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