Rodham InstituteHealth Equity and Medical EducationBeyond Flexner ConferenceSeptember 19, 2016
DR. GIGI EL-BAYOUMI, MD FACP, FOUNDING DIRECTOR, RODHAM INSTITUTEPROFESSOR OF MEDICINE
Objectives
Vision & Mission Teaching the Social Determinants of Health in
GME What Rodham is doing
My Personal Story
Why medicine? Clerkship Director and Program Director Caring for Political VIPs An opportunity
GW
Barry Farm
DC’s Health Status
It’s not good Lead the nation per capita in HIV, Cancer
Mortality, ESRD Average doesn’t tell the whole story Ward 8 has same HIV rates as Namibia Ward 3 average family income $220 K Ward 8 average family income $22.6 K
Anacostia History
Was initially going to be a port for Federal City
Opposition from Alexandria and Potomac
Barry Farm
Source: www.bbc.com
Challenges to Wards 7 and 8
Affordable Housing—AMI Returning Citizens Healthy Food Options Pharmacies Healthcare access Ward 9
Rodham Institute Founded in October 2013 In memory of Mrs. Dorothy Rodham
Format of the Summit
Action Oriented Institute to Impact Health Equity in DC
What should RI focus on? 3 hour discussion Charge by the Secretary
First Annual SummitOctober 2013
Participating Organizations100 Black MenAAMCAssociation of Black CardiologistsBlack Nurses AssociationCommunity Wellness CollectiveDC City CouncilDC DOHFood & FriendsGW Residents and StudentsGW School of NursingGW SMHSHRSAMilken InstituteNIDDKSE Tennis and Learning CenterUnity Healthcare
Vision and MissionVisionTo produce a cadre of health care providers in Washington, DC who possess knowledge of the factors influencing health equity, coupled with the skills and attitudes to help achieve it in concert with community partners.
MissionThe mission of the Rodham Institute is to partner with the local Washington D.C. community to achieve health equity by cultivating the next generation of community-oriented health care providers, and training them in innovative strategies to improve health care for all.
Guiding Principles
The Community is in the Driver’s Seat Inclusive Consistency Respect Building a Bi-Directional Bridge Gestures reflect Principles Transparency Reciprocity
Medical Education and Community Needs
Population Health Community Health Family Health Individual Health Community Needs Assessment—IRS requirement
Three Areas of Focus
Clinician Service LearningHealth Education Leadership Program
(HELP)Community Collaboration
Service Learning: Rationale
Academic Medicine has to be part of the solution Obligation to the Community Regaining Trust Increasing Demand by the Public for Accountability Outcomes and Reimbursement Everything Old is New Again—Drs. Schlein, Talpers &
Wilkinson, Case Western, the Rest of the World Training Servant Leaders
AAMC Report
Graduate Medical Education (GME)
White paper on Service Learning in Medical Education
Literature Review Exemplar programs at the UME level Nothing exists at the GME level
National Initiative V
AIAMC Organization of Residency Programs that don’t have a
Medical School Innovators in Medical Education Patient Safety, CLER 38 Residency Programs Across the Country ACGME likely to adopt and require LCME has already begun
Health Equity Education
Didactic Student Led HEALing Clinic Student Social Justice Group SNMA and Latino Student Organizations Being Incorporated into UME
Service Learning Programs
Internal Medicine Community Health Elective Underserved Medicine and Public Health (UMPH)—
started in 2011 Established by Drs. Catalanotti and Popiel Cohort of 4 IM Residents yearly 2 Years long—beginning of PGY2 2nd Continuity Clinic in the Community Bi-Monthly Seminars Capstone Project
See the City That You ServeJune 15, 2015
June 15, 2015
Through the “See The City You Serve” Community Visit, Rodham Institute creates an opportunity for The George Washington University’s residents, students, faculty, and staff to learn about and experience the unique social determinants of health and history of Washington, DC.
Deeper awareness leads to greater understanding between The George Washington University community members and the residents of Washington, DC.
During the visit participants will acquire: A nuanced image of DC’s underserved communities; Information about DC’s unique Ward 7 & 8 neighborhoods and their
diverse populations; Retrospective self-reflection about how clinical training differs from real
world experiences when working with underserved populations; Contacts for community organizations highlighted during the visit; “The Tale of Two Cities”: The stark differences in the built environments
in neighborhoods East of the River; Resources on how to get involved in community based service and
research.
GME Core Lecture Series
Required for all Residents and Fellows 2 Sessions in 2015 Community Based Organizations and NGOs Food Security Mental Health What would you want doctors to know or do differently?
Graduate Medical Education (GME)
UMPH
2 Week Elective
Mini-Electives
See the City That You ServeEducation Council: Community & Faculty Champions
Graduate Medical Education (GME)
UMPH
2 Week Elective
Mini-Electives
See the City That You ServeEducation Council: Community & Faculty Champions
2011 –Present
E-MedIM
PsychPeds
OB/GYN
All incoming interns and PT
students
2017
2017
Health Education Leadership ProgramHELP Rationale
National Medical Association (NMA) Report on African American Health in 2013
Health Care Professionals from UMR groups Impact Health Equity
Not just for gifted and talented kids
Health Education Leadership Program (HELP)
Piloted in 2013 Students Exposed to STEM-H and to Clinician Learners Initially students were the children of MFA staff Year-long health-focused, 12 week Social Impact Projects Health education, Professionalism, Community Service, Leadership Nth Dimensions Dr. Bonnie Mason Model Program
Health Education Leadership Program (HELP) Collaboration between Upward Bound and SMHS Current and Past Partners:
Advisory BoardBlack Nurses AssociationGW School of NursingGWUMilken Institute SPHSMHS
Engaging Youth
Tyler, Age 6Future Doctor
Visited GW April 15th, 2016
GW Existing Programs
Lots of Programs: HAP, Upward Bound, Dr. Keith Mortman
Silos Not under one umbrella
HELP Success Stories
Son of Mammography Technician—Full Ride Scholarship to University of Wisconsin through the Posse Foundation
At risk high school drop out graduating from high school, Coolidge Alumni Association Scholarship Recipient, Interested in Nursing School
1 enrolled in University of the District of Columbia and another enrolled in Prince Georges Community College
Not enough…..
Barry Farm Healthy Living Festival August 22nd, 2015 – Barry Farm Recreation Center, SE DC “Community Hub” 60+ local organizations present GW Medical Students Day of Service
Barry Farm Healthy Living Festival
Barry Farm Healthy Living Festival
Barry Farm Healthy Living Festival
Saturday Academies Barry Farm Community Hub December 8th, 2015; April 9th, 2016
GW Med Students, International Fellows organized Children’s Room
Workplace Education
Staff at GW MFA and SMHS—Many are from Wards 7 and 8
Lunch & Learns Nursing Careers Health Equity Education Success Story: RN career participant now
enrolled in Nursing School
PATH – C
Establish a consortium for pipeline programs to health careers for youth, focus on African-American boys
Model similar to the Alameda County (CA) Health Pipeline Partnership
Quarterly Meetings Goals that meet the DC Public Schools, DC DOH
Workforce and the Community Needs Evaluation, Tracking, Research and Sharing
Pathways for All to Health Careers in DC
PATH – CPartners include:AAMCDC Department of Health – Oral Health; Primary Care
Bureau, Healthcare Workforce DC Primary Care Association (DCPCA)DC Public SchoolsGeorgetown UniversityGW Medical Faculty AssociatesGWU – SMHS Dean’s Office for Diversity, Inclusion &
Student Affairs; Career ServicesHealth Alliance NetworkHoward UniversityNth DimensionsPosse Foundation DCUnited Medical CenterUniversity of The District of ColumbiaUpward Bound at GWYoung Docs DC
New Health Sciences Academy
NAF Academies in IT, Hospitality Industry Coolidge High School over 50% of students come
from Wards 7 and 8 Academic Year 2017-2018 Tracking Outcomes
Community Collaboration Exchange: Alliance for Nutrition and Disease Partnership between Food & Friends, Dr.
Gurusher Panjrath and the GW Heart and Vascular Institute, and The Rodham Institute
Pilot study measure the effects of nutrition services on improving health outcomes of individuals with poorly controlled diabetes and co-morbidities
Initial results are promising
Community Collaboration Exchange: initiative by The Rodham Institute to build a comprehensive, searchable catalogue of ongoing and future health and wellness projects in the Washington, D.C. area.
Annual Summit Gathering of partners, supporters, GW and local community-based
organizations Present Progress Report to Community Poster presentations
Annual Summit 4th Annual Summit: October 20 2016 Theme: Engaging Youth to Build Healthier Communities
Coming Soon:
How to Make a Difference in Health Equity
1. Acknowledge people2. Offer words of encouragement3. Volunteer
Food & Friends, DC Central Kitchen, DC Greens4. Attend events
NAMI, Health Alliance Network, DC City Council, etc.5. Visit Community Based Organizations: Covenant House6. Sign up For Database Exchange to Find Community
Partners
Monique Duwell, MD MPH
Director of Special Projects
Tracie Bass-Harrell
Director of HELP Program
Freya Spielberg, MD MPH
Director of Research and Evaluation
Aileen Chang, MD MSPH
Assistant Director for Research
Marcus Andrews, BA
Presidential AdministrativeFellow
Sara Mutnick
Project Manager
Ambrose LaneChair, Health Alliance Network
Consultant
Bonnie S. Mason, MDFounder, Nth Dimensions
Consultant
Support Us!
Please donate to the Rodham Institute!HTTPS://SMHS.GWU.EDU/RODHAMINSTITUTE
Community Development
Community Development = Health Equity Anchor Institutions – e.g. movie theatre Housing / “Affordable” Housing Choosing the right neighborhood Zip code is strongest social determinant of health
outcomes
CME for Front Line Clinicians
Average Tenure 2 years High Rate of Burn Out CME on Mental Health Co-Sponsored by AmeriHealth Caritas and RI Next event on HIV in Women-Black Women’s
Health Imperative, Dr. Chavon Onumah
Community Collaborations
Legacy of Distrust—past and ongoing abuses One and Done Use for Research Projects Lack of Consistency Partners not Parachutists RWJ Culture of Health Building Trust
Environmental Scan
CHW Khadija Tribble, co-founder of Community Wellness Collective
Conducted survey of residents in Wards 7, 8 Mental Health #1 priority
DC Community Health Connect
Informal educational and networking events for community-based health care providers in Washington, DC
Provides a forum for providers to connect with one another, experts, and resources
Previous Event Topics: Childhood obesity Mental Health HIV in Minority Populations Upcoming: July 2016: Toxic Stress
Heal the Healers Self-care mini-retreat for
healthcare providers Saturday, April 23rd, 2016, Camp
Moss Hollow – Family Matters of Greater Washington
Facilitator: Jeff Menzise, Ph.D , Associate Professor, Institute for Urban Research, Morgan State University
Rodham Institute staff & Paving the Way staff attended
Grants Writing Workshops April 18th, June 13th, July 29th
Facilitator: David Lindeman CFRE, GPC, CF APMP, professional grant writer and editor, Research Development Consultant with the Office of Vice President for Research (OVPR)
Represented Organizations:American Diabetes AssociationBlack Women’s Health ImperativeBreathe DCCapital Area Food BankChildren's National Medical CenterCommunity of HopeGeorge Washington UniversityMilken Institute SPHHealth Alliance NetworkPost-Partum Support VirginiaProject Healthy LivingMedical Faculty AssociatesUnity Health CareMedStar
Food Solutions
Healthy Corner Stores Produce Plus Change in consumption habits
Academic Community Collaboration Award (ACC)
Seed Grants Formed to stimulate and advance community-university collaborations
around research and program development Grants are awarded to partnerships that most successfully demonstrate the
potential for advancing the health and well-being of the residents of D.C. Dr. Khurana and Wholesome Wave Grant Winner 2015 Three $10,000 grants 2016 Theme: Engaging Youth to Build Healthy Communities