Serving together, thriving together | 2023 Year In Review

Dear Friends,

I am thrilled to present the 2023 edition of the “We Serve Together” year in review, which highlights the incredible work of our caregivers and their unwavering commitment to the diverse communities we serve.

Innovation is everywhere at ChristianaCare, as we harness new technologies and develop new ways of working to make health care more effective, safe, convenient and affordable. We’ve launched an incredible array of entirely new ways of working and delivering care, including virtual acute care nursing and semiautonomous cobots in our hospitals, and the delivery of hospital care, primary care and even robotassisted care in the home.

Our patients and our caregivers are loving these new experiences, as technology automates and supports tasks so that caregivers can focus on the human touch and the aspects of care that most require their expertise.

The pace of innovation is accelerating even faster today because of generative artificial intelligence, and ChristianaCare is at the forefront of exploring the potential of this new technology in health care while ensuring that it’s used responsibly, ethically and safely.

As technology enables us to serve people in new ways and in new places, we also continue to grow and enhance the full range of health services we provide in Delaware, Maryland, Pennsylvania and New Jersey. Among the most exciting examples of this growth is the ChristianaCare West Grove Campus in southern

Chester County, Pennsylvania, which will soon be the site of ChristianaCare’s first neighborhood hospital, as well as new primary care and specialty services.

Our success is tempered by the incredible challenges that the health care industry is facing today, including workforce shortages, rising costs and decreasing revenue.

These challenges are real, and they make our work more difficult.

And yet, I have never been more optimistic about the future of health care and the future of ChristianaCare.

Challenge brings opportunity. We have the opportunity to be bold, idealistic and creative as we continue to design new health care for the 21st century that is safe, effective, equitable and affordable—and exceeds consumer expectations.

Thank you for taking some time to learn about ChristianaCare and our incredible caregivers in the pages ahead. As we serve together, we thrive together—For the Love of Health™!

Janice E. Nevin, M.D., MPH President and Chief Executive Officer

Creating Health

IN THE MANY COMMUNITIES WE SERVE

For more than 130 years, ChristianaCare has served the health needs of its community. Today, that reach extends through Delaware, Maryland, Pennsylvania and New Jersey — and even beyond, as virtual care and innovative partnerships expand ChristianaCare’s ability to improve health.

MD

Expanding SERVICES AND ACCESS TO CARE

MARYLAND

Maryland residents have more access than ever to ChristianaCare’s expert health services, bringing expanded primary and specialty care to Cecil County with:

• The new ChristianaCare Primary Care at Elkton, a practice serving adults and children with appointments in person, by phone and virtually.

• The opening of the renovated Family Birth Center at Union Hospital, a warm, welcoming space with the latest technology to provide an exceptional experience for families.

• The addition of ChristianaCare Cardiology Consultants at Elkton, bringing nationally recognized heart care services to Cecil County.

• An expanded peer recovery program for help with substance use disorders.

PENNSYLVANIA

ChristianaCare will open a neighborhood hospital and a health and wellness center at its West Grove campus in southern Chester County, Pennsylvania, which will include a full-service emergency department and 10 inpatient beds, and will offer diagnostic capabilities, including ultrasound, CT scans, X-ray and laboratory services to support emergency and inpatient care. Additional new outpatient services coming to the West Grove campus include primary care, women’s health, cardiology, outpatient diagnostics and a variety of other specialty services. The neighborhood hospital is expected

DELAWARE

Opened in 2022 alongside a more traditional ChristianaCare primary care practice in Rehoboth Beach, Delaware, our innovative My65+ practice offers personalized care tailored to adults 65 and older. In addition to general primary care services, the My65+ practice provides medication management, behavioral health care, specialist coordination and additional provider consultation time and is adding services from ChristianaCare’s Swank Center for Memory Care and Geriatric Consultation. Patients are also able to connect virtually with specialists in cardiology and neurology. ChristianaCare plans to expand this model to new locations in the future.

ACCESS TO CARE FROM THE comfort OF HOME

Innovations in technology are making it possible to provide care for people in their homes in entirely new ways. ChristianaCare is at the forefront, recognizing that care in the home often leads to better health outcomes at lower costs—and people love it!

Hospital Care at Home

ChristianaCare’s Hospital Care at Home program provides acute care in the home for patients who would otherwise be admitted to the hospital. Since its launch in 2021, this program has treated approximately 1,000 patients with safe, high-quality, hospital-level care in the home. Hospital Care at Home is yielding excellent outcomes: Infection rates and readmissions for patients in this program are well below the national average for brick-and-mortar hospitals. Patient experience scores are about three times the national average for traditional hospital stays. A recent patient called the program “nothing short of fantastic.”

Center for Virtual Health

Your health doesn’t pause between doctor visits, and neither should your care. Our Center for Virtual Health provides asynchronous care that allows patients to communicate with their care team securely and safely — often by text message — to help them stay connected with their health. This consistent communication includes an average of 24,000 text message exchanges each month, to check in with patients about symptoms, answer questions about medications, schedule appointments and more.

Primary Care at Home

A multidisciplinary team of physicians, nurse practitioners, nurses and social workers in Primary Care at Home provides elderly homebound patients a way to meet their medical, emotional and social needs without leaving home. In 2023, 260 patients were served in the program, which also has relationships with HomeHealth, palliative care and hospice programs to provide a seamless continuum of care.

Robot-Assisted Care

A robotic assistant is merging the tech of today with ChristianaCare’s 100 years of home health expertise. Our Health & Technology Innovation Center and ChristianaCare HomeHealth are piloting Astro, a home-based robot that uses facial and voice recognition to support patients’ medical needs and help them adhere to their care plans, while also providing companionship that can elevate their mood and combat social isolation. Programmed by our nurses, Astro works in tandem with smart speakers and generative artificial intelligence (AI) to bring 24/7 monitoring and care into the home.

Harnessing Artificial Intelligence

A type of artificial intelligence that can create new content based on the data it has been trained on, generative AI has the potential to assist with a range of health care needs, including routine information-gathering, diagnosis and even treatment. ChristianaCare is pioneering generative AI technology in health care and has developed Blossom GPT, ChristianaCare's in-house generative AI.

“ROBOTICS AND AI ARE THE NEXT EVOLUTION OF HOME HEALTH CARE — THESE TECHNOLOGIES ARE ABOUT EXTENDING OUR CARE FOR PATIENTS IN THEIR HOMES, WHERE THEY WANT TO BE.”

— ANN PAINTER, MSN, RN, PRESIDENT,

Reaching MORE PATIENTS WITH VIRTUAL BEHAVIORAL HEALTH

Access to psychological and psychiatric care in the comfort of home has been a game-changer for patients. “What started as a needed service during the pandemic has become a standard in care,” said Psychiatry Chair Mustafa Mufti, M.D. In 2023, the number of virtual visits was approximately 2,500 a month — a 29% increase over 2022.

“Virtual behavioral health has opened the door for more individuals to get the right care in a very accessible way, including patients in geographic areas where behavioral health services are limited,” said Vanessa Patel, M.D., of Behavioral Health. “Virtual care eliminates transportation barriers and reduces the need for time off work, for childcare and other obligations so patients can focus on their health.”

PEDIATRIC CARE CENTER BECOMES A vital COMMUNITY RESOURCE

ChristianaCare’s Pediatric Care Center, at the Newark campus inside the Center for Women’s & Children’s Health, celebrated its first birthday in 2023 with amazing results. In its first year, the Pediatric Care Center served more patients than projected for its fifth year of operation.

Since opening this 24/7, walk-in facility that provides emergency room care for kids, we’ve expanded the reach of ChristianaCare’s pediatric expertise. Overall pediatric patient volume in the emergency departments has increased 69% with the center’s opening in fall 2022. About 40% of the patients who visit are new to ChristianaCare, and they come from over 250 zip codes and all four states in our region.

“HEALTHY CHILDREN MEAN HEALTHY COMMUNITIES. IT’S OUR PRIVILEGE TO PROVIDE EXCEPTIONAL CARE FOR CHILDREN AND TO EXPAND PEDIATRIC CARE SERVICES FOR OUR NEIGHBORS.”

— MEGAN MICKLEY, M.D., MBA DIRECTOR, PEDIATRIC CARE CENTER AND DIVISION DIRECTOR, PEDIATRIC EMERGENCY MEDICINE

Care COMES TO COMMUNITIES THROUGH MOBILE VANS

ChristianaCare has hit the road with generous philanthropy from Barclays. Our two mobile health vans have covered more than 11,400 miles across the state of Delaware, providing primary care, sports physicals, behavioral health, obstetrics and gynecological services in communities and neighborhoods where these services otherwise are not easily accessible. There have been more than 2,180 interactions aboard the vans, including 958 vaccinations and 682 health visits.

NEW SLEEP WELLNESS CENTER improves QUALITY OF LIFE

More than 70 million Americans suffer from sleep-related problems. To address this growing need, ChristianaCare opened a new comprehensive sleep wellness center on the Newark Campus. The Sleep Wellness Center provides expert, multidisciplinary diagnosis and care for every kind of sleep problem, including obstructive sleep apnea, restless leg syndrome and narcolepsy. The expert staff coordinates with diseasebased programs at ChristianaCare to integrate sleep services into cardiac care, weight loss surgery and renal transplant care. They also partner with surgeons to manage hypoglossal nerve stimulation therapy, a major advancement in obstructive sleep apnea treatment. “With information collected through testing, our sleep experts can determine the source of a sleep problem and begin a treatment plan to help patients improve their quality of life,” said Shilpa Kauta, M.D., medical director of the ChristianaCare Sleep Wellness Center.

PROVIDING LOVING, EXPERT CARE THAT you CAN TRUST

The Helen F. Graham Cancer Center & Research Institute is one of the most advanced cancer centers in the country. A multidisciplinary care team of specialists including a surgeon, a medical oncologist or hematologist and a radiation oncologist provide the best treatment options. We offer the most advanced cancer-fighting technology and participate in the National Cancer Institute’s NCI Community Oncology Research Program.

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PATIENT VISITS

NEW PATIENTS

EXTERNAL RADIATION BEAM TREATMENTS

PATIENTS ENROLLED IN CLINICAL TRIALS

CLINICAL TRIAL PATIENT PARTICIPATION RATE

The Center for Women’s & Children’s Health is the region’s only National Community Center of Excellence in Women’s Health and offers innovative, patientcentered care for mothers, babies and families. The center provides private rooms for mothers and families after delivery and is one of the only hospitals in the United States to provide couplet care in the NICU, keeping mother and baby together even if they both require medical care. In 2022, the center added a 14bed Pediatric Care Center that provides 24/7 short-stay inpatient and emergency care for children and teens.

OUTPATIENT VISITS

INPATIENT VISITS

NEW PATIENT VISITS

NICU ADMISSIONS

PEDIATRIC CARE CENTER PATIENT VISITS

The multidisciplinary Neurosciences team provides comprehensive and advanced care for neurologic illnesses across the acute and ambulatory settings. As the largest and most comprehensive neurology practice in Delaware, ambulatory subspecialties include stroke, epilepsy, multiple sclerosis, movement disorders, neuromuscular disorders, headaches/migraines, pediatric neurology and Botox specialists. Our inpatient team of experts includes neurointerventional surgeons, neurocritical care physicians and vascular neurologists. Our Newark campus is the only comprehensive stroke center in Delaware and includes the only Epilepsy Monitoring Unit in the state.

PATIENTS ENROLLED IN CLINICAL TRIALS

PATIENTS TRANSFERRED TO CHRISTIANACARE FOR ADVANCED

The Center for Heart & Vascular Health is among the largest, most capable regional heart centers on the East Coast. It is the only center in the region that integrates cardiac surgery, vascular surgery, vascular interventional radiology, cardiology and interventional nephrology in a single location.

VISITS

NEW PATIENTS

TOTAL PATIENT PROCEDURES

CARDIAC REHAB INPATIENT/OUTPATIENT VISITS

OPEN HEART SURGERIES

PATIENTS ENROLLED IN CLINICAL TRIALS

Affordable and Accessible MAKING CARE

We believe that accessing health care should be easy and affordable—because there’s nothing more important than our patients’ health!

FINANCIAL ASSISTANCE PROGRAMS help PATIENTS WITH COSTS

ChristianaCare is making it easier for patients to understand and pay their medical bills.

ChristianaCare patients in Delaware, Pennsylvania and New Jersey with primary health insurance can sign up for AblePay, a free consumer program that provides savings, flexible payment options and convenient ways to pay for out-of-pocket medical expenses.

We've also expanded and supported access to care for vulnerable patients by updating our Charity Care and Patient Financial Assistance policy. In 2023, ChristianaCare increased its financial assistance eligibility threshold to 400% of the federal poverty level. In addition, patients facing catastrophic costs from a health care episode can now apply for financial assistance with a reduced burden to provide supporting documentation.

DIGITAL CHECK-IN speeds PRACTICE VISITS

Rather than filling out paperwork in the waiting room, patients at a growing number of ChristianaCare practices now receive a text or email before their appointment with an online link to confirm their information and fill out forms.

As a result, digital intake forms have been completed ahead of time in more than 70% of eligible appointments — making the entire process more convenient for our patients and saving thousands of hours of work for our caregivers.

ACHIEVING quality AND affordability THROUGH VALUE-BASED CARE

ChristianaCare has a long-standing commitment to population health and value-based care, which is care that is designed to incentivize quality and patient experience. Unlike more traditional “fee-for-service” models in which providers are paid based on the tests or services they provide, in valuebased care arrangements, providers take on risk so that they are rewarded for delivering high-quality outcomes at lower costs — or they are penalized if they don’t deliver those results.

Here are some of the ways we are redefining health care delivery through our work in population health:

The ChristianaCare Clinical Alliance is a network of providers working together to provide high-quality, coordinated care and better patient outcomes while reducing the cost of care. Launched as a formal partnership in January 2023, the alliance includes clinicians from across the care continuum, a difference that sets it apart from other clinically integrated networks. As of Dec. 31, 2023, 1,643 clinicians have joined.

ChristianaCare is a founding member of the eBrightHealth Accountable Care Organization (ACO), which for the seventh consecutive year reduced health care costs for its beneficiaries. The ACO reduced spending by about $9.5 million in performance year 2022 while maintaining high-quality outcomes.

More than 6,500 older Delawareans are participating in a Medicare Advantage plan from Highmark Blue Cross Blue Shield of Delaware, together with ChristianaCare and Bayhealth. This collaboration reduces costs for seniors and improves care coordination, provider-patient experience and management of chronic conditions so that seniors can enjoy the important people and activities in their lives.

“WE ARE PARTNERING WITH CLINICIANS AND HEALTH CARE ORGANIZATIONS THROUGHOUT DELAWARE TO BE INCREASINGLY MORE SUCCESSFUL IN HELPING PEOPLE ACHIEVE OPTIMAL HEALTH.”

— CHRISTINE DONOHUE-HENRY, M.D., MBA CHIEF POPULATION HEALTH OFFICER

80% ADDRESSING THE OTHER OF HEALTH

It’s estimated that medical care accounts for only 20% of a person’s overall health outcomes — the rest is influenced by where they live, their environment and other conditions that make up their daily lives.

Stark differences in these factors, collectively known as social drivers of health, can lead to big differences in life-span and risk of disease.

ChristianaCare is leading the way and helping to be a catalyst in addressing these social drivers of health in the communities we serve.

FOOD IS good MEDICINE

If an apple a day keeps the doctor away, imagine what a whole menu of healthy foods can do.

The Delaware Food Farmacy, a partnership between ChristianaCare and Lutheran Community Services, is helping more than 200 Medicaid patients with gestational diabetes, poorly controlled type 2 diabetes, hypertension or congestive heart failure take control of their health. In Maryland, ChristianaCare collaborates with Hungry Harvest, a healthy online grocer, to deliver fresh groceries to more than 200 under-resourced Medicare patients with complex health needs.

Kim Solomon’s refrigerator is filled with local produce, eggs and meat from the Food Farmacy, but it’s community health worker Michelle Torres who keeps the Bear, Delaware, woman on the path to good health.

“It took me getting very sick to finally make my own health a priority in my life,” Solomon said. “Michelle has been very helpful with cooking, with support, with everything. This is not just about food — it is about friendship, and it really gives me motivation. It keeps me excited to hear her voice and know that she’s there for me.”

SOCIAL SCREENING helps IDENTIFY PATIENT NEEDS

ChristianaCare is asking adult patients about their lives to better understand how their experiences and environment affect their overall health. Patients in the hospital and in most primary care settings now complete a social drivers of health screening as part of their intake that asks about their access to food, transportation, housing and risk of interpersonal violence.

“It is difficult to be concerned about health care when some of our patients do not know where their next meal is going to come from,” said Sherry Mendez, LMSW, MPH, director, Community Health and Social Care Integration. “By screening for social drivers of health, we are often able to address these nonmedical needs and improve their overall health.”

As of January 2024, 21% of those screened indicated having at least one unmet social need. Caregivers from the Social Care Connection Center in the Department of Community Health follow up with these patients and connect them to available resources through the Unite Us social care platform.

PARTNERING TO boost THE HEALTH OF OUR COMMUNITIES

Since 2019, ChristianaCare’s Community Investment Fund has given over $4 million to nonprofit organizations to enhance their services. In 2023, ChristianaCare announced more than $1 million in new funding to 19 local nonprofits in Delaware, Pennsylvania and Maryland.

Among those organizations is Good Neighbors Home Repair, headquartered in Kennett Square, Pennsylvania, which will use the funding to expand its free home repair services to benefit more low-income households.

“Many of the houses that we repair belong to people who are coming home after a hospital discharge,” said Brad Dunn, advancement director for Good Neighbors Home Repair. By making these needed repairs at no charge, Good Neighbors enables people to stay safely in their homes. “We are deeply appreciative that ChristianaCare is supporting our efforts to provide services that keep our clients safe, healthy and at home.”

UNITING TO connect MORE PEOPLE TO SERVICES

In partnership with the national organization Unite Us, ChristianaCare operates Unite Delaware and Unite Maryland—online social care networks that are integrated with ChristianaCare’s electronic health record and can connect patients with local agencies and organizations to help with housing, food assistance, transportation and other nonmedical needs. The networks have expanded this year to 527 organizations throughout Delaware and Maryland—up from 140 organizations in fiscal year 2022.

Lutheran Community Services receives referrals through Unite Delaware for homelessness prevention, emergency financial assistance, smoking cessation and other essential patient needs.

“The only way collaboration works is if everyone knows what other partners are doing. The Unite Delaware system makes that possible,” said Rob Gurnee, executive director of Lutheran Community Services.

"IT'S ONE LESS THING TO WORRY ABOUT AND IT LETS YOU KEEP YOUR FOCUS ON WHAT MATTERS."

—ROSE WILLIAMS

Working through electronic referrals, the expanded Unite Delaware and Unite Maryland networks served more than 650 clients this fiscal year.

55%

INCREASE IN CASE VOLUME FOR HOUSING AND SHELTER SERVICES

117%

INCREASE IN THE NUMBER OF REQUESTS FOR FOOD ASSISTANCE

210%

INCREASE IN HELP NEEDED WITH THE COST OF UTILITIES

ROUNDTRIP KEEPS

PATIENTS motoring TO APPOINTMENTS

A lack of dependable transportation can prevent some patients from keeping their health care appointments. To address this barrier and reduce the number of missed appointments, patients can reach out to a caregiver who will help them explore their options, including bus passes, paratransit services and assistance from Roundtrip, an online ride booking platform. ChristianaCare funded 11,348 rides for 1,056 patients through Roundtrip in fiscal year 2023, an increase of more than 160% since July 2022.

Without transportation or close family nearby, a doctor's appointment for Rose Williams or her three children previously meant catching the bus or relying on someone for a ride. Thanks to Roundtrip, she doesn't have to.

HOPE CENTER PROVIDES respite FOR MEDICALLY FRAGILE PATIENTS

The Hope Center Medical Respite Program began in 2022 for patients who are too medically fragile to stay in a traditional homeless shelter but do not require inpatient hospital services. Through an agreement with New Castle County, ChristianaCare uses 36 rooms for medical respite. In an office on the sixth floor of the Hope Center, the staff, including Ben Golden, M.D., has handled more than 2,000 patient encounters. Betty McGlothlin spent more years than she would like to remember worrying about finding a place she could call home. After losing her motel room and suffering a bad case of

“BEING HOMELESS IS NOT FUN. IT’S LONELY, COLD, JUST A MESS. IT’S BEEN A JOURNEY BUT BEING HERE HELPED ME GET BETTER AND BACK ON MY FEET. NOW I LOOK A LOT BETTER. I GOT THE COLOR BACK IN MY FACE. I FEEL BETTER.”

—BETTY MCGLOTHLIN

Whether it’s at the bench or bedside, research is critical for ChristianaCare to provide quality health care in every medical specialty. We are using research to transform patient care through innovative treatments, delivery models and ways of working.

care treatments SERVING TOGETHER, THRIVING TOGETHER 2023

USING MACHINE-LEARNING TO improve BRAIN CANCER DETECTION

Through a machine-learning approach called federated learning, clinicians from different institutions can collaborate on important research without sharing private patient data — a discovery that has the potential to unlock data silos that currently exist in large multisite studies. Gaurav Shukla, M.D., Ph.D., a radiation oncologist and research clinician at the Graham Cancer Center, was part of a global machine-learning study that demonstrated federated learning has the ability to improve the detection of malignant brain tumors by 33%. Federated learning trains a machine-learning algorithm across multiple decentralized devices or servers without exchanging the sensitive information.

DISCOVERY MAY LEAD TO MORE precise TREATMENTS FOR COLORECTAL CANCER

Researchers at ChristianaCare’s Cawley Center for Translational Cancer Research at the Helen F. Graham Cancer Center & Research Institute have demonstrated for the first time that microRNA (miRNA) expression leads to a diversity of cancer stem cells within a colorectal cancer tumor. The findings broaden the understanding of how miRNA expression adds to cancer stem cell diversity and may lead to more precise anticancer treatments for patients with advanced colorectal cancer. The research builds on prior discoveries by scientists at the Graham Cancer Center about how cancer stem cell activity contributes to the development and spread of colorectal cancer.

USING CRISPR GENE EDITING TO advance CANCER TREATMENT

The Gene Editing Institute’s translational team is investigating how best to use CRISPR-directed gene editing to overcome cancer drug resistance that develops in virtually all solid tumors. This research is ultimately aimed at improving the effectiveness of chemotherapy for some cancers, including lung cancer. Data from animal models show that tumors that have undergone gene editing grow much more slowly and exhibit increased sensitivity to anticancer drugs and an increase in survival. The researchers are also working on establishing a plug-and-play model with this approach to treat other cancers. The Gene Editing Institute, working with its spin-out company CorriXR Therapeutics, will seek approval from the FDA to start clinical trials in humans in 2025.

A learning LAB LIKE NO OTHER

When Pauline Zhuang and her classmates from the Charter School of Wilmington visited the Gene Editing Institute’s Learning Lab on the University of Delaware’s STAR campus, they quickly realized this field trip wasn’t like most.

In the immersive, hands-on space, students spread bacteria over agar plates. They practiced measuring liquids using a micropipette. They tackled a real-life gene editing experiment using the Gene Editing Institute’s innovative CRISPR in a Box™ educational toolkit.

The goal of the Learning Lab is to break down barriers that keep students from pursuing science as a career. The Gene Editing Institute hopes to educate 1,000 students by spring 2024.

“MY CLASSMATES AND I HAVE BEEN ABLE TO EXPERIENCE FIRSTHAND WHAT IT IS LIKE TO ACTUALLY DO GENE EDITING.”

—PAULINE ZHUANG, CHARTER SCHOOL OF WILMINGTON STUDENT

great

FOSTERING A PLACE TO WORK

At ChristianaCare, we are proud to be nationally recognized as a great place to work. We understand that by creating an environment in which every caregiver has the opportunity to thrive, we enable our caregivers to be at their very best for our patients.

ChristianaCare continually invests in technologies, services and benefits that support our workforce and enable them to work top-of-license while creating exceptional experiences for everyone we serve.

BUILDING A diverse WORKFORCE

At ChristianaCare, we recognize that when our workforce reflects the diversity of the communities we serve, it helps our patients feel welcomed and respected, and ultimately leads to better care.

Here are a few examples of how we’re working to grow and strengthen the diversity of our workforce pipeline:

Camp Scrubs, a partnership with Cecil College and Union Hospital, shows tweens and teens what it’s like to be a health care professional and helps them understand the important role of medical care within a community.

Through the Nursing Career Collaborative, students from William Penn High School get visits from ChristianaCare nurses, take field trips to specialty and inpatient units at Christiana Hospital and even meet one-on-one with a recruiter to learn what to expect in a job interview.

Nearly two dozen caregivers have challenged themselves with a new career after graduating from the Medical Assistant Academy, created by the ChristianaCare Medical Group in partnership with Delaware Technical Community College.

Five early-career ChristianaCare physicians were honored with the inaugural Harrington Minority Physician Award, recognizing their commitment to advancing health equity through their clinical work, mentorship and academic service.

Eight students attending Historically Black Colleges and Universities spent the summer at ChristianaCare as part of its Future of Health scholarship program. In 2022, ChristianaCare committed to providing $500,000 in support to 10 high school graduates, along with a paid internship each summer while they are in college.

“MY MOTIVATION IS TO PROVIDE CONTINUOUS SUPPORT TO OUR PATIENTS AND THEIR FAMILIES SO THAT CHRONIC DISEASES ARE MANAGED ALONG WITH SOCIAL DETERMINANTS OF HEALTH. THROUGH MY WORK I WANT TO CREATE A MORE LIVABLE COMMUNITY.”

BRIDGET PETERS, M.D., PH.D. FAMILY MEDICINE CENTER AT WILMINGTON PRIMARY CARE

VIRTUAL NURSING: personalized SUPPORT THROUGH TECHNOLOGY

More than 2,000 ChristianaCare hospital patients have experienced virtual acute-care nursing, an innovative program that enables nurses to meet with hospitalized patients virtually using an iPad to take their patient histories, oversee education and discharge instructions, monitor labs and talk with family members. The virtual nurse works as part of the care team with the in-person bedside nurses and is able to focus on these time-intensive conversations with the patient without distractions, freeing the bedside nurses to manage the other aspects of care.

“As virtual nurses who have experience at the bedside, we understand what patients need, and we understand what the staff needs,” said Melanie Ries, RN, MEDSURG-BC, who works as a virtual nurse. “We are an extra resource.”

WHAT IT MEANS TO SERVE together

More than 1,400 caregivers are part of employee resource groups (ERGs) at ChristianaCare, a 39% increase this year. ERGs promote an inclusive experience engaging all caregivers to unleash their potential. Our 11 ERGs connect caregivers who share a common interest or bond with one another — with tangible ways to bring our whole, authentic selves to work such as community service, professional development and heritage celebrations. ERGs are part of ChristianaCare’s nationally recognized commitment to diversity and inclusion.

FLOURISHING FRAMEWORK MEASURES CAREGIVER well-being AND SUPPORTS NEW SKILLS

Our Center for WorkLife Wellbeing offers caregivers the assistance they need to provide safe, effective care to our patients.

At ChristianaCare, our goal is enabling every caregiver to thrive. To make that happen, we’ve developed the Flourishing Framework, which identifies five essential components for workplace health and well-being, based on the surgeon general’s framework for workplace mental health and well-being.

We are asking our caregivers to rate our performance in these areas through a measurement that we are calling the Flourishing Index. This index will help us track how we’re doing and how we can continue to create an environment that enables every caregiver to thrive.

In 2023, we were honored as:

• A Best Employer for Diversity and Inclusion in the U.S. by Forbes for the second consecutive year.

• The No. 1 health care employer and No. 6 employer overall for veterans in the U.S. by Forbes.

• A Top 100 Company with Inclusive Benefits by Mogul.

Protection from harm

Connection and community

Work-life harmony

Mattering at work

Opportunity for growth

ENSURING

CAREGIVER safety IN THE WORKPLACE

To further support the safety of our caregivers, an interprofessional team of caregivers is leading efforts to prevent workplace violence and preserve security and safety throughout ChristianaCare. The team’s focus aligns with leading practices in workplace violence prevention, including establishing a foundation for zero tolerance, focusing on prevention, expanding education and training for all caregivers, responding to and learning from events, and providing support for our caregivers. This year, there was a 54% increase in caregivers trained in de-escalation skills.

PATIENTS thank THEIR CARE TEAM THROUGH THE THANKYOU PROJECT

Through the Thank You Project, a program of the Center for WorkLife Wellbeing and Patient Experience, patients and their loved ones who were touched by the kindness and caring they experienced during their hospital stay have the chance to reunite with caregivers and care teams at ChristianaCare to express their gratitude. Caregiver-patient reunions serve as reminders of the things that truly matter.

Eastern Shore resident Gretchen Dejter reached out to ChristianaCare to thank caregivers who saved her life after a blood vessel ruptured in her brain. Despite the challenges her mother faced at the time, Megan Dejter said she was confident she was in the best place to recover. “I felt like I was leaving her with my best friends. They were so sweet and so caring,” she said.

Educating THE HEALTH CARE

PROFESSIONALS OF TOMORROW

As the largest academic medical center between Philadelphia and Baltimore, ChristianaCare plays a key role in educating future physicians. Our staff includes nearly 400 residents and fellows across more than 30 specialties, including 105 new residents and fellows who were welcomed in June 2023.

ChristianaCare serves as a branch campus for Sidney Kimmel Medical College of Thomas Jefferson University and the Philadelphia College of Osteopathic Medicine. In the last 10 years, approximately 220 medical students have come through our branch campus. More than half have a direct Delaware connection.

Our strong reputation for graduate medical education was bolstered by the federal Consolidated Appropriations Act, which awarded ChristianaCare some of the first direct and indirect medical education slots distributed to teaching hospitals nationwide.

love + generosity = impact

Philanthropy takes many forms, but at its core is love. Thank you to the ever-growing circle of donors who create life-changing possibilities in our communities through your compassion and generosity.

HITTING THEIR stride IN THE FIGHT AGAINST CANCER

More than 330 people laced up their shoes at Bellevue State Park in Wilmington for the Friends of the Helen F. Graham Cancer Center & Research Institute 5K Run/ Walk, which raised more than $155,000. Proceeds from the event go toward the purchase of Neoprobes, a vital resource in the early detection and treatment of breast cancer. The Friends have raised more than $3.7 million since 2002.

GOLF CLASSIC HITS milestone IN FUNDRAISING

Thanks to nearly 200 golfers at the DuPont Country Club in Wilmington, the annual ChristianaCare Golf Classic raised more than $200,000 for ChristianaCare — the highest amount at this event to date. The 32nd annual Golf Classic featured 53 sponsors, including Presenting Sponsor OC Reilly, and 18 new participating companies who hit the links to support ChristianaCare programs and services.

DONOR generosity IMPROVES CANCER CARE

We are grateful for the generosity of our donors, whose selfless giving impacts the care of patients across our health system. Here are two examples of giving:

• A $1 million gift from the Bacchieri family will support the purchase of a state-of-the-art radiography system to analyze breast cancer specimens at the Graham Cancer Center and expand a fellowship program to reduce disparities in breast and lung cancer. Pathologists at the Graham Cancer Center will be able to process approximately 2,000 breast cases per year, 500 more than before.

• The Breast Center at the Graham Cancer Center has been named the Tatiana Copeland Breast Center in recognition of Gerret and Tatiana Copeland’s generous financial support.

Please visit Giving.ChristianaCare.org or call 302-327-3305 to make a gift to any ChristianaCare program or service.

RAISED BY THE FRIENDS OF THE HELEN F. GRAHAM CANCER CENTER & RESEARCH INSTITUTE SINCE 2002

WORKFORCE TRAINING PROGRAM OFFERS TEENS PATH TO HEALTH CARE careers

A $100,000 grant from JPMorgan Chase is helping ChristianaCare strengthen its commitment to building a diverse and inclusive workforce through a youth employment program. Health Impacts is a yearlong pilot program designed to connect Wilmington teens ages 16 to 18 with career opportunities and pathways in health care. An intensive training program during the summer and a nine-month paid internship will culminate with permanent employment at ChristianaCare. During the pilot, teens will get additional career coaching from ChristianaCare caregivers and participate in work-based learning assignments to help them develop skills and build relationships.

PUTTING THE ‘fun’ IN FUNDRAISING FOR PEDIATRIC CARE CENTER

If anyone knows how to have a good time while raising money for a good cause, it’s the Junior Board of ChristianaCare. This year’s annual fundraiser, JB Cause, was held at the Newark Campus and featured a memorable evening of shopping, music, raffles, tasty food and more. At the end of the night, attendees raised $85,000 to benefit the Pediatric Care Center, which meets the unique health care needs of children and adolescents in our area.

UNION HOSPITAL AUXILIARY supports HEALTH IN CECIL COUNTY

The Union Hospital Auxiliary is known for its thoughtful giving and volunteering through its operation of the Gift Shop, the Good as New Shop thrift store and hospital vending machines. Their selfless work has resulted in a $120,000 donation to Union Hospital to advance several health projects, including renovation of the Family Birth Center, behavioral health services and renovation of the Breast Health Center.

Supporting HEALTHY MEALS DURING PREGNANCY

A $50,000 grant from the Edna G. Kynett Memorial Foundation will help implement a pilot program supporting pregnant patients and their families. The program will provide high-quality groceries critical for a healthy pregnancy, as well as meals for their family members. In addition, ChristianaCare will provide culinary equipment, skills training and culturally relevant recipes from a multidisciplinary team.

Expansion OF HEALTH LITERACY PARTNERSHIP

ChristianaCare received an $80,000 grant from Highmark Blue Cross Blue Shield Delaware to support the Health Literacy Council of Delaware. Funded through Highmark’s BluePrints for the Community program, the grant will be used to fund education and awareness for clinicians and other caregivers on best practices in making health care information easier for patients to understand. In addition, ChristianaCare will provide education in the community to increase health literacy and enable people to make informed, healthy choices.

HealthEveryone for

ChristianaCare’s long-term strategic plan includes this bold aspiration: End disparities.

“As an industry, we’ve long talked about the concept of ‘zero harm’ as something that’s imperative and achievable, and it has helped us make great strides in quality and patient safety,” said ChristianaCare President and CEO Janice E. Nevin, M.D., MPH. “It’s time we started talking about ‘zero disparities,’ because we find that when we solve for disparities, we often tend to get health care right for everybody.”

ChristianaCare has committed to identifying and eliminating health disparities throughout the communities we serve.

WE ASK because WE CARE

Arnell Puckham is a community service specialist who schedules patient appointments in Cecil County, Maryland. When talking with patients, he asks the same four questions: what name they prefer to use, their gender identity, their biological sex on their birth certificate and their sex on their state ID.

For Puckham, it’s another way to show patients care and respect. It’s a model also recommended by the National Institutes of Health, the Centers for Disease Control and Prevention, the American Academy of Pediatrics, the American Academy of Family Physicians and other leading organizations.

“I’m proud to be a part of an organization that cares deeply about understanding and addressing the unique needs of every individual we serve,” Puckham said. “This approach reflects our dedication to providing thoughtful and comprehensive care to diverse patient populations. It demonstrates a commitment to personalized and equitable health care.”

BRINGING SPIRITUAL HISTORY into CARE PLANS

The Supportive and Palliative Care team has increased the percentage of spiritual histories completed as part of a plan of care. Spiritual history documentation completion increased to 49% and the percentage of surveyed caregivers who reported initiating conversations with patients regarding their wish for spiritual discussion increased to 60%.

Healthy ENVIRONMENT, Healthy PEOPLE

An unhealthy environment makes people sick — including illnesses from air pollution and contaminated water, injuries and premature death from extreme weather, and the complex health impacts of climate change, which the medical journal The Lancet has called “the greatest global health threat facing the world in the 21st century.”

As one of the nation’s leading health systems, ChristianaCare recognizes the important link between health and the environment and is taking a bold, comprehensive approach to environmental stewardship. Actions we took in 2023 included:

• Advanced work on the White House Climate Pledge to procure 100% renewable energy by 2025, reduce greenhouse gas emissions by 50% by 2030 and achieve net zero emissions by 2050.

• Created an Environmental, Social and Governance structure to help advance our five-year strategic plan to put us on a course to meet these goals.

• Established the Environmental Sustainability Caregiver Committee and Eco-Champion program, giving all caregivers the opportunity to be environmental change-leaders in their workplace.

• Reduced our carbon footprint by 37% by purchasing emission-free electricity.

• Recycled 96,663 pounds of paper, which preserved 11,485 trees.

• Reduced air pollution by releasing an estimated 33,000 fewer pounds of nitrogen oxides and sulfur oxides through the use of our cogeneration energy plant on our Newark campus.

• Donated 34,095 pounds of unused food to the Sunday Breakfast Mission in Wilmington.

• Donated 1,575 pounds of unused medical equipment to Project C.U.R.E., ChristianaCare’s Virtual Education and Simulation Training Center and Delaware Technical Community College.

“I AM SO PROUD TO BE PART OF AN ORGANIZATION THAT IS TAKING THE PROACTIVE STEPS NOW TO PROTECT OUR ENVIRONMENT AND THE HEALTH OF OUR COMMUNITY GOING FORWARD.”

DEANNA BENNER, MSN, APRN, CO-CHAIR, ENVIRONMENTAL SUSTAINABILITY CAREGIVER COMMITTEE

Increasing HEALTH EQUITY IN KIDNEY CARE

A multidisciplinary team at ChristianaCare eliminated race from the estimate of kidney function and evaluated its impact on improving equity in the detection of abnormal kidney function in Black patients. The revised equation led to a statistically significant increase in the percentage of Black patients diagnosed as having an abnormal kidney function and reduced the difference compared to non-Black patients, improving health equity. This project was the winner of the People’s Choice Award in this year’s ChristianaCare Way Awards.

Reducing DISPARITIES IN BREASTFEEDING

Caregiver-led efforts in the neonatal intensive care unit (NICU) to use standardized practices for colostrum and maternal breastmilk feedings are also helping to eliminate racial disparities in maternal milk usage among very low birthweight infants. As a result, 45% of Black mothers with infants in the NICU used maternal breastmilk instead of formula over a 15-month period, up 11% from the project’s start. The use of maternal breast milk is an evidence-based practice associated with enhanced immune status, reduced risk of sepsis, improved growth and other benefits.

RESEARCHERS identify DISPARITIES IN BREAST CANCER SCREENING LOCATIONS

A first-of-its-kind study by researchers from the Helen F. Graham Cancer Center & Research Institute found geographic and racial disparities in the location of mammography screening sites in Delaware. The study, published in Breast Cancer Research, found rural areas and locations with higher populations of Black residents in the state have less access to mammography units and Breast Imaging Centers of Excellence (BICOEs). Researchers also identified potential locations for new mammography facilities to increase equitable access.

Black women also are disproportionately affected by triple-negative breast cancer (TNBC). Preliminary evidence suggests the benefits of screening mammography extend to early detection of TNBC.

A separate commentary published in the Population Health Management journal called upon community members, health care providers and other stakeholders in Delaware to collaborate to address disparities in breast cancer, just as they did to successfully erase the racial disparities in colorectal cancer in the First State.

“WE’RE DOING THIS BECAUSE DELAWARE IS NUMBER FOUR IN THE INCIDENCE OF BREAST CANCER IN THE UNITED STATES AND NUMBER ONE IN THE INCIDENCE OF TRIPLE-NEGATIVE BREAST CANCER IN THE UNITED STATES,” DAWN LEONARD, M.D.,

BREAST SURGEON AT THE GRAHAM CANCER CENTER

triple-negative breast cancer

WE SERVE TOGETHER WITH

Love & Excellence

We commit to being exceptional today and even better tomorrow. We seek new knowledge, ask for feedback and are open to change. We use resources wisely and effectively. We are curious and continuously look for ways to innovate. We are true to our word and follow through on our commitments. We anticipate the needs of others and help with compassion and generosity. We embrace diversity and show respect to everyone.

We listen actively, seek to understand and assume good intentions.

We tell the truth with courage and empathy. We accept responsibility for our attitudes and actions.

Best of the Best!

ChristianaCare continues to earn national recognition for quality and safety.