As the United States population continues to age and the incidence of Alzheimer’s Disease and related disorders (ADRDs) increases, it is crucial that we examine end-of-life care in this patient population.
The prevalence of dementia in older adults is currently at 50% of the population over age 85. By 2030, approximately 8 million individuals will suffer from dementia. Unfortunately, end-of-life care for this population is less than adequate, and hospice care is too often underutilized. To explore this issue further, the Pennsylvania Hospice Network (PHN) developed a Task Force to survey Pennsylvania Hospice providers about barriers to and facilitators of hospice access for patients with dementia. PHN partnered with the Jefferson School of Population Health and the Delaware Valley Chapter of the Alzheimer’s Association to develop and refine the Survey instrument. The Survey link will be sent to hospice agencies via email this week with a request for response no later than October 31st.
In addition to hospice demographic data, the survey will illuminate providers’ access and quality concerns, such as the number of hospice enrollees with dementia and length of hospice stay in 2006-2008, trends in hospice admission for patients with dementia, perceived regulatory and other barriers to hospice care for this population, hospice capabilities in providing care to persons with dementia, and community outreach activities.
The Survey is a first step toward quantifying hospice access for persons with dementia. We expect that the findings will provide direction for further research and enhanced advocacy efforts, and data to inform policy direction. We will update you with more information in the near future.
If you have questions, please contact JoAnne Reifsnyder, PhD (joanne.reifsnyder@jefefrson.edu) or Laura Kimberly, MSW, MBE (laura.kimberly@jefferson.edu).
JoAnne Reifsnyder, PhD
Assistant Professor
Program Director, Chronic Care Management
Jefferson School of Population Health
Friday, October 16, 2009
Wednesday, October 7, 2009
What is Population Health?
The term “population health” is often misunderstood. So, what does it really mean? Is it public health? How does the population differ from the public? David Kindig, a Senior Advisor at the Population Health Institute at the University of Wisconsin has been working on improving population health in his quest to make Wisconsin the healthiest state and is regarded as an authority on the topic. Kindig defines population health as the distribution of health outcomes within a population, the health determinants that influence distribution and the policies and interventions that impact the determinants. Mention of health determinants and policy clearly indicate that public health is a large component of population health, but that is not where it ends. The key difference between public and population health is the focus on health outcomes, which entails a clinical component as Dr. Abatemarco indicated in the last blog post. While population health is NOT public health the two are intertwined.
Population health is holistic. It seeks to reveal patterns and connections within and between multiple systems that can be analyzed in order to respond to the needs of the population. It must be interdisciplinary, collaborative and transparent. We have set out to create a learning environment for students here at Jefferson to learn these key concepts and develop population health leaders of the future. Many of our students have diverse backgrounds and that is the greatest asset, in my opinion, to the learning community. While the need for population health management is evident in every newspaper you pick up, news story you hear or journal article you read, our role is providing students with practical knowledge to be real change agents. With all of this in mind, we have been working to create a text describing these key concepts, which will serve as a resource for both students and professionals. Population Health: Innovation, Strategy and Practice will be published by Jones and Bartlett, Sudbury, Massachusetts in August 2010. Dr. David Nash, Dr. JoAnne Reifsnyder and I are collaborating from JSPH with Dr. Ray Fabius to edit this multi-authored text. We have engaged 32 authors from various backgrounds; medicine, public health, policy disease management, education, and industry. Our goal is to create a text that describes innovative approaches to address population health needs, provides strategies to work toward those goals and advises readers on how to integrate these concepts into practice or their daily work. I hope that you will share your comments and thoughts about the often misunderstood “population health” concept and look for our new book in late summer 2010!
Valerie Pracilio
Project Manger for Quality Improvement
Jefferson School of Population Health
Population health is holistic. It seeks to reveal patterns and connections within and between multiple systems that can be analyzed in order to respond to the needs of the population. It must be interdisciplinary, collaborative and transparent. We have set out to create a learning environment for students here at Jefferson to learn these key concepts and develop population health leaders of the future. Many of our students have diverse backgrounds and that is the greatest asset, in my opinion, to the learning community. While the need for population health management is evident in every newspaper you pick up, news story you hear or journal article you read, our role is providing students with practical knowledge to be real change agents. With all of this in mind, we have been working to create a text describing these key concepts, which will serve as a resource for both students and professionals. Population Health: Innovation, Strategy and Practice will be published by Jones and Bartlett, Sudbury, Massachusetts in August 2010. Dr. David Nash, Dr. JoAnne Reifsnyder and I are collaborating from JSPH with Dr. Ray Fabius to edit this multi-authored text. We have engaged 32 authors from various backgrounds; medicine, public health, policy disease management, education, and industry. Our goal is to create a text that describes innovative approaches to address population health needs, provides strategies to work toward those goals and advises readers on how to integrate these concepts into practice or their daily work. I hope that you will share your comments and thoughts about the often misunderstood “population health” concept and look for our new book in late summer 2010!
Valerie Pracilio
Project Manger for Quality Improvement
Jefferson School of Population Health
Thursday, October 1, 2009
Improving Population Health through the Integration of Public Health and Clinical Care
My name is Dr. Diane J. Abatemarco and I am energized by being here at the beginning of an exciting process – the creation of a school of population health that is cutting-edge in its science and its vision. I’d like to tell you a bit about my research. My primary areas of expertise include evaluation research methods, behavioral epidemiology and intervention science.
My primary research is focused on maternal and child health. I am the Co-Principal Investigator of Practicing Safety, a study to evaluate a pediatric-based practice change intervention to prevent child maltreatment of children age 0 to 3 years of age. The work is highlighted as an AHRQ Innovation http://www.innovations.ahrq.gov/content.aspx?id=1806, and can also be found on the American Academy of Pediatrics website http://www.aap.org/practicingsafety. The project is funded by the Doris Duke Charitable Foundation through the American Academy of Pediatrics. This work is important because a healthier start to life is necessary for a healthy life not only through childhood but into adulthood as well.
I’ve had several global health experiences; one is a US/Croatian Healthy Cities Partnership to delay the onset of alcohol use among adolescents in Split, Croatia. We implemented Project Northland, a U.S. intervention developed by Perry and Williams. My work in Croatia included the use of experimental design, qualitative and quantitative methods in implementation and evaluation. Working with the country of Croatia for more than four years was an incredible experience. Croatia has wonderful citizens who showed me how a country recently war torn could remain hopeful about life and their country.
The work I have done in social epidemiology has been to conduct a study of HIV infected pregnant women to determine their rates of treatment and to identify factors associated with receipt of treatment. I also conducted numerous survey research projects to determine tobacco prevalence among pregnant women, college students, and adults and surveyed prenatal providers about tobacco dependence treatment practices. Current and ongoing research includes the measurement of stress, anxiety, and socioeconomic factors as determinants of maternal health and birth outcomes, and an exploration of biomarkers that may inform us as to how anxiety affects gestation. We experience a great amount of stress in our lives and understanding how stress affects us biologically may lead to interventions that enhance the quality of our lives, thereby reducing stress, anxiety and depression.
Additionally, I am currently evaluating an obesity prevention program developed by a professor at Carnegie Mellon University. The project is called Fitwits - www.Fitwits.org. This exciting multidimensional intervention has received national attention from the Clinton Foundation. Watching the children interact with the Fitwits characters and seeing them digest (no pun intended) the nutritional knowledge shows that even our youth can make better eating choices with the right support.
All of my work is predicated on improving population health through the integration of public health and clinical care. As a key dimension of population health, each project promotes empowerment over one’s own health behavior. Join me in learning more about our new school as I begin to work with the faculty to develop doctoral programs in Population Health Sciences.
Diane J. Abatemarco, PhD, MSW Associate Professor, Director of Doctoral Programs
Jefferson School of Population Health
My primary research is focused on maternal and child health. I am the Co-Principal Investigator of Practicing Safety, a study to evaluate a pediatric-based practice change intervention to prevent child maltreatment of children age 0 to 3 years of age. The work is highlighted as an AHRQ Innovation http://www.innovations.ahrq.gov/content.aspx?id=1806, and can also be found on the American Academy of Pediatrics website http://www.aap.org/practicingsafety. The project is funded by the Doris Duke Charitable Foundation through the American Academy of Pediatrics. This work is important because a healthier start to life is necessary for a healthy life not only through childhood but into adulthood as well.
I’ve had several global health experiences; one is a US/Croatian Healthy Cities Partnership to delay the onset of alcohol use among adolescents in Split, Croatia. We implemented Project Northland, a U.S. intervention developed by Perry and Williams. My work in Croatia included the use of experimental design, qualitative and quantitative methods in implementation and evaluation. Working with the country of Croatia for more than four years was an incredible experience. Croatia has wonderful citizens who showed me how a country recently war torn could remain hopeful about life and their country.
The work I have done in social epidemiology has been to conduct a study of HIV infected pregnant women to determine their rates of treatment and to identify factors associated with receipt of treatment. I also conducted numerous survey research projects to determine tobacco prevalence among pregnant women, college students, and adults and surveyed prenatal providers about tobacco dependence treatment practices. Current and ongoing research includes the measurement of stress, anxiety, and socioeconomic factors as determinants of maternal health and birth outcomes, and an exploration of biomarkers that may inform us as to how anxiety affects gestation. We experience a great amount of stress in our lives and understanding how stress affects us biologically may lead to interventions that enhance the quality of our lives, thereby reducing stress, anxiety and depression.
Additionally, I am currently evaluating an obesity prevention program developed by a professor at Carnegie Mellon University. The project is called Fitwits - www.Fitwits.org. This exciting multidimensional intervention has received national attention from the Clinton Foundation. Watching the children interact with the Fitwits characters and seeing them digest (no pun intended) the nutritional knowledge shows that even our youth can make better eating choices with the right support.
All of my work is predicated on improving population health through the integration of public health and clinical care. As a key dimension of population health, each project promotes empowerment over one’s own health behavior. Join me in learning more about our new school as I begin to work with the faculty to develop doctoral programs in Population Health Sciences.
Diane J. Abatemarco, PhD, MSW Associate Professor, Director of Doctoral Programs
Jefferson School of Population Health
Monday, September 28, 2009
The Health Care Reform Dialogue Continues at JSPH
Speaker of the House Nancy Pelosi was on the Jefferson campus last week with a local Congressional delegation. She emphasized the need for reform of our broken system and campaigned for the house bill. She is committed to a public option and to universal coverage. Her comments were compelling and they attracted a good deal of local press attention too. Dr. Nash was fortunate enough to be interviewed by Jefferson’s local ABC affiliate in a story that aired just after the Speaker’s visit!
Last week the Jefferson School of Population Health (JSPH) also hosted a symposium on The Future of Health Care in Pennsylvania: Developing Leaders in Health Care Quality and Safety. Thomas Jefferson University (TJU)’s president, Dr. Bob Barchi, kicked off the event by speaking about the need to improve quality, outcomes and access to health insurance. He also highlighted TJU’s commitment to improving the health care crisis by founding JSPH. The event included two panel discussions, and Kim Taylor, President of Centocor Ortho Biotech Inc., announced the recipients of full scholarships for two JSPH Health Policy students.
Rosemarie Greco, Senior Advisor to the Governor’s Office of Health Care Reform, served as the featured speaker and talked about the need for cultural transformation within health care. According to Greco, everyone must be involved in this transformation, and everyone must ask and understand the “why” behind need for health care reform. Unless there is a common understanding of the “why,” meaningful reform cannot take place.
The first panel discussion, moderated by Josh Goldstein of the Philadelphia Inquirer, focused on the stimulus plan and its national impact on health care. Much of the conversation centered on stimulus dollars for Health Information Technology (HIT) and the use of HIT to improve outcomes. Panelists also called for research to build the evidence base for higher quality bedside care and better outcomes.
The second panel, moderated by Chris Satullo of WHYY, explored health care reform in Pennsylvania and how we can leverage our state resources. Significant takeaways from the panel included innovation and its role in health care reform, opportunities and obstacles in the greater Philadelphia region to encouraging and embracing innovation, and the lack of a regional start-up culture. The panel also touched on public medical education in Pennsylvania and the importance subsidizing the cost of medical education in this region in order to bring young, talented people into a setting where medical innovation thrives. Dr. Nash concluded the afternoon by announcing that he hopes everyone will continue to participate in local and regional dialogue about these key issues.
David B. Nash, MD, MBA
Dean, Jefferson School of Population Health
Laura Kimberly, MSW, MBE
Director of Special Projects, Jefferson School of Population Health
Last week the Jefferson School of Population Health (JSPH) also hosted a symposium on The Future of Health Care in Pennsylvania: Developing Leaders in Health Care Quality and Safety. Thomas Jefferson University (TJU)’s president, Dr. Bob Barchi, kicked off the event by speaking about the need to improve quality, outcomes and access to health insurance. He also highlighted TJU’s commitment to improving the health care crisis by founding JSPH. The event included two panel discussions, and Kim Taylor, President of Centocor Ortho Biotech Inc., announced the recipients of full scholarships for two JSPH Health Policy students.
Rosemarie Greco, Senior Advisor to the Governor’s Office of Health Care Reform, served as the featured speaker and talked about the need for cultural transformation within health care. According to Greco, everyone must be involved in this transformation, and everyone must ask and understand the “why” behind need for health care reform. Unless there is a common understanding of the “why,” meaningful reform cannot take place.
The first panel discussion, moderated by Josh Goldstein of the Philadelphia Inquirer, focused on the stimulus plan and its national impact on health care. Much of the conversation centered on stimulus dollars for Health Information Technology (HIT) and the use of HIT to improve outcomes. Panelists also called for research to build the evidence base for higher quality bedside care and better outcomes.
The second panel, moderated by Chris Satullo of WHYY, explored health care reform in Pennsylvania and how we can leverage our state resources. Significant takeaways from the panel included innovation and its role in health care reform, opportunities and obstacles in the greater Philadelphia region to encouraging and embracing innovation, and the lack of a regional start-up culture. The panel also touched on public medical education in Pennsylvania and the importance subsidizing the cost of medical education in this region in order to bring young, talented people into a setting where medical innovation thrives. Dr. Nash concluded the afternoon by announcing that he hopes everyone will continue to participate in local and regional dialogue about these key issues.
David B. Nash, MD, MBA
Dean, Jefferson School of Population Health
Laura Kimberly, MSW, MBE
Director of Special Projects, Jefferson School of Population Health
Wednesday, September 16, 2009
First Day of School at JSPH
Last week was quite a week at the Jefferson School of Population Health. On Tuesday we hosted our first Orientation to welcome our incoming students, and Wednesday – 09/09/09 – was the first day of classes for the new school. Appropriately enough, President Obama brought his case for health care reform before a joint session of Congress that very same evening.
It’s likely that the students we greeted last week – the inaugural class of the Jefferson School of Population Health – will have witnessed historic changes to the way we organize and deliver health care in the United States – all by the time they complete their first year as a JSPH student. I continue to be amazed at the synchronous path we at JSPH continue to follow with our nation’s top domestic agenda in passing meaningful health care reform. I know that our students are tuned into our national dialogue on health care reform and how it meshes with our mission of preparing leaders with global vision to develop, implement and evaluate health policies and systems that improve the health of populations, and thereby enhance the quality of life.
The healthcare industry plays an increasingly vital role in our national economy, as employer and generator of almost 20 percent of our Gross Domestic Product (GDP). The intensifying complexity of this industry in an era of heightened expectations and scrutiny means that there is both need and demand for professionals and researchers who are well versed and prepared to assume leadership roles in public health, health policy and healthcare quality and safety.
To the members of our inaugural class, we look forward to serving you, and wish you success in the 2009-2010 academic year as we work together to fulfill our mission. The future of the United States as a vibrant nation depends on the nation’s leaders bringing affordable, quality health care to all Americans, and we will play a significant role in training and equipping these leaders for the job.
It’s likely that the students we greeted last week – the inaugural class of the Jefferson School of Population Health – will have witnessed historic changes to the way we organize and deliver health care in the United States – all by the time they complete their first year as a JSPH student. I continue to be amazed at the synchronous path we at JSPH continue to follow with our nation’s top domestic agenda in passing meaningful health care reform. I know that our students are tuned into our national dialogue on health care reform and how it meshes with our mission of preparing leaders with global vision to develop, implement and evaluate health policies and systems that improve the health of populations, and thereby enhance the quality of life.
The healthcare industry plays an increasingly vital role in our national economy, as employer and generator of almost 20 percent of our Gross Domestic Product (GDP). The intensifying complexity of this industry in an era of heightened expectations and scrutiny means that there is both need and demand for professionals and researchers who are well versed and prepared to assume leadership roles in public health, health policy and healthcare quality and safety.
To the members of our inaugural class, we look forward to serving you, and wish you success in the 2009-2010 academic year as we work together to fulfill our mission. The future of the United States as a vibrant nation depends on the nation’s leaders bringing affordable, quality health care to all Americans, and we will play a significant role in training and equipping these leaders for the job.
- Caroline Golab, PhD
Associate Dean, Academic and Student Affairs
Jefferson School of Population Health
Wednesday, September 9, 2009
SHAPE THE FUTURE
SHAPE THE FUTURE---In a stirring and forceful speech, President Obama delivered a bipartisan centrist message that appealed to our character as a nation. Noting that we cannot fix the economy without fixing health care and promising not to increase the deficit he inherited, the President called for mandated insurance coverage for all Americans. Recognizing that the status quo is untenable, he called for the creation of an insurance exchange and for the so called "public option" to be created whereby those without insurance currently, could get coverage ----noting that it might take up to four years to implement. He also explicitly linked our need to reduce waste, improve quality, reduce hospital acquired infections and practice better team based care to the set of tools needed as part of the solution. From a policy perspective the speech clarified his own views and reinforced the notion that we have to build on the existing system. He did not disconnect insurance from the place of employment, he did not call for a major Medicare overhaul and he did not create major new federal bureaucracies to make his plan operational. Much more work needs to be done but I believe he effectively re--set the clock, re--set the arguments, and crafted a political umbrella under which lawmakers can now operate together. DAVID NASH MD MBA, Dean, Jefferson School of Population Health, Phila, PA
Monday, September 7, 2009
We Are Back and Ready to Go !!!!
This coming Wednesday is a watershed day for Thomas Jefferson University and the new Jefferson School of Population Health. The date is 9--9--09 !! and the significance is the first day of school for all of our students across our three degree programs---Public Health, Health Policy and Quality and Safety. As the founding Dean I am incredibly proud of our team and the nearly two years of work leading up to this momentous day. We are proud to report that the inaugural class numbers more than 115 persons from all across our region with a very heterogeneous set of skills and backgrounds. I want to thank again several key individuals including of course our university President, Dr Robert Barchi and our Senior Vice President for Academic Affairs, Dr Mike Vergare for their amazing support and encouragement. The Dean's staff including Caroline Golab, Alexis Skoufalos, Neil Goldfarb and David Glatter get special kudos for their tireless work. I am indebted to our faculty and staff who share my enthusiasm and are committed to helping to fix what is wrong with our broken health care system. No matter what happens in Washington DC in the next few weeks, our Jefferson School of Population Health is going to be a part of the solution, not just another part of the ongoing problems we all face!! Thanks again and I sure would like to hear about any similar programs and encourage persons to go to our school website at www.jefferson.edu/population_health DAVID NASH
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