data and the great capabilities of the processing tools have allowed for some “juicy” findings from the medical records.
“You pick a disease, and we can study it,” he says.
A recent area of focus has been maternal and fetal health. Truveta announced in the spring that it has developed the largest and most complete mother-child electronic health record dataset available. According to information from Truveta, “with more than 1 million mother-child pairs, these data will enable researchers to discover insights into the continuum of care from prepreg-
nancy through childbirth and beyond, while upholding the highest standards of privacy protection and regulatory compliance.”
Truveta expects researchers to use this dataset to better understand the connection between maternal health and neonatal outcomes, monitor the safety of medications and vaccines used by pregnant women, and explore the correlation of various childhood conditions with mothers’ demographic characteristics and other factors.
Already, analysis conducted by Truveta’s internal research team has found, through the study of more than 500,000 cases in the Truveta dataset, a higher risk of heart failure in the 90 days following delivery for women who experience preeclampsia. The researchers found that Black women with preeclampsia are twice as likely to have heart failure as white women with the condition. The study sheds light on maternal health outcomes in the U.S., and how race may factor into related disparities.
Simonov says it is because of the smart use of large complete datasets and dataprocessing tools that this important information can be gleaned.
He says that such information can help clinicians and patients. He notes that without early intervention, disparities can worsen and poor health outcomes can result.
He says, “We’re doing all this to advance our mission of saving lives with data. It’s impactful work — it’s reaching patients.” jminda@chausa.org
Bon Secours — St. Mary’s Hospital colleagues, from left, Krista Davidson, director of rehab services; Dr. Leanne Yanni, chief medical officer; Andrea K. Williams, manager of care coordination; and Dr. Muktak Mathur, medical director of the Vituity hospitalist program, worked together to rethink and improve the Richmond, Virginia, hospital’s discharge process.
Simonov
Baylor St. Luke’s Medical Center in Houston has role in first implant of new artificial heart
By VALERIE SCHREMP HAHN
A surgeon at Baylor St. Luke’s Medical Center in Houston was part of the team that implanted a new artificial heart that holds promise for someday becoming a heart replacement.
The BiVACOR Total Artificial Heart, named for the company that created it, was implanted July 9 into a patient on the waitlist for a transplant. The device was removed eight days later when a donor heart became available for the patient.
Dr. Alexis Shafii is the surgical director of heart transplantation at Baylor St. Luke’s Medical Center and was the primary surgeon for the implant. The medical center is part of St. Luke’s Health, a subsystem of CommonSpirit Health.
“This is an amazing advancement as the BiVACOR Total Artificial Heart may offer hope for countless patients who suffer from end-stage heart failure,” Shafii said in a statement. “This device may serve as a lifesaving bridge to a heart transplant; future studies may prove its potential as a longterm pump that can effectively serve as a total replacement for a patient’s heart.”
BiVACOR says on its website that the titanium device has only one moving part, a rotor levitated by magnets, that pumps blood “to the systemic (body) and pulmonary (lung) circulations to replace both ventricles of a failing heart.”
The device is currently charged with a battery pack connected to wires that go through the skin. Its creators say it will eventually have internal batteries that can be charged through the skin, like a wirelessly charging smartphone.
“As we progress through, then that’s our ultimate goal. When we find that stage, we feel like we can rival heart transplantation,” Daniel Timms, the founder and chief technology officer of BiVACOR and the inventor of its artificial heart, said at a press conference July 25 in Houston.
Big potential
times a day.
“No man-made device can do that without breaking,” he said. “And that’s been borne out by all these hearts. They can keep a patient alive while we’re looking for a donor heart to transplant them, but they fail capriciously.”
Cohn said BiVACOR’s device could become the exception. “Perhaps someday, this will be used instead of a transplant because it’s small, it’s energy efficient, and it should never wear out,” he said.
12 years in development
Shafii spent time in the lab with researchers as they tested the artificial heart and implanted it into calves. So for the July 9 surgery, he had confidence in the device and the trust of the patient who agreed to the implant. If they didn’t act, the patient would get too sick for any type of transplant, Shafii explained during an interview.
“The patient thought that he himself was tenuous, and he was agreeable, and that’s how he accepted to move forward,” Shafii said.
“This device may serve as a lifesaving bridge to a heart transplant; future studies may prove its potential as a long-term pump that can effectively serve as a total replacement for a patient’s heart.”
— Dr. Alexis Shafii
enough blood to meet the body’s needs. Three days after the nearly six-hour operation, he was removed from a ventilator and able to sit up in a chair, Rogers said.
Seven days after the operation, the patient was able to walk the halls, and Rogers said his blood flow was like that of a person with a healthy heart.
A day later, the patient underwent the donor heart transplant. He celebrated his 58th birthday later in July and continues to recover.
“First and most importantly, I’d like to acknowledge the patient and his family,” Rogers said. “The courage that he displayed was remarkable. And he has a wonderful spirit ... I want to thank the clinical team. There were hundreds of people that surrounded the patient to make this happen.”
Team-building moment
Ascension chief advocacy officer is among SOAR! honorees
Peter Leibold, executive vice president and chief advocacy officer at Ascension, will be among the honorees at this year’s SOAR! (Support Our Aging Religious) Awards Gala.
Leibold will be honored along with his wife, Liz McCloskey, for their community leadership. Among his past positions, Leibold was general counsel for CHA. McCloskey’s accomplishments include founding the Women Who Stay, a program that lifts up women’s experiences and leadership in scripture and the Catholic Church.
The other honorees are Kerry Alys Robinson, president and CEO of Catholic Charities USA; and James D. Bishop, director of Catholic Charities Legal Network, Archdiocese of Washington.
The gala raises funds for SOAR! grants that help congregations ensure the safety, dignity and vitality of aging women and men religious across the United States.
The gala is Nov. 1 at the Italian embassy in Washington. Details are at soar-usa.org/ event/2024-washington-dc-awards-gala/.
HSHS supports designation of race riot site as national monument
Noting the heroic role played by the founding congregation of Hospital Sisters Health System, leaders of the system applauded President Joe Biden for signing a proclamation establishing the Springfield 1908 Race Riot National Monument.
The White House said the monument in Springfield, Illinois, “will tell the story of a horrific attack by a white mob on a Black community that was representative of the racism, intimidation, and violence that Black Americans experienced across the country. National outrage at the attack — which occurred just blocks away from President Abraham Lincoln’s home — spurred action on civil rights, including the creation of the organization now known as the NAACP.”
Damond W. Boatwright, president and CEO of HSHS, said in a release that the monument “memorializes a tragic event that is an unfortunate part of our nation’s history.”
He added: “Our founding Hospital Sisters, in the aftermath of the riot, cared for the injured at St. John’s while homes and businesses burned nearby. Their commitment to care for all of God’s people, regardless of race, set an example that continues to inspire us today to promote peace and racial justice.”
HSHS St. John’s Hospital is the Hospital Sisters’ campus in Springfield.
Preschool opens at CHRISTUS Children’s in San Antonio
The Rise School of San Antonio opened a preschool at CHRISTUS Children’s in August.
The school serves children with and without developmental delays. A CHRISTUS Health release said the system is providing the school with donated space and families whose children attend the school with discounted therapeutic services.
Dr. William “Billy” Cohn, chief medical officer of BiVACOR, pointed out at the press conference that heart failure is the No. 1 cause of death in the United States. The National Institutes of Health estimates that up to 100,000 patients could immediately benefit from mechanical circulatory support.
To date, Cohn noted, artificial hearts have had valves and other parts that wear out as they beat 144,000
Dr. Joseph Rogers is the president and CEO of the Texas Heart Institute and the national principal investigator on the research of the BiVACOR device. He reported at the press conference that the operation was the culmination of a 12-year development program. The patient was the first of five set to have the BiVACOR heart implanted as part of a U.S. Food and Drug Administration Early Feasibility Study.
At the time of the surgery, the 57-yearold patient was in cardiogenic shock, a condition in which the heart can’t pump
In an interview alongside Dr. Brad Lembcke, Baylor St. Luke’s Medical Center president, Shafii emphasized the importance of innovation, research and teamwork over the years to get to the point where the BiVACOR artificial heart was ready for implantation.
Shafii said: “The science behind the development of the actual device requires an enormous amount of patience. I’m more like, oh, OK, you’ve made your experimental plane. OK, I’ll fly it.”
Lembcke
Added Lembcke: “Everyone had to learn how to do this. And it’s just been one of those uplifting, team-building moments. And that’s what you want from an organization like this. That’s what our community expects out of Baylor St. Luke’s.” vhahn@chausa.org
The Rise School’s model is tailored explicitly for children ages 1-6. Rise schools provide “an inclusive environment where high-quality early childhood education and intervention are integrated into all learning activities,” the release said.
The first Rise School was founded 50 years ago at the University of Alabama. The one in San Antonio is the ninth school in the network. The new location will feature two classrooms for children ages 1-3 years and six teachers. It will grow by a class a year until fully enrolled to serve children ages 1-6 years. Four therapists — speech, physical, occupational and music — will work in classrooms and space devoted to therapies.
Daniel Timms, the founder and chief technology officer of BiVACOR and the inventor of its artificial heart, performs a blood loop test on his invention. Doctors at Baylor St. Luke’s Medical Center in Houston implanted the device into a patient for the first time on July 9.
Shafii
Cohn Rogers
Emory Saint Joseph’s uses cognitive training to build ‘culture of compassion’
By JULIE MINDA
About a year into the COVID pandemic, leaders and employees in Emory Saint Joseph’s Hospital’s mission department took a step back from the grind. They looked at the harm the pandemic had wreaked on team members and asked themselves how the hospital could help.
They knew clinicians and employees were overwhelmed, emotionally taxed and burnt out — with many considering leaving the medical field. These mission department colleagues were familiar with in-depth compassion training offered by Emory University. The mission colleagues wondered if the Cognitively Based Compassion Training program from Emory University’s Center for Contemplative Science and Compassion-Based Ethics could help the hospital’s team members and community.
Now, a year into offering compassion training at Emory Saint Joseph’s, those mission department colleagues say the training is having measurable positive impacts on the hospital’s staff, clinicians and patients.
“Nurses, physicians and others are having a sense of relief and are really paying attention to what is happening within them,” says Maureen Shelton, system director of education and training for Emory Healthcare’s spiritual health department. “They are having self-compassion and a warm heart, and this is protecting them from burnout and secondary trauma.”
She adds that Emory Saint Joseph’s is building “a culture of compassion. And this is a gift that has been flowering.”
Buddhist affiliation
Emory University, its Center for Contemplative Science and CompassionBased Ethics, and Emory Healthcare are all in Atlanta. Emory Healthcare is part of Emory University. The 410-bed Emory Saint Joseph’s is Atlanta’s oldest hospital, and it has been part of Emory Healthcare since Emory and Saint Joseph’s parent formed a joint operating company in 2012. The hospital has about 2,000 employees and more than 600 physicians.
The ethics center offers various iterations of its Cognitively Based Compassion Training. The center’s programming leads participants through eight modules. Each module teaches different skills or insights to build inner capabilities that deepen compassion toward oneself and others. Many of the skills are rooted in contemplative practices of Tibetan Buddhism, but the programming has been designed to be secular and to meld with each participant’s particular religious tradition or belief system.
The compassion center and its programming were founded and developed by Lobsang Tenzin Negi, the center’s executive director. Born in a remote Himalayan region adjoining Tibet, Negi became a Buddhist monk and completed monastic training in Dharamsala and Mundgod, India. He moved to Atlanta and in 1991 began graduate studies and teaching at Emory University. In 1998, he helped forge an affiliation between Emory University and the top Buddhist spiritual leader, the Dalai Lama, creating the center. In 2003, a student urged him
COGNITIVELY BASED COMPASSION TRAINING
The eight modules that are part of the Cognitively Based Compassion Training program at Emory University’s Center for Contemplative Science and Compassion-Based Ethics are designed to cultivate skills or insights that can help people be more compassionate to themselves and others. These are the modules, which move in sequence:
1
Connecting to a moment of nurturance, or calling to mind a moment when a person or place provided a sense of security, safety and care.
8
Harnessing the power of compassion, or extending compassion to others, potentially being inspired to action.
2
Developing stable and clear attention, or training attentional stability. This can be done by focusing on a particular object.
7
Deepening gratitude and tenderness, or recognizing the people and things that help one thrive.
3
Enhancing self-awareness, or developing the ability to respond to inner experiences and thoughts in a healthy way.
6
Expanding one’s circle of concern, or turning one’s attention from self to others and examining how one relates to others.
from Emory University’s Center for Contemplative Science and Compassion-Based Ethics runs a Cognitively Based Compassion Training retreat in
to find a way to apply the contemplative practices at the heart of his study and teaching to what that student saw as a burgeoning mental health crisis among students.
That spurred the past two decades of his work.
The outcomes included developing teacher certification and participant training courses, expanding the online tools of the center, and building awareness of compassion training among groups that could benefit. All along, Negi and his growing staff have collaborated with academic partners on numerous studies. That research has demonstrated that compassion training supports people’s health and well-being and improves how they impact others.
Perfect storm
Among their ideas: tapping into the compassion center’s expertise to offer training to Saint Joseph’s colleagues. The mission department group built a case for it with hospital leadership, and presented the research showing the training’s many benefits, such as reducing high blood pressure and other physical and mental stress responses.
4
Cultivating self-compassion, part one, or strengthening meditative abilities, including as a way to accept one’s vulnerabilities.
5
Cultivating self-compassion, part two, or finding meaning in one’s vulnerabilities.
“spa days” quarterly, when employees can go to a quiet, set-aside space to get a massage, stretch or meditate. Saint Joseph’s also offers meditative retreats in line with the compassion training.
Tiernan says she’s heard from employees who have completed the training that they better understand why self-care is so important and they feel they have new tools to care for themselves and others.
Garrido says beyond anecdotal evidence that team members are feeling less burned out, which helps them and those around them, the mission department has some quantitative evidence of change. He says employee resiliency, engagement and belongingness scores have improved on Press Ganey and other surveys since the compassion training started. Patient satisfaction scores also have improved.
Mission advancement
Garrido says the compassion training integrates nicely with the mission and core values of Saint Joseph’s, which was founded by the Sisters of Mercy. “You can infuse compassion training with your own tradition,” he explains.
Compassion is a core value associated with the Mercy charism, and “we see that value in relation to social justice,” he says. “We see that compassion moves people to change and to recognize the intrinsic value of every person. This is all related to the Sisters of Mercy, and their mission to relieve suffering.”
“This is a tangible expression of Christ’s love,” he says.
The mission department hopes to engage as many team members as possible in the training.
Emory’s Shelton notes that staff from other Catholic health facilities, including colleagues from Ascension and Trinity Health, have taken the compassion training at Emory’s center.
Mike Garrido has been vice president of mission integration at Emory Saint Joseph’s for about 3 1/2 years, and Cheri Tiernan has been a chaplain at the hospital for eight years. Several years ago, they and others in the mission department began exploring new ways to support the well-being of colleagues.
“After the pandemic hit, there was this perfect storm of conditions that led to burnout,” says Garrido. “We needed an evidence-based way for those who were overwhelmed and stressed to get help. We wanted to help them rebuild their resilience and inner strength. We wanted to reenergize our physicians.”
Once leadership signed off on the idea, multiple team members of the mission department took the training. Tiernan already had become certified to conduct that training herself. A colleague also became certified to do so. The mission department has been building awareness of compassion training among Saint Joseph’s colleagues and physicians and then providing it to those who want it. In some cases, they’ve presented the training to units, tailoring it for their needs. The courses can be between six and 10 weeks, with weekly classes ranging from 75 to 90 minutes each. Participants receive a guidebook and a set of audio recordings to support ongoing contemplative practice.
Walks, spa
days, retreats
Since Saint Joseph’s began offering the compassion training to team members last year, about 100 employees and physicians have taken it. Garrido and Tiernan say the groups who have taken the training are eager to continue their self-improvement efforts and they also enjoy continuing to practice their skills as a community. Staff have proactively organized regular contemplative walks. Saint Joseph’s now offers
“Burnout in health care is an epidemic now,” Tiernan says. “Our staff are good at caring for others, but they need to also care for themselves — and then they can give of themselves to others.”
She says that with what they’ve learned through compassion training, employees “have a wellspring to draw on. Through compassion training, we can see we all share a common humanity. We can be grateful for how we benefit each other. And we can find inspiration to help those who are suffering.”
Visit chausa.org/chw to learn more about how the center is expanding the reach of its programs.
jminda@chausa.org
Shelton
Negi
Garrido
Staff
October at the Ignatius House Retreat Center in Atlanta. The staff, from center to right, are Tim Harrison, Maureen Shelton and Byron Bell.
Spiritual care webinar
From page 1
Affairs article, spoke about the research and analysis on Aug. 13 during a CHAsponsored webinar called “Spiritual Care Dialogue — Spirituality as Determinant of Health: Implications for Catholic Health Care.”
Long is a research associate with the Institute for Quantitative Social Science at Harvard University. Symons is the director of the Plunkett Centre for Ethics at Australian Catholic University.
Long explained why she and other researchers did what the JAMA article calls “a systematic review of the available evidence regarding spirituality in serious illness and health outcomes.”
“There’s growing research in spirituality, illness and health, but there is limited, or I would say sometimes resistant, uptake in some cases to integrating it into health systems or into public health policy,” she explained. “Sometimes it’s because the research wasn’t getting into high-impact journals. Other times, there might be some bias at play with what editors wanted to put out into the world. There’s just different reasons. And so we thought, we know there’s a lot out there, what if we brought it all together?”
She added that there is “an ongoing recognition that health has a spiritual dimen-
Spirituality findings
“Spirituality in Serious Illness and Health,” published in JAMA in July 2022, offers eight findings that panelists agreed upon and were supported by strong evidence:
Spirituality is important for most patients.
Spirituality can play a role in medical decision-making.
Spiritual needs are common.
Spiritual care is infrequent in medical care.
There is “an ongoing recognition that health has a spiritual dimension, that people are more than just bodies, that there’s minds and spirits at play as well, and we have to attend to the whole person in pursuit of true health.”
— Katelyn Long
Spiritual care is frequently desired by patients.
Unaddressed spiritual needs are associated with poorer patient quality of life.
Spiritual needs are infrequently addressed in medical care.
Provision of spiritual care is associated with better patient end-of-life outcomes.
sion, that people are more than just bodies, that there’s minds and spirits at play as well, and we have to attend to the whole person in pursuit of true health.”
Thousands of articles
The researchers reviewed over 15,000 articles published from 2000 to 2022 and included ones with a larger sample size and stronger research methods. Of the articles they chose to include, 371 addressed topics related to the role of spirituality in the lives of patients who were hospitalized with serious illness or at the end of life, and 215 articles addressed spirituality and health in the general population.
A panel of researchers reflected on the evidence presented in the articles, and
came up with several evidence-based statements. Long emphasized four: Recognize spirituality as a social factor in health.
Use evidence-based approaches to spirituality and health.
Provide spiritual care education for health professionals.
Provide spiritual care and support within health systems.
The researchers looked at specific examples of where this already was being done, such as in a program in Memphis, Tennessee, that connects the Methodist Le Bonheur Healthcare system with 690 mostly Black churches, and a program at Atrium Health Wake Forest Baptist Medical Center in North Carolina that engages congregations in 26 counties to connect volunteers to patients.
Based on their analysis, Long and her coauthors’ first recommendation is to support spiritual and religious literacy at the training stage for medical students and public health practitioners, even if that means starting with one lecture to introduce these ideas.
The second recommendation is to pursue relationships and common goals between those in the public health and faith communities, rebuilding trust that was strained or broken during the COVID-19 pandemic, and thinking of creative ways to serve communities well.
The third recommendation is to think about how to pay for spiritual care within the U.S. health system.
Symons added that the researchers kept in mind all faith traditions. “In a sense, we’re even kind of transcending traditionspecific approaches or frameworks, where we’re hopefully also tracking a little bit how spirituality, very broadly conceived, can be very helpful for people,” he said. “It can be very helpful for guiding the way we provide health care.”
He added: “It strikes me that this is all material that can be examined specifically within the Catholic context. I think we’re well-positioned to do that within the Catholic sector, because ... there is so much going on already.” Those in Catholic health care need to be a little bit more intentional about examining their work and review the evidence base as much as they can, he said.
The Good Samaritan’s role
During the webinar, Ruth Jandeska, the system director for spiritual health and mission for Bon Secours Mercy Health, offered her perspectives on the research and how practitioners could take next steps. Jandeska said she was “excited and joyful to learn more about this work” and that it left her feeling “very optimistic as a health care leader and very validated as a chaplain.”
She revisited the CHA vision statement: “We will empower bold change to elevate human flourishing.” She said the statement “is really an invitation to all of us in Catholic health care to reimagine what health care can be, and specifically to those of us that carry out the expertise of clinical spiritual care, to begin to ask ourselves how we might join in this collective effort towards a future that serves the good of all, particularly those who are poor and vulnerable.”
She recounted the biblical story of the Good Samaritan, in which a stranger comes to the aid of a man who had been attacked and stripped by robbers.
Jandeska said she is aware of similar stories in Catholic health care, such as the clinicians who noticed a woman in anguish and screened her for spiritual distress, a chaplain who helped a man who had burned his bridges and struggled with substance abuse disorder, and a clinical pastoral educator who worked with her department director to design a curriculum to address today’s needs.
Recalling what Jesus said regarding the Good Samaritan, she urged: “Go and do likewise.” vhahn@chausa.org
Jandeska
run by the Parish of the Transfiguration, a Catholic church about a mile from the hospital, to offer a preventative food pantry. Catholic Medical Center patients who are identified as food insecure and who have chronic health conditions such as diabetes or congestive heart failure that call for specialized diets get a referral to visit the pantry. It is the first of its kind in the state.
Volunteers at the pantry, run from the church basement, make sure patients get boxes of food tailored for them and their families twice a month. Depending on the patient, the food in their boxes might be low in sodium, sugar and fat. The foods could be gluten-free or made with whole grains. For everyone, there are fresh fruits and vegetables and lean meats.
As of the end of May, the pantry had served 446 patients out of 557 referrals. Separately, the hospital set up a pantry at the church for its own employees in need of food assistance. The hospital gives taxi vouchers to people who need a way to get to the pantry.
An easy partnership Catholic Medical Center’s mission is “to carry out Christ’s healing ministry by offering health, healing and hope to every individual who seeks our care.” That includes access to healthy food options. The hospital notes that 14.9% of Manchester’s residents live below the federal poverty level and one in 14 face hunger on a daily basis.
The preventative food pantry launched in 2018 after the director of the New Hampshire Food Bank, a program of Catholic Charities New Hampshire, approached Catholic Medical Center about the concept. The program is based on one located inside Boston Medical Center.
Guillemette was part of a committee that explored the issue, but determined there wasn’t enough space at the hospital. The committee knew the Parish of the Transfiguration already had a pantry, and the hospital already had a relationship with the church through its parish nurse program.
“So it made perfect sense to reach out to them,” Guillemette said.
The church’s food pantry has been running since the 1990s. During the 2008 recession, it served more than 150 families a month.
“We knew that they would be able to handle the volume to serve these patients,” Guillemette said.
Improving health
The hospital got a $10,000 grant from the Bishop’s Charitable Assistance Fund of the Diocese of Manchester to buy an industrial size refrigerator and freezer to store foods at the pantry. At the start, the hospital’s employees donated $10,000 through its Gift
of Heart Campaign, and they have continued to donate since.
As part of a referral to the food pantry, the hospital’s dietary staff craft shopping lists and menus and give nutrition consultation to patients. The parish nurse program provides blood pressure and weight checks, and the nurses in that program say they have seen improvements among patients.
Tim Brockway is the pantry’s director. After a career in the grocery business, Brockway began volunteering at the pantry about 13 years ago. He had served as a store manager for a grocery store chain and as a purchasing agent and customer service supervisor for a grocery wholesaler.
“I know food well,” he said.
Brockway began running the food pantry shortly after he began volunteering there. When Catholic Medical Center leaders approached him, he said they were considering opening their own pantry within the existing pantry, possibly adding their own staff and infrastructure. Brockway thought it would be easier to incorporate the two pantries, keeping names and needs in the same database.
He sits down with everybody the pantry serves to determine their needs and situation. Among those who rely on the pantry are immigrant families from Ukraine, Democratic Republic of the Congo, Nepal, and other nations.
“We have quite a variety of nationalities, and we do our best to help them,” Brockway said. “Google translate is probably one of my best friends.”
He listens to their stories and hears about individual preferences and needs. “I can learn more by listening,” said Brockway.
In addition to collaborating on the preventative food pantry, the church pantry works with the hospital’s Health Care for the Homeless Program of Manchester. Part of that program is to provide items that are easy to open and shelf stable, such as canned goods with pull tabs.
Brockway points pantry users toward more sources of aid such as the Supplemental Nutrition Assistance Program or the Special Supplemental Nutrition Program for
Women, Infants, and Children, also known as SNAP and WIC. He’ll advise them to go shopping at stores only after they’ve picked up their boxes of food from the pantry, so they can supplement and plan.
“It’s expensive to eat healthy,” he said.
‘Plenty of good food’
Volunteers pick up food from grocery stores or distributors and pack the items into banana boxes, which are sturdy and have handles. “The world revolves around banana boxes,” Brockway quipped.
Other volunteers staff distribution days twice a week and hand out more than 120 boxes of food per month.
People who aren’t referred from the hospital and come to the pantry solely through the parish also benefit, because the food it stocks is generally healthier than what is given away at other pantries, he said.
Guillemette said after seeing the success of the preventative food pantry, the New Hampshire Food Bank and its suppliers began to make more low-sugar and low-
sodium items available. “So it’s impacting the entire state,” he said.
Brockway said he hears from weight loss patients about pounds they have shed, but he generally doesn’t get feedback about health improvements otherwise. Guillemette also hears only anecdotal evidence but says Catholic Medical Center clinicians see value in the program and continue to refer people.
Bob and Dianne Wilson began visiting the pantry about three years ago, after Bob Wilson had open heart surgery and was referred by the hospital. Both have noticed health improvements, but the visits make their hearts happy in other ways.
“Tim and all his workers are super,” said Bob Wilson, 80. “You’re on a first-name basis. There’s plenty of good food. There’s never any trouble. If I’ve forgotten my appointment, it doesn’t bother Tim in the least. I get rescheduled. It’s definitely an awesome experience, every time I go.”
“Everyone says hi, everyone has a smile,” said Dianne Wilson, 73.
She said she often makes spaghetti pie, pasta salad, fresh salads and other foods with the items from the pantry.
She teared up as she spoke about an area in the pantry where people can pick and choose things that they want beyond what’s in the prepacked boxes. She says sometimes she feels bad taking food that could go to other people, but Brockway always encourages her and her husband to help themselves, she said.
Brockway often reassures people who have never had to ask for help or visit a food pantry.
“That’s probably the longest talk that I have with people,” he said. “I explain that whatever their situation is, they’ve helped people along the line in their lifetime, now it’s time to accept a little bit of help from other people.
“And that’s what we’re here to do.”
vhahn@chausa.org
ETHICAL ISSUES IN LONG-TERM CARE
STARTING SEPT. 26 — 1 TO 2 P.M. ET AND CONTINUING INTO 2025
This new quarterly webinar series explores ethical issues in the context of long-term care settings. Each 60-minute presentation features a critical issue for administrators, clinical leaders, ethicists, mission leaders and direct care staff serving in long-term care organizations.
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SESSION THREE Building a Culture of Belonging
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Tim Brockway, the pantry’s director, began volunteering there about 13 years ago following a career in the grocery business.
Patients who come to the preventative food pantry sponsored by Catholic Medical Center in Manchester, New Hampshire, get boxes of food tailored for their preferences and health needs. The pantry is housed in the basement of the Parish of the Transfiguration.
Guillemette
JUST Birth Network
From page 1
birth and family education program, culturally competent doulas, navigators who are people of color, and other resources. The initiative also includes a scholarship program to increase the pipeline of doulas who are people of color.
Sauleiha Akangbe is the birth equity manager for Providence Swedish and the founder of the JUST Birth Network that is part of the initiative. Akangbe, who is Black, says, “The health system is not built for people who look like us. And it’s not built for people who are struggling with addiction and who have experienced trauma. The system fails people.”
She says the doulas connect with expectant moms on an individual level. “We want every patient to have the birthing experience that we ourselves would want to have,” she adds.
By and for Black women
Akangbe is a fourth-generation doula — a person trained to provide advice, information, emotional support, physical comfort and resources to a mother before, during and after she gives birth.
Akangbe had been working as a Providence Swedish doula since 2017 when that system’s leadership approached her about developing a doula program for women of color. In 2019, she became the lead postpartum doula and then in 2020 she became the community engagement lead and, with funding from Swedish Foundation, founded an overarching program called the Black Birth Empowerment Initiative.
In that role, with the backing of leadership, Akangbe canvassed local communities of color to get input to build a new program. She learned that many of the people she spoke to had very poor perceptions of maternity care at Providence Swedish. They did not feel that the services were tailored to
Resourceful
From page 1
services platforms. She says Essentia chose its branding to reflect more than the fact that the platform offers access to a bounty of resources.
“We wanted it to reflect a positive feeling, that the people who use it are resourceful,” she explains. “They’re not helpless.”
Collaborative effort
Kuenstler also notes that Essentia intentionally kept its name off the platform. While the system took the lead in the launch of the platform, building and updating the directory has been a collaborative effort with community partners, including other health care providers and a local United Way chapter.
Those partners have representatives on Resourceful’s oversight committee, which meets monthly. “We set goals each year to decide what geographies to focus on, look at our data and try to improve our closed loop rates, etcetera,” Kuenstler explains. “It’s definitely like a shared governance model with our several partners.”
Resourceful and its listings of almost 5,000 free or low-cost services can be accessed by anyone. All users do is type in their ZIP code and then click on the form of assistance needed, such as food, housing or transit. The screen will then show entries for specific assistance programs. The entries have details about what sort of help is available, information on how to contact each provider, and a map with providers’ locations. The platform can be accessed online
the needs of minority populations.
The Black Birth Empowerment Initiative grew into the JUST Birth Network, which began in 2022 with funding from the Providence St. Joseph’s Health Equity fund.
Akangbe since has been hiring staff and contracting with doulas who are Black women and other people of color. About 50 doulas now are connected with the program. Each has an ethnic background that is well represented in the local community. Akangbe has used their input and that of patients and community members to build out the programming.
Confidante, advocate
When expectant mothers who are Black, African American, African, Native American, Alaskan Native, Native Hawaiian or Pacific Islander seek care at Providence Swedish, their providers tell them about the JUST Birth Network. They can learn about the services that are available and then can opt to sign on with one of the doulas.
Each doula gets to know her clients and their circle of family and friends personally. She learns what each expectant mom’s hopes and fears are for her pregnancy and childbirth, what barriers and needs she faces, what childbirth customs or traditions she wishes to observe, and what topics she needs education on. The doulas then carry out their clients’ wishes, connecting them with appropriate resources, referring them to social service providers if need be, serving as a confidante and advocate, and running interference when the moms encounter problems.
The program also provides navigators who can guide the moms to additional help within the health care system. The initiative also offers classes on childbirth topics.
All programming is tailored to the needs of women of color, says Akangbe.
Obstetrical violence
Natasha Blanchard is a childbirth educator and birth and postpartum facilitator, and LaShaye Stanton-Phillips is a certified medical assistant. Both women are doulas with the JUST Birth Network. They
and Akangbe say the initiative is needed because of the disparities that women of color face and because of the changing dynamics of the communities they live in.
Akangbe says some of the most serious concerns women of color have as expectant moms and when giving birth in the hospital involve obstetrical violence, medical hierarchy, medical racism and disrespect. She says providers who don’t take the time to learn about the needs and preferences of women of color may ignore what those women are saying, talk down to them, impose decisions on them or make decisions that are counter to the women’s wishes. They may show no regard for the women’s humanity. When providers do not treat these women with respect and dignity, childbirth can “feel like a battlefield” for the mother, and she may feel she is not respected or heard, says Akangbe.
Blanchard explains that some of the disconnection that can happen between the woman giving birth and her medical providers comes down to cultural differences. The woman and her providers may fail to communicate well or understand one another. She adds that in medicine, minority women “may not see a lot of people who look like us, and it’s not just a distrust of the white coat but sometimes of the white face, too. The women may not feel safe. They may see that their providers don’t understand” their needs.
Akangbe notes that a disproportionate number of women of color experience trauma and addiction compared to white women, and medical providers must be attuned to these special circumstances before, during and after the women give birth. Stanton-Phillips and Blanchard commonly work with women with these types of concerns.
Blanchard says: “For many of us Black women, there is generational trauma that can affect us. A program like JUST Birth is needed because we often feel we are not heard, not advocated for, not represented,
or via a smartphone app.
Essentia has integrated Resourceful into its electronic medical records. The health system screens patients for social needs at primary care and pediatric appointments and upon hospital admission. When those screenings reveal unmet social needs, staff members can immediately tap into Resourceful and check for services. The referral is then noted and tracked in the patient’s medical records.
Kuenstler says that while Essentia’s nine community health workers make the most use of Resourceful, physicians, paramedics,
“We wanted it to reflect a positive feeling, that the people who use it are resourceful. They’re not helpless.”
— Emily Kuenstler
case managers and others also are tapping into it to guide patients to services.
“I think it’s really exciting to see this being integrated into all types of care that we provide in many different roles,” Kuenstler says. “We’re trying to extend that care to the community and connect people with the resources that they need to be healthy.”
Training and outreach
Before and since the platform launched in December 2021, Kuenstler says Essentia has offered training to staff on how to access and use it. That training is live and via video. Essentia also sends out reminders about the platform and about training opportunities in internal communications.
“That’s something that is definitely a lesson learned from our program,” Kuenstler says. “It’s not like you just do a training when it launches. It’s a continual reinforcement of this being available. We use all the communication methods we have at our disposal.”
To spread the word about Resourceful outside of Essentia, the system’s commu-
not seen (by providers).”
She adds that many women of color have other emotional, physical and psychological needs that come to the surface during pregnancy and childbirth that must be addressed.
On top of all this, Stanton-Phillips notes, the close-knit family and friend networks that used to form a supportive community around pregnant women and new moms have broken down for many women. This is because many women’s families are now scattered, rather than living close together.
Progress and awareness
Since the start of the Black Birth Empowerment Initiative and its JUST Birth Network, hundreds of women of color have gotten support from the doulas and navigators, received help connecting with social services and other resources, and accessed the education the initiative offers. Plans call for the initiative to add Latina doulas. In time, Akangbe says, the initiative plans to help spread the approach beyond Providence Swedish, to help women at more facilities.
The initiative has been having an impact on the obstetrical medical providers at Providence Swedish by helping to build awareness of the particular needs of women of color. Akangbe says she’s seen great progress among medical staff members, with many gaining a better understanding of the needs of women of color and of how to meet those needs in a culturally competent way.
Akangbe sees awareness spreading throughout Providence Swedish but says there’s more work to do. “We need care and compassion throughout our hospitals, not just in the birthing area,” she says. “We want more patient advocacy, better relationships with the community and medical provider accountability when it comes to health equity.
“We need to fix the system,” she says of the grand aspirations of the initiative.
To view videos about the program and to read patient testimonials, visit swedish. org/services/pregnancy-and-childbirth/ just-birth. jminda@chausa.org
nity outreach manager meets with community groups to introduce them to the platform and with community organizations to teach them how to get their services listed.
Once an organization has a listing, the group can take ownership and revise and update that listing on its own. Resourceful automatically generates a prompt every six months to a contact for each listing asking if the information is still accurate.
Among examples of Resourceful’s use that Kuenstler can point to are a person who was living in a camper and hadn’t eaten for a day. One of Essentia’s community health workers used the platform to help that person get immediate food assistance and to apply for housing assistance and federal food aid. Another time, a community health worker helped a patient who lived in a rural community get assistance to rebuild a collapsed well.
Needs indicator
Kuenstler explains that while Essentia and its community partners oversee the entries for local services on Resourceful, the platform also connects users with entries for state and national programs that are in Findhelp’s database.
With Essentia in the planning stage of its next community health needs assessments, Kuenstler says metrics from Resourceful are going to be used as key indicators in that process.
“We can see what the community as well as what our staff are searching for, and then utilize that to help us understand where there are gaps in services so we can build our community health needs assessment programs around addressing those greatest need areas,” she says.
leisenhauer@chausa.org
Akangbe
Blanchard
The Resourceful platform can be accessed online or via a smartphone app. A search on the website brings up entries for available low- or no-cost services. The platform has entries for 5,000 services.
Kuenstler
KEEPING UP
California facilities that are part of CommonSpirit Health’s Dignity Health have made these changes:
Sue Andersen to president and CEO of French Hospital Medical Center in San Luis Obispo, from interim president and CEO. She also will continue in her role as president and CEO of Marian Regional Medical Center in Santa Maria and Arroyo Grande Community Hospital. Andersen replaces Patrick Caster, who has been named president and CEO of Dignity Health St. John’s Regional Medical Center in Oxnard and St. John’s Hospital Camarillo.
Betsy Hart to president and CEO of Glendale Memorial Hospital and Health Center, from chief operating officer of Northridge Hospital Medical Center.
Jeremy Zoch to president and CEO of Northridge Hospital Medical Center, from CEO of Providence St. Joseph Hospital in Orange.
Marlow Levy to president of Mercy Fitzgerald Hospital in Darby, Pennsylvania, and Saint Francis Hospital of Wilmington, Delaware. He was vice president of operations and system leader for laboratory, environmental health, and protective services for Baptist Health System in Jacksonville, Florida. Mercy Fitzgerald and
Kidney transplants
From page 1
In June, he and his wife vacationed in Mexico to celebrate their anniversary. He happily left behind the two pieces of luggage he had needed in recent years to carry his dialysis supplies. “It was much easier,” Hicks says.
New calculation
The formula adjustment that changed the calculus for Hicks and other Black Americans waiting for a kidney transplant was approved in June 2022 by the United Network for Organ Sharing, which oversees the nation’s donation and transplant system. The network said the change was “intended to address disparities in waiting times faced by Black patients on the kidney transplant waitlist.”
The calculation that changed involved the glomerular filtration rate, a measure of how quickly a person’s kidneys remove a waste product called serum creatinine from the blood. The rate is used to determine the point of kidney failure and when a patient is eligible to be put on the transplant waitlist. Since 2009, race had been one of the factors in the calculation, along with age, sex and the amount of serum creatinine in the blood.
The change that removed race from the calculation took effect Jan. 5, 2023. In addition, the United Network for Organ Sharing required transplant centers to review their waitlists and credit time to any patients who had been affected by the old formula.
A year later, the network said the revised formula had resulted in recalculations of the timing of kidney failure for 14,701 Black transplant candidates, with a median of 1.7 years of wait time credited. Wait times are among the variables that factor into prioritization for transplants. Of the transplant candidates whose wait times were revised, the network said 2,709 received a deceased donor transplant and 158 received a living donor transplant.
Saint Francis are part of Trinity Health Mid-Atlantic.
Guy A. Medaglia plans to retire as president and CEO of Saint Anthony Hospital in Chicago, effective Jan. 10. He plans to retain his role as president and CEO of Chicago Southwest Development Corp., an organization focused on bettering underserved neighborhoods in Chicago.
Drew Talbott has retired as president of Via Christi Hospital, capping off a 30-year career at the Pittsburg, Kansas, hospital. The hospital, which has been part of Ascension, is to be acquired by Mercy health system Sept. 1.
ADMINISTRATIVE CHANGES
Dr. Chris Acker to Nebraska/Iowa market chief medical officer of CommonSpirit Health’s central region. He also will continue as chief medical officer of CHI Health Mercy Council Bluffs in Iowa.
Stacey Johnson to chief operating officer of Trinity Health Senior Communities of Livonia, Michigan.
Dr. Taimur Mirza to chief medical officer of ArchCare, the Archdiocese of New York’s health care system.
Dr. Catherine O’Neal to chief academic officer for Franciscan Missionaries of Our Lady Health System in Baton Rouge, Louisiana. That is a new role at the system.
wait times was changed.
Wait times can mean the difference between life and death for kidney patients. The Department of Health and Human Services says there were more than 90,000 patients on the waitlist for a transplant last year and just over 28,000 operations. The United Network for Organ Sharing says 13 people die every day waiting for a kidney.
Significant impact
Dr. Sanjeev Akkina is a transplant nephrologist and medical director for the kidney transplant program at Loyola Medicine, of which Loyola University Medical Center is part. He estimates that the change that expedited Hicks’ transplant affected as many as half of Loyola Medicine’s Black patients on the waitlist. He says that translates into 40-50 people.
“It was a pretty significant number,” Akkina says.
Facilities within Bon Secours Mercy Health have made these changes: Gabe Bahala to chief financial officer at Fairfield Hospital in Cincinnati.
Shiley Harper to chief financial officer for Mercy Health — West Hospital in Cincinnati.
Zach Lambert, who is chief financial officer of Mercy Health — Anderson Hospital in Cincinnati, now is also chief financial officer of Clermont hospital in Batavia, Ohio.
Victor Sprague to chief financial officer of The Jewish Hospital — Mercy Health in Cincinnati and of Mercy Health — Kings Mills Hospital in Mason, Ohio.
Kristen L. McSorley to vice president of nursing for Bon Secours Harbour View Medical Center, which is slated to open in Suffolk, Virginia, next year.
Dr. Jason Chung to vice president, medical affairs and chief medical officer for SSM Health St. Anthony Hospital — Midwest and SSM Health St. Anthony Hospital — Shawnee, both in Oklahoma.
Facilities within Hospital Sisters Health System have made these changes: Timothy Layman to chief administrative officer of HSHS St. Mary’s Hospital of Decatur, Illinois. Allison Paul to chief nursing officer of the HSHS Central Illinois market.
Thomas Bushlack to senior director of
The change also had a significant impact for dozens of patients with kidney failure at SSM Health Saint Louis University Hospital. Of 118 Black patients on the transplant waitlist whose records were reviewed by the hospital, 68 gained additional credit for wait time and 12 got transplants earlier than they would have if not for the change.
Dr. Krista Lentine, an SSM Health nephrologist specializing in the treatment of adult patients with kidney disease, says the revised transplant formula is an indication of changing times in health care.
“Across medical disciplines, there is increasing recognition that categorizing race as a biologic rather than social construct has contributed to health care disparities,” Lentine says. “This problem is particularly apparent in the burden of kidney disease, which affects Black Americans three to four times as often as white persons.”
She was among 10 researchers who published a study in October 2021 on the use of the glomerular filtration rate in the calculations for kidney function. The study found strong support among staff at kidney transplant centers for revising the equation to improve transplant access. The findings were shared with the task force that was evaluating the revised equation.
An unintended consequence
Lentine says race was part of the earlier equation because it had been identified in kidney research data as associated with glomerular filtration rate. That research had shown, based on self-reported race, a difference between Black and white patients in measures of glomerular filtration rate levels. Research has never established what the root cause of the difference was.
The fact that the formula meant Black patients waited longer than other patients for kidney transplants, Lentine says, “was an unintended consequence of prior allo-
the Center for Theology and Ethics in Catholic Health. CHA launched the center last year.
GRANTS
Holy Cross Health in Fort Lauderdale, Florida, part of Trinity Health, has received a $1 million donation from philanthropist and financier Donald Sussman. Holy Cross will use the funds to modernize the building that will become the new Holy Cross Family Health Center. With Sussman’s gift, the family health center will be equipped with new technology and equipment. That center will provide outpatient care to underserved people. Sussman is the founder and chief investment officer of Paloma Partners.
Mercy Hospital Oklahoma City has used a $500,000 gift from Oklahoma City-based Braum’s ice cream and dairy company to create an infant milk room. In the room, staff who are certified milk technicians will safely store breast milk and formula for infants hospitalized in the neonatal intensive care unit. The technicians also will ensure the milk or formula is properly prepared for the babies’ use. Also at the milk room, parents can check in breast milk to be labeled and stored for their own newborn’s use. The space is expected to serve nearly 600 babies annually.
cation policy, not a factor in how the original equations were developed or planned for use.”
The study Lentine and other researchers published notes: “Critics have argued that use of race in clinical tools, although ostensibly in service to precision, is a poor proxy for individual genetic differences, exacerbates inequities, and may propagate structural racism.”
In terms of addressing disparities in kidney care for Black Americans, Akkina says revising the formula used to determine kidney failure “was one of the easier fixes we could do.” Among the more difficult and more impactful fixes the nation could undertake, he and Lentine say, would be addressing social factors that affect health. Those factors include access to screenings for diabetes and other conditions that can lead to kidney failure and access to transportation to medical appointments.
A fair chance
Hicks says his doctors never diagnosed the cause of his kidney failure. By the time it was detected in 2015, his kidney function was only 50%. It wasn’t until he went on dialysis in 2019 that his doctors told him he also would be put on the transplant list. He didn’t know that race had been a factor in how he was prioritized for a transplant until last year, when he learned from the transplant center in Iowa where he was also on a transplant registry that he likely qualified for a wait time adjustment. Once that adjustment was made, his turn for a transplant came up quickly at Loyola.
Hicks says he can’t say enough about the quality of care he received there and how grateful he is to have a new kidney. He would like to see more done to identify and address disparities like the one that might have delayed his transplant.
“I just hope that they change the system all around for fairness, for whatever race or color, (so) that everyone gets a fair chance at getting a kidney donated,” he says.
leisenhauer@chausa.org
Mario Hicks got a kidney transplant years sooner than he was expecting after a formula used in determining
Akkina
Lentine
Andersen Zoch
Acker Caster Levy Johnson Hart Talbott Layman Paul Bushlack PRESIDENTS/CEOS
Teen cardiac arrest survivor runs 5K to help Trinity Health hospital that saved her life
By NANCY FOWLER
On the morning of Feb. 1, Alivia Henkel strode into her high school as if it were any other day. But standing at a friend’s locker, she began to feel dizzy. Then she passed out.
“From what I’ve been told, my friend caught me before I hit the ground,” Henkel says. “Then our school resources officer started CPR, and when paramedics arrived, they used a defibrillator on me.”
Paramedics rushed the 18-year-old track, volleyball and basketball star to nearby Rochelle Community Hospital, 80 miles west of Chicago. Henkel’s mother, Geri Hayden, was 40 minutes away when she got the call. When Hayden arrived at the hospital, a doctor came to meet her.
“I asked, ‘Is she alive?’” Hayden says. “And the doctor said, ‘We’re doing everything we can.’”
Henkel had suffered a cardiac arrest. She was struggling, and doctors knew that transporting her to Loyola University Medical Center in the Chicago suburb of Maywood would give her a better chance.
Loyola, a member of Trinity Health, offers quaternary care, an advanced level of specialized medical attention.
Loyola physicians including Dr. Julie Fitzgerald, a pediatric critical care specialist, were ready and waiting when the ambulance transporting Henkel screamed into the bay. It was a “truly life-ordeath” situation, according to Fitzgerald.
“I’ve been an intensive care physician for 25 years,” Fitzgerald says. “And I’ve probably seen cardiac arrest in a person this young and healthy less than five times.”
‘I knew it was bad’
Doctors put Henkel on an extracorporeal membrane oxygenation, or ECMO, device, an external machine that performs heart and lung function when a patient’s own organs can’t.
For two days, Hayden and the rest of Henkel’s family—including her father, stepfather and two brothers—held their breath. Henkel’s first awareness was waking up intubated, unable to talk. As she came to, she saw her family’s deep worry.
“People were crying,” Henkel says. “I didn’t really know what was going on, but I knew it was bad.”
Without the ability to talk, Henkel immediately began communicating in American Sign Language, which she learned as a young child. Her loved ones breathed a deep sigh of relief, knowing she retained full cognitive function. Soon she transitioned to pen and paper. Their hopes soared when she was able to come off the ventilator.
Hayden was touched by the way doctors knelt at her daughter’s bedside to talk
to her at eye level. Throughout the hospital stay, she appreciated how the Loyola team encircled Henkel with love, even praying for her recovery. She will never forget the gentle way Fitzgerald sat down with her daughter’s friends to explain Henkel’s medical situation.
“Dr. Fitzgerald told them, ‘OK, girls, what questions do you have?’” Hayden says. “For her to give her time to those teenagers who were scared for their friend was really beautiful.”
Fitzgerald says: “I’m an ICU doctor, but I’m also a mom. So I’m happy to take that extra bit of time to talk things through, to make sure everybody understands what’s going on.”
On the night Henkel would have played in her school’s senior night basketball game, a nurse wanted to be sure she could at least watch it on television. Perched on a stepladder to reach an Apple streaming device, the nurse fiddled with the device until she found the game, enabling Henkel to see her Rochelle Township High School teammates and many of their parents displaying her number, 23.
“How many nurses would do that?” Hayden says. “It was really sweet.”
Running and reconnecting
The exact cause of Henkel’s cardiac arrest is unknown. But suspecting it might have been prompted by an abnormal heart rhythm, doctors surgically implanted a defibrillator to detect any future recurrence and shock her heart back into rhythm. Given a choice of devices, Henkel picked a newer side-implanted model that’s easier to replace.
After Henkel went home from the hospital, she quickly went from going on walks to jogging. In May, she tried running again, and soon began training for an event that would help her give back to the hospital that saved her life. The annual Loyola Medicine 5K Supporting Pediatric Care & Research would take place June 15, almost exactly
Author Kaveny will keynote virtual forum for ethicists
Scholar and author Cathleen Kaveny will be the keynote speaker at this year’s Catholic Healthcare Innovation in Ethics Forum, which is being hosted by Hospital Sisters Health System.
The virtual event is Oct. 15-17 and registration is open.
The annual conference, known as CHIEF, provides a venue to present innovative ideas or projects, receive critical feedback, and contribute to evolving how Catholic health care thinks about and implements ethics.
CHIEF is designed around short talks and a keynote address and time for networking. Kaveny is a professor at Boston College. Her position includes appoint-
ments in both the theology department and at the law school. Her teaching and writing focus on the relationship of law, religion and morality. She has written four books and is a columnist for the Catholic journal Commonweal
Kaveny’s keynote address at CHIEF is titled “Prophet, Priest, or Royal Ruler: The Identity Crisis for Catholic Ethicists Today.”
Ethicists working in Catholic health care and students pursuing an ethics-related degree who have a desire to work in the Catholic health care ministry are invited to attend the forum. The cost is $50. The fee is waived for students who are not employed full time.
To register, email Rachelle Barina, chief mission officer at HSHS, at rachelle. barina@hshs.org.
four months after Henkel went home. Henkel looked forward to returning to competitive running as well as reconnecting with Loyola.
“I was excited that I would be able to see some of my doctors again,” Henkel says. “I am so grateful for what they did for me.”
Fitzgerald is overjoyed with Henkel’s progress.
“I would say it’s miraculous, given what she went through, to, within just a couple of months, be strong enough to participate in a 5K,” Fitzgerald says.
When Fitzgerald and Henkel saw each other before the race began, they shared a big hug.
Henkel’s family and doctors cheered her on as she completed the race without difficulty. Even though she didn’t match her personal 5K best, she was pleased to be back in the game.
“My favorite quote is from Dr. Martin Luther King: ‘If you can’t fly, then run. If you can’t run, then walk. If you can’t walk, then crawl. But whatever you do, you have to keep moving,’” Henkel says.
The 5K raised more than $70,000 for Loyola. Among the beneficiaries of this year’s funds are an interdisciplinary clinical trial exploring new treatments for children facing cancer. Past runs have funded Loyola’s neonatal and pediatric intensive care units.
“It feels great to support anyone who’s been through anything like I have,” Henkel says.
World-Class Speakers:
Doubting Thomas 1602–1603 Caravaggio
Alivia Henkel, right, runs in the Loyola Medicine 5K Supporting Pediatric Care & Research in June with a friend. Henkel suffered a cardiac arrest in February.
Kaveny
Fitzgerald