College partners with nursing on nearly $1M grant to address multiple chronic conditions patients

University of Alabama students are learning the value behind the “two heads are better than one” concept when addressing the health care needs of rural communities.

The Capstone College of Nursing received a $997,173 grant from the U.S. Department of Health and Human Services to implement a collaborative team-based approach to working with patients who have multiple chronic conditions.

Chronic conditions are conditions that last a year or more and require ongoing medical attention. They include both physical conditions – arthritis, cancer, HIV infection – as well as mental and cognitive disorders, such as ongoing depression, substance addition and dementia. Multiple chronic conditions are two or more chronic conditions that affect a person at the same time.

“People are living longer, but they are getting sicker earlier,” said Dr. Leigh Ann Chandler Poole, assistant professor in nursing and coordinator of the Nurse Practitioner Concentration in Mental Health and Primary Care for Rural Populations. “What we’re doing is not working, so we’re moving to models that use interprofessional teams to provide quality patient-centered care.”

The primary component of the three-year grant is the development of interprofessional grand round teams. These teams will be comprised of graduate-level students from the College of Community Health Sciences, the School of Social Work and the Nutrition Department, as well as nurse practitioner students in the Capstone College of Nursing, who will be taking lead on this project.

Each nurse practitioner student will be assigned patients, from rural areas, who have multiple chronic conditions, and they will follow those patients for up to a year. Nurse practitioner students will meet with their patients, do the initial workup and then present the patient to the interprofessional grand round team via telemedicine.

The team will meet on a weekly basis to come up with a plan on how to improve the patient’s quality of life and decrease problems associated with the multiple chronic conditions. That plan will then be presented to the patient’s primary care provider who will ultimately decide whether or not to implement the recommendations made by the team.

“This incorporates all disciplines, working together as a team and learning from each other and from the patient to develop best evidenced-based practice plans for the patient,” Poole said. “The patient needs to be part of the process in deciding what will work for them. The providers need to know their patient and their motivations and determine how we can best help the patient achieve their health-related goals.”

According to the Department of Health and Human Services, multiple chronic conditions are associated with substantial health care costs in the United States. Approximately 66 percent of the total health care spending is associated with care for over one in four Americans with multiple chronic conditions.

With the Affordable Care Act, health care providers have to prove what they’re doing works in order to get reimbursed, Poole said. For instance, if someone with congestive heart failure is readmitted to the hospital within 30 days, the hospital will not be reimbursed. But they still have to provide the care.

“We hope to provide quality team-oriented care, and find evidence that this process works in improving the patient’s quality of life and health status and, at the same time, decreases the financial burden associated with multiple chronic conditions,” Poole said. 

Medical students elected to national honor society

Three University of Alabama School of Medicine students who are receiving their clinical training at the College of Community Health Sciences were elected to the Gold Humanism Honor Society (GHHS) early this month. 

The students, all in their fourth year of medical school, are: Sam Ford, Paige Partain and Daniel Partain. The College also functions as a regional campus of the University of Alabama School of Medicine.

As a nationally recognized honor society, GHHS is comprised of individuals who have been recognized for practicing patient-centered medical care by modeling the qualities of integrity, excellence, compassion, altruism, respect and empathy.

The students’ nominations for the honor society originated with their student peers who have observed in them the characteristics related to humanism. Then, a selection committee evaluated the students’ academic eligibility, program director evaluations and essays indicating the nominees’ willingness and qualifications to serve if selected. At the end, only 10 to 15 percent of each class was selected to membership.

“We are very proud of these students,” says Cathy Gresham, MD, director of Medical Student Affairs. “This recognition is one of the most respectable awards from my perspective, as it recognizes the intent to treat and the evidence of treating all patients with respect, empathy and dignity regardless of social status, means or life experiences, as well as the student’s ability to learn from all patients.”

Since the late 1990s, GHHS has pursued a goal of maintaining a networked community that shares ideas, resources and support in order to sustain and advocate for humanism in medicine. GHHS sponsors medical school chapter projects and events, research related to GHHS, physician development programs, lectures and conferences, and society communications.

     

John Packard, founding father of College, dies at 93

John Packard, MD, an internist and cardiologist who established the College of Community Health Science’s undergraduate medical education program, died July 12 in Homewood, Alabama. He was 93 years old.

Packard served as the College’s Associate Dean for Clinical Affairs and Professor and Chair of Internal Medicine from 1973 to 1976. He was recruited from the Alabama Regional Medical Program in Birmingham. 

Photo credit: alssar.org

Photo credit: alssar.org

According to the book, A Special Kind of Doctor, written by former College Dean Wilmer Coggins, MD, Packard was “much admired by [the College’s founding Dean William R.] Willard and was asked to develop the undergraduate program as coordinator of education programs for the College. His office was structured to serve medical students on the Tuscaloosa Campus, helping them to function as effectively as possible while achieving their educational goals.”

Packard was born in Saranac Lake, New York, in 1920. He graduated from Yale University and Harvard Medical School, interned at Columbia-Presbyterian Hospital in New York City and was a medical resident at Peter Bent Brigham Hospital in Boston, Massachusetts.

A veteran of WWII and the Korean conflict, Packard completed military service as a Flight Surgeon in the United States Navy in 1954. He was in private practice in internal medicine and cardiology in Pensacola, Florida, from 1954 to 1968, then moved to Birmingham as Director of the Alabama Regional Medical Program, Professor of Medicine and Associate Dean of the Alabama School of Medicine. In 1973, he joined the College of Community Health Sciences.

Packard left the College in 1976 and accepted the position of Director of Medical Education at the Birmingham Baptist Medical Centers, retiring in 1992.

“I am pleased that I got to have some contact with Dr. Packard during my training. His educational record is impressive. He was tall and towering above students yet he was gentle and genuinely interested in those learning,” says Dan Avery, MD, professor and chair of Obstetrics and Gynecology at the College. “A legend in his own time.”

Family Medicine residents graduate

“This has been an amazing journey for you,” Michael Taylor, MD, told 2013 graduates of the University of Alabama Tuscaloosa Family Medicine Residency. “This is about celebrating the end of a long journey and the transition to something new.”

Michael Taylor, MD, former College professor and chair of the Department of Pediatrics, addresses graduating residents at June ceremony.

Michael Taylor, MD, former College professor and chair of the Department of Pediatrics, addresses graduating residents at June ceremony.

Taylor was the guest speaker at the College’s graduation ceremony for its Family Medicine Residency. The event was held June 29 at the North River Yacht Club in Tuscaloosa and honored 12 graduating residents. Graduates and guests were welcomed by new residency Director Richard Friend, MD.

The residency is a three-year program that provides specialized training in the discipline of family medicine. The College’s residency is among the oldest and largest in the nation.

Taylor is a former professor and chair of the College’s Department of Pediatrics and also served as assistant dean for Information Technology. He retired from the College in January after almost 22 years of service.

“This is an extraordinary time to be in medicine,” Taylor said, noting that vaccines have nearly eliminated deaths from chicken pox and significantly reduced deaths from cervical cancer. He encouraged graduates to “stay happy in medicine” and avoid listening to those who claim medicine is not as good as it should be or that insurance companies do not adequately reimburse physicians.

“Ignore that,” he said. “Think about why you got into medicine. You will have to work with the system, but you are mostly working with patients. Don’t focus on your income or injustices in life or you will become cynical.”

He advised graduates to find balance “in your professional and personal life. Get involved in your community. Laugh a lot.

“I know each of you will be successful,” he continued. “My wish for you is that you are always blessed with abundant happiness.”

Taylor is now a professor of pediatrics and division chief of the Violence Intervention and Prevention program at the Medical University of South Carolina in Charleston. His clinical passion is the evaluation, support and care of abused children. While at the College, he was the only board-certified and child abuse pediatrician in Alabama and one of only 234 in the United States, according to the American Board of Specialties. He was also founder and medical Director of the West Alabama Child Medical Evaluation Center.

The Next Step

A look at where graduating residents will practice and complete fellowships:

Brent Ballard, MD – Winfield, Alabama

Scott Boykin, MD – Sports Medicine fellowship at the College of Community Health Sciences

Scott Kemp, MD, and Matthew Satcher, MD – will practice together in Tuscaloosa, Alabama

Tucker Leigh, MD – sports medicine fellowship in Birmingham, Alabama

Elizabeth Marshall, MD – Tuscaloosa, Alabama

Haley Overstreet, MD – Austin, Texas

Amish Patel, MD – Knoxville, Tennessee

Amanda Stevens, MD – Tuscaloosa, Alabama

Dana Todd, MD – Greensboro, Alabama

Todd Vaughan, MD – Livingston, Alabama

Shelley Waits, MD – Obstetrics fellowship at the College of Community Health Sciences

 

 

Vijaya Sundar, MD, former chair of Department of Internal Medicine, retires in May

Vijaya Sundar, MD, retired in May after 27 years with the College. She was an associate professor and chair of the Department of Internal Medicine. She was also a supervising physician for the College’s Department of Psychiatry and Behavioral Medicine and an adjunct assistant professor of Psychology in the University’s College of Arts and Sciences. Her research interests included endocrinology and obesity prevention. Sundar spearheaded the College’s Continuing Medical Education efforts and was very involved with its Capital Campaign. She continues to sit on the College’s Board of Visitors, a group of 35 volunteers who assist in the development, strategic planning, advancement and leadership of the College. 

Vijay Sundar, MD, (center) retired from the College in May after 27 years with the University.

Vijay Sundar, MD, (center) retired from the College in May after 27 years with the University.

During her tenure at the College, Sundar was honored with a Faculty Recognition Award by graduating medical students and nominated numerous times for the Argus Award, given annually to the best teacher on all three University of Alabama School of Medicine campuses: Birmingham, Tuscaloosa and Huntsville. For the education and training of medical students, the College is a regional campus of the School of Medicine. 

“Dr. Sundar was a fixture for such a long time at the College and contributed so much over the years,” says College Dean Richard Streiffer, MD. “We wish her well in retirement, but hope she will decide to still spend some time now and then joining us at conferences, doing morning report and perhaps teaching in the medicine clinic.” Sundar says she plans to continue, on a volunteer basis, her passion of teaching medical students and resident physicians.

John Maxwell, former director of SHC, retires in April

John Maxwell, former director of the Student Health Center, which is operated by the College, and founder of the College’s Collegiate Recovery Community, retired in April after 25 years with the University.

John Maxwell, pictured with his wife Alice, retired from the College in April after 25 years with the University.

John Maxwell, pictured with his wife Alice, retired from the College in April after 25 years with the University.

During those years, Maxwell served as the chief administrative officer for University Medical Center, which is also operated by the College, and was later promoted director of the Student Health Center. In 2006, he received one of the University’s top awards for outstanding work—the Dr. Minnie C. Miles Endowed Excellence Award—for his efforts in developing plans for the new facility for the Student Health Center, providing a smooth transition to the new building, navigating through a conversion to electronic health records and leading efforts that resulted in a three-year accreditation for the center.

One of Maxwell’s passions while working in student health was providing a community for students in addiction recovery. He often opened his home to recovering students for dinners and social gatherings to provide fellowship and a close-knit support system. He also recruited to the College Greg Snodgrass and Adam Downs, alumni of the Texas Tech University’s Collegiate Recovery Community—a program Maxwell used as a model for the one that opened its doors to University of Alabama students last fall.

“John was a longtime, loyal College leader who left a big pair of shoes to fill,” says College Dean Richard Streiffer, MD. “We really appreciate what he has contributed, particularly in building the Student Health Center and its programs into the nationally recognized center that it is today.”

Family Medicine faculty accepted to research fellowship

halli-tierney

Anne Halli-Tierney, MD

Anne Halli-Tierney, MD, assistant professor in the College’s Department of Family Medicine, has been accepted into the Grant Generating Project, a mid-career, primary care research fellowship based at Virginia Commonwealth University in Richmond, Va.

 

The Grant Generating Project seeks to equip family medicine researchers with the skills they need to successfully develop and submit grants for research funding. Once learned, these skills continue to help generate funds for family medicine research and training and can be generalized to benefit both the participant and her supporting department.

Over the course of one year, participants of the project will select a mentor, write a concept paper and develop a proposal to be submitted to a funding agency. 

Halli-Tierney’s concept paper outlines an innovative project called “Real-time Telemonitoring of Home Health Patients with Chronic Illness.” At the end of the fellowship program, Halli-Tierney plans to submit her proposal to the Agency for Healthcare Research and Quality for funding consideration.

In her paper, Halli-Tierney explains how the established home health provider relationships and resources available through existing medical training centers will be used.  

“We plan to establish a technology-based intervention that will provide patients and home health care providers with point of care assistance from a physician in order to streamline medication adjustment,” she says in her paper. “The intervention will facilitate day-to-day management of complicated, burdensome chronic illnesses such as congestive heart failure and diabetes.”

Since its establishment in 1995, the alumni of the Grant Generating Project have reported more than $700 million in funded grants as either principal investigators, co-investigators or in other significant roles, since participating in the program. Sources of funding include the National Institutes of Health, various state and local government entities, pharmaceutical companies, charitable organizations and numerous private foundations.

     

Rural Scholars Program grooms primary care docs

A program at The University of Alabama helps students prepare for the rigors of medical school—and careers as primary care physicians. Mark Christensen, MD, knew he wanted a career in medicine ever since he served as an emergency medical technician with the volunteer fire department while still in high school at his tiny hometown of Toney in northern Alabama.

“I always thought it would be interesting to go the extra step and become a physician,” Christensen says. “I enjoyed going into people’s houses and taking care of them there and going all the way up to the hospital doors. But I wanted to see that other side of the doors as well and continue that care from inside the hospital throughout their stay.”