Picker Institute/Gold Foundation Graduate Medical Education Challenge Grant Program
Picker Institute, Inc. &The Arnold P. Gold Foundation G R A D UA T E M E D I C A L E D U C A T I O N C H A L L E N G E G R A N T P RO G R A M
Page 2 www.cgp.pickerinstitute.org Graduate Medical Education Challenge Grants ProgramThe purpose of the Picker Institute/Gold Foundation Challenge Grant Pro- gram is to support the research and development of successful patient- centered care initiatives and best practices in the education of our coun- try’s future practicing physicians. The Picker Institute/Gold Foundation Graduate Medical Education Challenge Grant Program funds proposals that illustrate specific interventions and innovations in graduate medicaleducation programs regarding patient-centered healthcare and/or human- ism in medicine. The expected outcome of a grantee’s project will be a demonstration, including a robust dissemination plan, of the measurableeffects and sustainability of the effort to enhance compassionate, patient- centered-care in residency education. For more information and to visit the GME toolbox go to: http://cgp.pickerinstitute.org
www.cgp.pickerinstitute.org Page 3 Picker Institute MissionPicker Institute Inc. is an independent nonprofit organization dedicated tothe global advancement of the principles of patient-centered care. PickerInstitute sponsors research and education in the fields of patient-centeredcare in support of and in cooperation with educational institutions andother interested entities and persons. The Institute’s mission is to foster abroader understanding of the concerns of patients and other healthcareconsumers, and of the theoretical and practical changes needed to facili-tate a more patient-centered approach. Picker Institute supports the ad-vancement of the patient-centered care approach through a variety ofeducation programs, awards, research and dissemination of evidence-based knowledge focused entirely on fostering continued improvement inhealthcare from the patient’s perspective. “Through the patient’s eyes.” Gold Foundation MissionThe Gold Foundation is a nonprofit organization dedicated to the ad-vancement of humanism in medicine, restoring a balance between thescience of medicine and compassionate, respectful patient care. TheFoundation is a proponent of medical care that is as humanistic in its de-livery as it is sophisticated in its technology to improve healing and health-care outcomes. The Gold Foundation supports the development and dis-semination of innovative medical education that furthers this mission.
Page 4 www.cgp.pickerinstitute.org The Arnold P. Gold Foundation criteria to advance humanistic, patient-centered care: Shows respect for the patient’s viewpoint Displays effective & empathetic communication & listening skills Demonstrates sensitivity in working with patients and family mem- bers of diverse cultural and social backgrounds Is sensitive to and effectively identifies emotional and psychological concerns of patients and family members Engenders trust and confidence Adheres to professional and ethical standards Displays compassion and respect throughout the patient interaction Picker Principles of Patient-Centered Care: Respect for patients’ values, preferences and expressed needs Coordination and integration of care Information, communication and education Physical comfort Emotional support and alleviation of fear and anxiety Involvement of family and friends Continuity and transitions Access to careAdvancing Excellence in Patient-Centered Care Through Education, Research and the Dissemination of Best Practice Strategies
Page 5 www.cgp.pickerinstitute.org 2011/2012 Graduate Medical Education Challenge Grant Initiatives Children’s National Medical Center Principal Investigator: Dale Coddington, MD, MA Project Title: Caring for Children with Special Health Care Needs: An Online Medical Home Pro- fessionalism Curriculum for Pediatric ResidentsObjective: This initiative is an experiential and online curriculum to helppediatric residents acquire the necessary knowledge, attitudes, and skillsto deliver effective, patient‐centered care to children with special healthcare needs. This initiative will utilize direct experience in care delivery,individual and collective reflections, and collaboration with a broad healthcare and community team, all in the setting of residency continuity clinicexperience. A component of this initiative is for residents to engage inreflective blogging with feedback from faculty and peers as an innovativemethod to learn professionalism in the context of caring for children withspecial healthcare needs in resident continuity clinic. This initiatives Al-ways Event will be that, at the close of each clinical encounter, the physi-cian and patient/family agree on next steps and on the specific responsi-bilities of the physician and the patient/family. Dana Farber Cancer Institute Principal Investigator: Kristen G. Schaefer, MDProject Title: Teaching Patient‐ and Family‐Centered Care in the Settingof Life‐Threatening Illness: A Resident Outpatient Palliative Care RotationObjective: This initiative is a competency‐based, clinical rotation in avariety of interdisciplinary palliative care outpatient specialty settings, withemphasis on addressing the physical, emotional, social, spiritual and exis-tential dimensions of suffering that accompany advanced illness. Throughoutpatient clinical encounters, individualized feedback about patient-centered communication skills, and mentored self-reflection exercises,residents will learn about the importance of humanism in patient care andprofessional development.
www.cgp.pickerinstitute.org Page 6 Geisinger Medical Center Principal Investigator: Michelle Thompson, MD Project Title: Employing a Patient-Centered Approach to Develop a Medical Passport to Improve Transitions and Educate Health Care ProvidersObjective: This initiative is designed to gather patient preferencesthrough focus groups, refine the medical passport using a patient-centered approach and pilot its use, emphasizing training of healthcareproviders in maintaining a patient-centered approach during its implemen-tation. Jacobi Medical Center Principal Investigator: Kenneth Rivlin, M.D., Ph.D. Project Title: Experiential Learning of Patient/Family-Centered CareObjective: This initiative addresses a critical question: “how do we moti-vate residents to practice patient/family-centered care?” Building upon asuccessful model for resident-run quality improvement, the project teamwill introduce the practice of PFCC by partnering our residents with pa-tient/family advisors to solve patient and resident identified problems(gripes). It is believed that this program will alter resident perspectivesbecause the value of PFCC will be experienced not merely taught.
Page 7 www.cgp.pickerinstitute.org New York Presbyterian Hospital Principal Investigator: Nicholas H. Fiebach, MD Project Title: The Patient’s Voice: Institution-wide Training for House staff in Patient-Centered CareObjective: This initiative targets resident interactions with patients at thekey transition points of hospital admission and discharge. Guidance forhouse staff will be developed and disseminated to promote Always Eventsat these critical junctures, including clear introductions and orientation,assessment of patients’ language and communication needs, empathiccommunication, eliciting questions and concerns from patients’ and theirfamilies, and checking on patients’ preferences and understanding. Thisproject will integrate three distinct components that will serve to identifythe “voice of the patient,” develop and pilot strategies for delivering patient-centered care that grows out of residents’ experiences with patients; and,design a half day intensive workshop on patient-centered practices inte-grating lessons learned from the first two components. SUNY Upstate Medical University Principal Investigator: Stephen Knohl, MD Project Title: Learning to TalkObjective: This initiative will build on and enhance the established"Learning to Talk" program at SUNY Upstate Medical University with theaddition of the Always Event of "Discharge Guides". The "DischargeGuides" will be firmly grounded in respect, clarity, and education and willimprove physician-patient communication skills. This initiative will intro-duce residents to hand-written "Discharge Guides" for outpatient cases.“Discharge Guides” will foster the patients’ comprehension of, and comfortwith, their discharge plan and will be portable to follow-up appointments toensure quality continuity of care.
www.cgp.pickerinstitute.org Page 8 University of Chicago Principal Investigator: Vineet Arora, MD MAPP Project Title: Engineering Patient Oriented Clinic Handoffs (EPOCH) ProjectObjective: To truly design a patient‐centered clinic handoff, understand-ing the patient experience is imperative. The goals of this initiative in-clude: (1) To understand how patients cared for in a resident clinic per-ceive the end of year handoff process, with a particular focus on barriersand challenges that they face; (2) To develop a patient‐centered end ofyear clinic handoff process for internal medicine training; (3) To evaluatethe impact of this patient‐centered end of year clinic handoff process onresident satisfaction, patient satisfaction, and relevant patient outcomes. University of California San Francisco / VA Medical Center, San Francisco Principal Investigator: Calvin L. Chou, MD, PhD Project Title: Development of Interprofessional Team-based Observed Structured Clinical Examinations to Ensure Patient-Centeredness in Primary Care TeamsObjective: We propose to construct an Interprofessional Team-basedObserved Structured Clinical Examination (ITOSCE): an assessment thatuses standardized patients and team members to ensure that a traineeexplicitly incorporates the patient’s goals of care and illness perspectiveinto a comprehensive care plan. University of South Florida Principal Investigators: Deanna Wathington, MD , MPH and Charles N Paidas MD, MBA (DIO) Project Title: Enhancing Medical Resident Cultural and Linguistic CompetencyObjective: This project evaluates the efficacy of two unique training inter-ventions to enhance cultural and linguistic competency among a diversegroup of trainees and program directors across a variety of specialties in alarge urban residency program. The project seeks to evaluate potentialbest practice interventions/curriculum for residents to enhance patientcentered and humanistic care.
Page 9 www.cgp.pickerinstitute.org 2010/2011 Graduate Medical Education Challenge Grant Initiatives Dartmouth-Hitchcock Medical Center Principal Investigator: Marc L. Bertrand, MD Project Title: Integrating Patient and Family-Centered Care Principles into a Simulation-Based Institutional CurriculumOverview: This project will develop a curriculum and simulation-basedtraining experience for DHMC residents that will improve physician-patientcommunication related to patient safety. We propose to develop an insti-tution-wide curriculum based on the key principles of PFCC that will iden-tify “always events”- observable behaviors that ensure all patient careexperiences are firmly grounded in dignity, respect, and information shar-ing. The curriculum will specifically include simulations focused on in-formed patient choice and breaking bad news. Hebrew Rehabilitation Center/ Beth Israel Deaconess Medical Center Principal Investigator: Jennifer Rhodes-Kropf, MD Project Title: “How Do You Have the Conversation?” A Curriculum for Residents.Overview: The goals of this initiative are to, 1) Develop an innovativecurriculum that will teach internal medicine residents how to discuss withfamilies the natural progression of dementia and what their options are forthe goals of care for their loved ones; 2) To increase internal medicineresidents comfort levels and knowledge for discussion of living wills withpatients. Each resident will be better able to work positively and effectivelywith patients and their families, and end-of-life discussions will become anAlways Event during the taking of a patient’s history and physical exami-nation.
Page 10 www.cgp.pickerinstitute.org Johns Hopkins University Principal Investigator: Roy C. Ziegelstein, MD Project Title: Development and Implementation of a Patient-Centered Discharge CurriculumOverview: The overall goal of this curriculum is to teach interns and resi-dents the skills and attitudes necessary to facilitate safe, effective, patient-centered transitions of care. It is hypothesized that an additional criticalelement for safe, effective, transitions of care is the inclusion of the patientand significant others as full partners in discharge planning. This projectproposes that the inclusion of the patient, and the patient’s perspective, in Mount Sinai Medical Center Principal Investigator(s): Joel Forman, MD & Christine Low, LCSW Project Title: Project PARIS (Parents And Residents In Session)Overview: The goal of this initiative, which was implemented during the2010/2011 grant cycle, is to implement and test a novel approach to teachpediatric residents about patient and family-centered care (PFCC). Theapproach calls for a supervised meeting between a family member of apreviously hospitalized child and a resident in the context of a pediatricresidency rotation (behavioral and developmental pediatrics). Project Title: Project PARIS: Parents and Residents In Session – the next generationOverview: This 2011/2012 initiative builds on the previous results andextends them to provide the PARIS intervention to a large group of medi-cal students while performing a controlled trial of its efficacy in promotingknowledge and improving attitude about patient and family centered care(PFCC). The goal of this initiative is to implement a meeting between fam-ily faculty and medical students who are on their pediatric rotation in themedical center. The meeting will be standardized to include discussions ofthe core components (core tenets of family centered care) that were iden-tified in the pilot study.
www.cgp.pickerinstitute.org Page 11 Riverside Methodist Hospital/ Ohio Health Foundation Principal Investigator: Sara Sukalich, MD Project Title: Teaching Disclosure: A Patient-Centered Simulation Training for the Crucial ConversationObjective: This project will attempt to close the gap by providing a robusttraining and competency assessment for medical residents on how todisclose medical errors and improve communication skills, using the Na-tional Quality Forum’s guidelines. The goal of this project is to ensure thatthe skills needed to provide full disclosure of medical errors are taught totrainees, and assessment of trainees’ competence in these skills is evalu-ated. The Regents of the University of California Principal Investigator: Danielle Perret, MD Project Title: Humanism in the Perioperative EnvironmentObjective: This curriculum centers on the patient’s entire perioperativeexperience, with close attention to the patient’s fears, pain, and anxiety.The goal is for residents to develop perioperative Always Events that inte-grate and promote patient-centered medicine, resulting in a personalizedpatient perioperative experience. The program creates an overt and com-prehensive curriculum that gives anesthesia residents the skills to identifyand address a patient’s pain, anxiety and personal needs in the pe-rioperative setting.
Page 12 www.cgp.pickerinstitute.org University of Maryland School of Medicine Principal Investigator: Susan D. Wolfsthal, MD Project Title: Empowering Patients to Optimize Their Medication Regi- mens: A multidisciplinary approach.Objective: This initiative will provide residents with skills in assessingtheir continuity patients’ barriers and adherence with medication use.Residents will gain knowledge through a series of seminars and evaluatetheir own clinical practice through a practice based learning (PBL) exer-cise. Through an interdisciplinary partnership with a clinical pharmacist,residents will utilize existing resources to assist patients to cope with in-creasing economic pressures. University of Massachusetts Medical Center Principal Investigator: Kathleen E. Walsh, MD, MSc Project Title: Home Medication Education and Support (HOMES): A Resident Module on Home Care in ChildrenObjective: This study will address the challenges that families face, whencaring for chronically ill children, by training new physicians to be sensitiveand responsive to parents needs and to proactively provide parents withthe support needed to successfully care for children with chronic condi-tions at home. The overarching goal is to develop a curriculum that willgive residents the knowledge and clinical skills needed to support safehome medication use for children and families in their practice.
Page 13 www.cgp.pickerinstitute.org University Medical Center Foundation, Arizona Principal Investigator: Eric Brody, MD, FACC Project Title: The Native American Cultural Competency CurriculumObjective: This project will develop a cultural competency curriculum thatwill include, but not be limited to, eight hours of lecture time to exploretopics such as: an overview of health issues among Native Americans,language/translation issues in providing care for Native American pa-tients, culture and spirituality of Native American peoples (particularly inthe Southwest), presentation/discussion of multiple case studies under-scoring specific points regarding clinical care for Native American pa-tients, a session of resident case presentations, and a session of conclud-ing remarks/wrap-up. Wake Forest University Health Center Principal Investigator: Franklin Watkins, MD Project Title: Improving Transitions of Care for Older Adults through Interdisciplinary Education for Medical ResidentsObjective: This initiative will develop an Acute Care for the Elderly UnitTransitional Program (ATP) to teach optimal discharge planning andreinforce interdisciplinary communication through trainee home visits tovulnerable older patients after hospital discharge. The ATP will provide a“living laboratory” to enhance the medical trainees’ understanding of theimportance of appropriate discharge planning, communication with thepatient, family and caregivers, as well as impact a culturally and socio-economically diverse population. Successful hospital discharge and tran-sitions of care can be considered Always Events, as all patients experi-ence at least one (and often multiple) care transition following hospitaliza-tion.
Page 14 www.cgp.pickerinstitute.org Challenge Grant Program Cycle: 2009-2010Train Pediatric Residents in the Delivery of News and the Discussion of IssuesRelated to Death and Dying in a Pediatric PopulationPrinciple investigator: Heather Huszti, PhD, Director of Training, PsychologyChildren’s Hospital of Orange County, CACommunication in Family Meetings: Developing and Assessing a Curriculum forResidentsPrinciple investigator: Julie T. Irish, PhD,Beth Israel Deaconess Medical CenterImproving Patient Communication Skills Among Surgical ResidentsPrinciple investigator: Rajiv Y Chandawarkar MDUniversity of Connecticut Health CenterDevelop Health Care Transitions, a Resident Learning Module on Building BridgesPrinciple investigator: Suzanne McLaughlin, MDBrown University Alpert School of Medicine/Rhode Island Hasbro HospitalsTeaching Family-Centeredness in the PICU: a novel approach using medical simu-lationsPrincipal investigator: Ira M. Cheifetz, MDDuke Childrens HospitalIntroduce a Family Centered Care Curriculum to a Pediatric Residency Programand Measure its Effects on the Centeredness of Pediatric ResidentsPrincipal investigator: Keith J. Mann, MDChildren’s Mercy HospitalTransitioning from Pediatric to Adult .Centered Medical Care (the patients perspec-tive)Principal investigator: Niraj Sharma, MD, MPHBrigham & Womens/Boston Childrens Hospitals/Harvard Medical SchoolScreening and Managing Interpersonal Violence During Pregnancy at an UrbanTeaching HospitalPrinciple investigator: Suneet Chauhan, MDAurora Health Care, Inc.Create a patient-centered care plan (PCCP) within an electronic medical record;and evaluate the impact of PCCP use on patients and health-care team membersPrincipal Investigators: Judith Pauwels, MD & Larry Mauksch, M.EdUniv of WA Family Medicine Residency Challenge Grant Program Cycle: 2005-2009Transitioning Adolescent Patients (TAP) from Pediatric to Adult CarePrincipal Investigator: Emily von Scheven, MD, MAS, Pediatric Rheumatology,University of California San FranciscoImproving Patient Rounds (IPR)Principal investigator: Walter J. Moore, MD, Center for Patient- and Family-Centered Care, Medical College Georgia
www.cgp.pickerinstitute.org Page 15Resident Performance from the Patient’s ViewPrincipal investigator: Dick M. Wardrop, MD, PhD, FAAP, Director of ResidentResearch, Internal Medicine, Carillion Clinic, Roanoke, Va.Patient-Centered Training of Residents on a Medical WardPrincipal investigator: Robert C. Smith, MD, MS, Internal Medicine,EW Sparrow Hospital/Michigan State University College of Human Medicine“Emergency Medicine Resident Training in Interprofessional Skills: Evaluating aNeeds-Based Curriculum”Principal investigator: Sondra Zabar, M.D., Associate Professor of MedicineLinda Regan M.D., New York University School of Medicine“Cultural Sensitivity Initiative for Medical Education”Principal investigator: John M. Tarpley, M.D. Vanderbilt Medical Center/VanderbiltUniversity“Simulation Used to Measure the ACGME Core Competencies and Patient-Centered Care”Principal investigator: Pamela J. Boyers, Ph.D., Riverside Methodist Hospital“Improving Patient Compliance and Outcomes in Hypertension Management in the‘Stroke Capital’ of the World”Principal investigator: William H. Hester, M.D., McLeod Family Medicine Resi-dency Program“Development and Implementation of an Interdisciplinary Palliative Care End-of-Life Education Program for Residents Who Rotate through the Surgical IntensiveCare Unit”Principal investigator: Anthony A. Meyer, MD, PhD & Renae E. Stafford, MD, MPHThe University of North Carolina at Chapel Hill, Trauma and Critical Care Services/ External Evaluation Committee MembersMax Bassett, Georgia Health Sciences UniversityPamela J. Boyers, PhD, University of ToledoJim Cichon, ACGMEVirginia Collier, MD, Christiana Care Health SystemNettie Engels, Georgia Health Sciences UniversitySusan Frampton, PhD, PlanetreeRichard Frankel, PhD, Veterans Administration Medical CenterMary Joyce Johnston, ACGMEAdina Kalet, MD, MPH, NYU School of MedicineSusan Edgman-Levitan, Executive Director, John D. Stoeckle Center forPrimary Care InnovationCarl Patow, MD, MPH, MBA, FACS, University of MinnesotaV. Seenu Reddy, MD, MBA, FACS, UT Health Science Ctr. - San AntonioChristopher Simien, ACGMERichard Wardrop III, MD, University of North Carolina School of Med.Mitzi Williams, MD, Georgia Health Sciences University
Picker Institute Board of DirectorsJ. Mark Waxman, Esq., ChairmanStephen C. Schoenbaum, M.D., Vice ChairmanSamuel Fleming, Treasurer and SecretarySir Donald Irvine, MD, FRCGP, FRCP, F.Med.SciDavid C. Leach, M.D., Former Executive Director, ACGMEGail L. Warden, MHA, President Emeritus, Henry Ford Health SystemLucile Hanscom, Executive Director11 Main Street, 4th FloorPO Box #777Camden, Maine 04843Tel 1.207.236.0157 1.888.680.7500Fax 188.8.131.5270Email email@example.comWebsite http://pickerinstitute.org http://alwaysevents.pickerinstitute.orgHannah Honor, Grants Coordinator, firstname.lastname@example.orgThe Arnold P. Gold FoundationBarbara Packer, Managing Director, COO619 Palisade AvenueEnglewood Cliffs, NJ 07632Tel 1.201.567.7999Email email@example.comWebsite http://humanism-in-medicine.orgAnn Bruder, Director of Programs