Download Urban Health Issues - University of Detroit Mercy

Urban Health Issues:
Impact of the Affordable Care Act
A Southeast Michigan Community Focused Healthcare
Symposium
University of Detroit Mercy in The Fitness Center
4001 W. McNichols, Detroit, MI 48221
College of Health Professions
Friday, April 4, 2014
7:30 AM-12:30 PM
Continuing Education Accreditation
Nurse Continuing Education Contact Hours: Henry Ford Health System Nursing Development (OH 312, 11/1/2015) is an
approved provider of continuing nursing education by the Ohio Nurses Association (OBN-001-91), an accredited approver by
the American Nurses Credentialing Center’s Commission on Accreditation.
ACHE Face to Face Credits: This program has been developed and is presented locally by MCACHE (formerly MHEGA). The
American College of Healthcare Executives has awarded 1.5 ACHE Face-to-Face Education Credits for each session.
CME Credits for Physician Assistants: The program is approved for 3.25 hours of AAPA Category I CME credit from the
Physician Assistant Review Panel.
CE Statement: Criteria for successful completion are attendance at entire lecture and completion/submission of evaluation form.
The planners and faculty for this program have no conflict of interest to disclose.
Co-Sponsors:
Welcome
Dear Honored Guests, Colleagues and Students,
Please accept my sincere and heartfelt welcome to the University of Detroit Mercy (UDM) as we
participate in the Urban Health Issues: Impact of the Affordable Care Act. This event demonstrates
the favorable impact that interprofessional dialogue can have on improving the well-being and
health outcomes for citizens in our community. As an academic partner, the UDM College of Health
Professions is pleased that we are co-sponsoring this program with the Midwest Chapter of the
American College of Healthcare Executives. The conference planning committee has executed an
outstanding program that is designed to engage participants in thoughtful reflection and provoke
new ideas for health care delivery during this time of national, regional and local transformation.
We hope that you have the opportunity to engage in discussion with a wide range of colleagues and
that you take some time to meet with students and review some of the posters that they have
prepared during the course of their classes here at the university. We thank you for joining us at this
event and sincerely hope that you enjoy the conference.
Christine M. Pacini, PhD, RN
Dean and Professor
College of Health Professions
McAuley School of Nursing
UDM Mission Statement:
The University of Detroit Mercy, a Catholic university in the Jesuit and Mercy traditions, exists to
provide excellent, student-centered, undergraduate and graduate education in an urban context. A UDM education seeks to
integrate the intellectual, spiritual, ethical, and social development of our students.
UDM Vision Statement:
The University of Detroit Mercy will be recognized as a premier private university in the Great Lakes region, distinguished by
graduates who lead and serve in their communities.
College of Health Professions Mission:
The College of Health Professions, in the Mercy and Jesuit traditions, prepares professionals to lead individuals, families, and
communities to optimal health and well being.
College of Health Professions Vision:
The College of Health Professions is an Urban Center of academic excellence that prepares graduates to lead and serve the
complex health care needs of our local and global communities and will be recognized for leadership and innovation in higher
education.
Acknowledgement
The recent federal legislation concerning health care reform has resulted in significant changes throughout the health care
community, especially in the delivery and reimbursement of services provided to those populations who have been uninsured,
underinsured and underserved.
A significant portion of the urban population in Southeast Michigan faces many obstacles to staying healthy. Ranking counties in
Michigan for social and economic factors that influence health, the Robert Wood Johnson Foundation ranked Wayne County last
among counties in Michigan for social and economic factors. The low Medicaid reimbursement and poor access to prescription
medications also negatively impacts the health of the urban population. The State of Michigan Community Health website states
the rate of mortality in all categories was lower in Wayne County in comparison to the rates in these categories for the state.
To address urban health issues, faculty of the College of Health Professions at the University of Detroit Mercy and members of
the Midwest Chapter of the American College of Healthcare Executives met with leaders from several local health organizations
concerned about the health of the urban population. Our goal in planning this conference is to bring attention to this population
and provide you with updated information about the state of urban health issues.
Please acknowledge the outstanding sponsors of this conference for their support and continued search for providing quality
care to the citizens in our community:
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Henry Ford Health System
Greater Detroit Area Health Council
Michigan Organization of Nurse Executives
National Association of Health Services
The American Academy of Physician Assistants
Trinity Health
Keynote Speaker:
Nancy M. Schlichting, MBA,
CEO Henry Ford Health Systems
Nancy Schlichting is Chief Executive Officer of Henry Ford Health System (HFHS), a nationally recognized
$4.5 billion health care organization with 24,000 employees and recipient of the 2011 Malcolm Baldrige National Quality Award. She is credited with leading the health system through a dramatic financial turnaround
and for award-winning patient safety, customer service and diversity initiatives.
Schlichting joined HFHS in 1998 as its Senior Vice President and Chief Administrative Officer and was named
President and CEO in 2003. Her career in health care administration spans 30 years of experience in senior
level executive positions.
Schlichting serves on national and community Boards: The Kresge Foundation, Walgreen Company, Federal
Reserve Bank of Chicago – Detroit Branch, Detroit Regional Chamber, Greater Detroit Area Health Council,
Citizen’s Research Council of Michigan, Detroit Economic Club, Downtown Detroit Partnership, America’s
Essential Hospitals and the United Way of Southeastern Michigan Cabinet.
Schlichting’s most recent awards include: Becker's Hospital Review “130 Nonprofit Hospital and Health System CEOs to Know”, Modern Healthcare “100 Most Influential People in Healthcare-2013” (named for a sixth time), 2013 Becker's Hospital
Review Annual Healthcare Leadership Award, Modern Healthcare “Top 25 Women in Healthcare - 2013” (named for a third time), Crain’s Detroit Business “2012 Newsmaker of the Year”, HealthLeaders Media “20 People Who Make Healthcare Better-2012, Becker’s Hospital Review
“50 Most Powerful People in Healthcare,” Modern Healthcare “100 Most Powerful People in Healthcare,” The Harvard Business School Club of
Michigan “Business Leader of the Year,” Ernst & Young “Spirit of Entrepreneurship Award,” Modern Healthcare “Top 25 Women in
Healthcare” (named for a second time), Becker’s Hospital Review “Women to Know in Health Care,” Michigan Health & Hospital Association “
Meritorious Service Award,“ Crain’s Detroit Business “Women to Watch,” WJR “Women Who Lead,” Crime Stoppers “Eleanor Josaitis Visionary
Leader,” Vanguard Community Development “E. L. Vann Visionary,” Detroit’s Ambassador Magazine “Power Player” and Health Care Weekly
Review “Health Care Executive of the Year.”
Schlichting received her A.B. in Public Policy Studies, Magna Cum Laude from Duke University and her M.B.A. from Cornell University. She has
also been the recipient of honorary degrees from Walsh College and Central Michigan University.
Program Moderator:
Mary Ellen Howard, RSM, BSN, MA,
Executive Director, St. Francis Cabrini Clinic
Sister Mary Ellen Howard is the Executive Director of the St. Frances Cabrini Clinic of Most Holy Trinity
Catholic Church, the oldest free medical clinic in the nation, providing primary care to uninsured poor persons, located in southwest Detroit. For over 20 years Sister Mary Ellen served as a health care administrator
in Mercy hospitals across Michigan, including as CEO in Grayling and Muskegon.
Sister Mary Ellen currently serves on the Advisory Board Vice Chair for Jordan Health Center at Marcus Garvey Academy (DPS), a school-based health center. She is the founding member of Steering Committee of
the La Vida Domestic Violence Program, and is on the McAuley School of Nursing Advisory Board, University of Detroit Mercy. In addition, Howard is the Board President of Free Clinics of Michigan as well as a
Board member of the Detroit Wayne County Health Authority, the Greater Detroit Area Health Council and
Michigan Consumers for Healthcare representing Free Clinics of Michigan.
Howard’s most recent awards include: Badger of the Year – Motor City Badgers, U of Wisconsin Alumni
Association, Susan B. Anthony Award – U of M Dearborn Commission on Women, Community Champion
Award – Molina Healthcare of Michigan, Kern Foundation Annual Award, Community Champion Award, Eagle Award for Visionary Leadership – Greater Detroit Area Health Council, Best of Safety Net Award – Detroit Wayne County Health Authority. Sister Mary Ellen Howard
earned her BSN at Mercy College of Detroit, her Masters in Health Care Management from the University of Wisconsin School of Business at
Madison, and was conferred an honorary Doctor of Humane Letters from the University of Detroit Mercy.
Panel I: The Clinician/Care Provider Perspective
Panelists:
James D. Forshee, MD, MBA- Dr. James D. Forshee is Vice President, Medical Affairs & Chief Medical Officer at
Molina Healthcare of Michigan. In this role, Dr. Forshee is responsible for medical management with oversight
responsibilities for utilization management, quality improvement, credentialing, pharmacy, and risk management
activities. Dr. Forshee received his MBA degree from the University of Michigan and his MD degree from Michigan State University. He is Board Certified in Family Practice.
Carla Groh, PhD, RN, PMHNP-BC– Dr. Groh has been at UDM since 1996 teaching within all the programs in the
College of Health Professions. Her primary teaching interests include research methods, health policy and women's studies. In addition to teaching, Dr. Groh is a certified nurse practitioner in psychiatric/mental health nursing
and practices at the McAuley Center. She earned her BSN and MSN from Wayne State University in adult psychiatric/mental health nursing and her PhD in nursing from University of Michigan.
John McGinnity, M.S., P.A.-C– Mr. John G. McGinnity is a Clinical Associate Professor at Wayne State University,
where he is a course coordinator and lecturer in Physician Assistant Studies and the Physical Therapy Program. Mr.
McGinnity is President-Elect of the American Academy of Physician Assistants and is a Past President of the Michigan Academy of Physician Assistants. Mr. McGinnity serves on the editorial board of Advance for NP’s & PA’s and
has authored or co-authored numerous articles in such journals as the American Journal of Cardiology, Circulation, JAAPA and Advance for NPs and PAs.
Panel II: The Financial Perspective
Panelists:
Chris Allen, FACHE-Executive Director/CEO Detroit Wayne County Health Authority. Mr. Chris Allen, the first Executive Director of the Detroit Wayne County Health Authority, has health care and hospital administration expertise that spans more than 35 years. Mr. Allen pioneered the award-winning Family Road Program, providing prenatal and health education services to more than 184,000 young mothers throughout the City of Detroit. Mr. Allen is a Fellow of the American College of Health Care Executives and Chairman of the Catholic Medical Mission
Board.
Joy Calloway, MHSA, MBA-Ms. Calloway currently serves as President and Chief Executive Officer of New Center
Community Mental Health Services in Detroit, MI. Ms. Calloway earned degrees from the University of Michigan
in Organizational Psychology (BA), Health Services Management/Policy (MHSA) and Human Resources (MBA).
She has been active in the National Black MBA Association and is a member of Delta Sigma Theta Sorority, Incorporated. Ms. Calloway is the recipient of the American Business Womens’ Association (Concepts Chapter) “Boss
of the Year” Award.
Kate Kohn-Parrott, MBA, CMA, CIA– Ms. Kate Kohn-Parrott was appointed president and CEO of GDAHC in January 2012. Ms. Kate Kohn-Parrott holds a master's degree in business administration (MBA) from the University of
Detroit Mercy and a bachelor's degree in business administration (accounting) from Eastern Michigan University.
She is a Certified Management Accountant and a Certified Internal Auditor. Kate is Chair of the Board of Visitors
of the Wayne State University College of Nursing, and a member of the HR Committee at the Detroit Institute of
Arts.
ABSTRACTS
Carla J. Groh, PhD, PMHNP-BC, FAAN
Funded by Blue Cross Blue Shield Michigan Foundation
Carla Groh, PhD, PMHNP-BC, FAAN, Katherine Moran, DNP, CDE,
Brooke McConnell, BSN Student, & Angelia Lee, BSN Student
A Life-Style Change Program for Obese Urban Women:
Exploring the Relationship between Diabetes Mellitus, Depression,
The Integration of Exercise, Nutrition and Spirituality
Self-Efficacy and Glycemic Control in an Urban, Minority Population
Purpose: To determine if a program that integrated chair exercises, nutritional and educational counseling would help obese urban African American women make positive lifestyle changes.
Methods: Six cohorts completed the lifestyle program with the first cohort
starting in September 2008 and the sixth cohort ending in April 2011. Ninety-four women (mean age 48.7; SD 9.4) attended at least one session; the
average number attended was 14.1 (SD 8.3).
Data were collected at baseline, 4, 8, 12, and 24-weeks for waist circumference, BMI, systolic and diastolic blood pressure; and at baseline, 12 and 24
-weeks for hemoglobin A1C, lipids, and SF-36.
Findings: Repeated measures of variance were calculated to determine
statistical significant between the data entry points. Difference were detected for BMI (p=.011); systolic blood pressure (p=.031); waist circumferences (p=.000); total cholesterol (p=.008) and hemoglobin A1C (p=.046).
The mental component summary of the SF-36 improved from baseline to
12-weeks but dropped at 24-weeks. The physical component summary
score did not vary over the three data collection points.
Implications: The lifestyle program was a cost effective intervention in
helping women make lifestyle changes that resulted in statistically significant improvements in several of the outcome variables.
Background: Evidence suggests that depression and low self-efficacy are
associated with worse glycemic control in adults with diabetes, but the
relationship is poorly understood. Moreover, many of the studies conducted have been with white and/or middle class samples. This leaves a
gap in the knowledge about the relationship of these variables in an urban/primarily minority population.
Purpose: To determine if there is a relationship between depression, selfefficacy and glycemic control in diabetes patients in an urban setting and
to identify strategies that improve outcomes.
Methods: A mixed-method design was used. Volunteers were recruited
from McAuley Health Center using the following criteria: ≥18 years old;
T1/T2 diabetes for ≥1 year; ability to read English; two documented A1c
measurements; willingness to complete surveys and participate in a focus
group.
Results: The most recent data will be presented on the study measures:
depression and self-efficacy questionnaires, focus group themes, and A1c
measures.
Significance: To expand the knowledge of the role that depression and self
-efficacy has in glycemic control.
ABSTRACTS
Dane Adams BSN student & Kathryn Adams DPT
Tracy Threat, MS, FNP-BC, Bhavi Shah, MHS, Clinic Manager &
Carla Groh, PhD, Project Director
Continuing the Ongoing Diversity of Healthcare Experiences for
McAuley Health Center:
University of Detroit Mercy Students by Health Education of
Challenges, Opportunities and Lessons Learned in an Urban Clinic
Urban Populations
Introduction: McAuley Health Center (MHC), a community outreach of the
University of Detroit Mercy McAuley School of Nursing, opened in 2002
with funding from HRSA. MHC is a nurse managed clinic located on the
east side of Detroit, and provides primary care from birth to death for underinsured Detroiters primarily residing on the east side of Detroit.
The Better Men Outreach (BMO) program was created in 2009 for men
over 16 years old. The mission is to enhance the physical, social, and ethical growth of young men and to improve the surrounding communities.
Being an advisor, I had noticed a shortfall in the healthcare component of
this program. The local community’s lack of access to free health information and healthcare resources warranted a critical need for awareness.
In collaboration with several metro Detroit healthcare organizations, a
local parish, the BMO program and University of Detroit Mercy, I designed
a free community health fair. The fair was able to reach out to not only
the BMO men, but also local residents, men and women from the Neighborhood Service Organization (NSO) and University of Detroit mercy faculty and students. Topics included physical activity, diabetes, advanced directives, blood pressure and Stress. There was also a presenter on the
government health insurance marketplace helping to enroll individuals.
Purpose: The purpose of this poster is four-fold: (1) summarize the history of nurse managed centers in Michigan; (2) describe the evolution of
MHC over the past ten years; (3) identify the challenges and opportunities
encountered working in an urban setting with a vulnerable and underinsured population; and (4) illustrate creative programs and community partnerships that have been implemented at MHC that have resulted in improved patient health outcomes.
ABSTRACTS
Natalie Dumais, BSN student, Kaitlyn Kus, BSN student,
Andrea Kwasky DNP, & Catherine Corrigan, DNP
Practicing Self Awareness within an Urban Context: A Model for
Educating Future Nurses
Vulnerable groups (political, social, economic – the aged and mentally ill)
are particularly disempowered. Typically, they are less likely to have a
voice or be formally represented. Social exclusion and stigmatism can be
problematic for the vulnerable. Service learning affords students the
experience to come face to face with social issues that shape how they
care for those most at risk within our society. The Ford Community Corp
Partnership has provided a unique experience for two junior nursing
student leaders to mentor sophomore nursing students through a multisite
service learning experience. The student leaders were present in the
classroom and the community to assist students to utilize their service
learning experiences to understand vulnerable populations, diversity,
social justice, and become more self-aware of their own attitudes and
beliefs. These are lessons that become the core of the University of Detroit
Mercy nursing curriculum as students focus on relationship-based care in
an urban context.
LeTrice Nash, MSN, RN
A Systematic Review of Delegation and School Nurses:
Perceptions, Training and Supervision of Unlicensed Assistive Personnel
The increased numbers of children with chronic diseases in schools, budget constraints, and school nurse shortages have affected school nurse to
student ratios (NASN, 2010a). Due to these factors, schools have choice
but to delegate many traditional nursing services to unlicensed assistive
personnel (UAP’s) (Resha, 2010). There are clinical, legal, financial and
educational issues related to delegation in schools. This systematic review
found that delegation to UAP’s in the school setting is a concern to school
nurses; policies related to medication administration in schools vary widely; there is limited literature on best practices on training and supervision
of UAP’s; and there are no studies that demonstrate whether delegation
to UAP’s in schools is safe or effective. This poster emphasizes the need for
greater understanding of delegation to UAP’s among school nurses and
more research is required to ensure that school nurse delegation to UAP’s
is safe and effective in schools.
ABSTRACTS
Mitzi M. Saunders, RN, PhD, ACNS-BC
Elaine Webber DNP, PPCNP-BC, IBCLC & Jean Benedict RN, BSN, IBCLC
Clinical Nurse Specialist, the Bridge for Patients to System, Nurses
to System, and Nurses to Patients: Findings of a Qualitative Study
Promoting Infant Health: Improving Access to Breastfeeding
Support Services for Underserved Populations
The Clinical Nurse Specialist (CNS) has faced a history of difficulty
articulating the benefits of this role. Documenting the work and
outcomes of CNSs is crucial to support the role in the future of
health care reform. Likewise, it is vitally important to meet the
needs of the growing tsunami of older adult patients with CNSs who
have advanced clinical knowledge in the needs of older adults. The
findings of this study support those currently in the CNS role. The
findings provide evidence of how CNSs match work with quality and
safety metrics as a systems leader. CNSs make a difference by
pairing clinical decisions with business decisions as advocates for
patients, nurses, and the over-arching goals of the organization.
Minority and medically underserved populations in the United
States suffer from a significantly higher infant mortality rate as compared with other populations. The Surgeon General’s 2011 ‘Call to
Action’ states breastfeeding is one of the most highly effective
measures a mother can take to protect the health of her infant.
Improving breastfeeding outcomes could have a positive impact on
reducing infant mortality; however, medically underserved women
do not have access to the professional support often needed for
breastfeeding success due to financial barriers. Lactation consultants do not receive direct insurance reimbursement thus limiting
their ability to provide services. To decrease financial barriers a
hospital based Breastfeeding Clinic was established with
collaboration between lactation consultants, pediatricians and nurse
practitioners.
Patients are seen jointly by both lactation and
medical providers, with services billed to commercial and state
insurances through the pediatric medical practice. The outcome is
better access to care leading to improved breastfeeding outcomes
as well as increased revenues for the facility.
ABSTRACTS
Natalie Dumais, BSN student, Kaitlyn Kus, BSN student,
Andrea Kwasky DNP, & Catherine Corrigan, DNP
Practicing Self Awareness within an Urban Context: A Model for
Educating Future Nurses
Vulnerable groups (political, social, economic – the aged and
mentally ill) are particularly disempowered. Typically, they are less
likely to have a voice or be formally represented. Social exclusion
and stigmatism can be problematic for the vulnerable. Service
learning affords students the
experience to come face to face
with social issues that shape how they care for those most at risk
within our society. The Ford Community Corp Partnership has
provided a unique experience for two junior nursing
student
leaders to mentor sophomore nursing students through a multisite
service learning experience. The student leaders were present in
the classroom and the community to assist students to utilize
their service learning experiences to understand vulnerable
populations, diversity, social justice, and become more self-aware
of their own attitudes and beliefs. These are lessons that become
the core of the University of Detroit Mercy nursing curriculum as
students focus on relationship-based care in an urban context.
Special Thank You To Our
Corporate Sponsors
College of Health Professions
Agenda
7:30 AM
Registration & Networking
8:00
Welcome & Introduction
8:15
Key Note Presentation: The Challenges of Health Care Delivery to Urban Populations
9:00
Panel I: The Clinician/Care Provider Perspective
10:15
Break with Viewing of Poster Presentations
10:45
Panel II: The Financial Perspective
12:00 PM
Summation & Closing