Pennsylvania Hospital’s Interprofessional Grand Rounds series offers clinical and non-clinical staff alike the chance to come together each month to continue their education in a collaborative environment. But this August, Pennsy tried something a bit different. Rather than discussing one topic, like the impact of implicit bias on health equity or the future of pain management, staff were instead invited to share their own scholarly pursuits during the inaugural “Spotlight on Scholars” presentation and luncheon.
The PAH Library Committee, led by clinical information librarian Ene O. Belleh, MLS, AHIP, sponsored this new take on grand rounds in an effort to celebrate the innovative scholarship that so many physicians, nurses, pharmacists, social workers, and other staff members are engaged in.
“Staff are already busy with their daily responsibilities, but the Spotlight on Scholars also illustrated that they’re not just thinking about today’s patients — their research will help them to provide even better care and a better patient experience in the future,” said Stacey C. Peeples, MA, curator and lead archivist of the hospital’s historic collections.
“You may not always know what your colleagues are working on outside of the day-to-day, and this gave staff a chance to learn about and appreciate their coworkers’ professional and academic interests,” Tanya Carmichael, MSN, RN, RNC-OB, RN-BC, director of Nursing Education, added.
A total of 45 scholars submitted 55 publications and scholarly presentations, all of which were recognized during a poster reception. In addition, five staff members were given the opportunity to showcase their scholarly pursuits in more detail. Read more to get a glimpse of their work:
Understanding Chemotherapy-Induced Anemia
About 70 percent of patients who receive chemotherapy develop anemia — a condition in which the body lacks enough healthy red blood cells to effectively carry oxygen. In addition to causing fatigue, anemia can delay or limit a patient’s access to therapeutic options. Research led by Emily Bryer, DO, a resident in Internal Medicine, aims to better define, quantify, and treat chemotherapy-induced anemia (CIA).
CIA negatively impacts a patient’s response to chemotherapy, quality of life, and chance of survival. There are three treatment options — packed red blood cell transfusions, iron supplementation, and medications that stimulate the bone marrow to make red blood cells. Because CIA is influenced by factors ranging from age to the stage of cancer to chemo administration schedule, Bryer’s research supports personalized treatment guidelines.
As she continues to assess which regimens are associated with risks and which correlate with the best outcomes, Bryer anticipates this work will help other clinicians prevent or promptly treat CIA, which should ideally result in “fewer dose delays, fewer dose reductions, and improved patient outcomes.”
Supporting Head and Neck Cancer Patients
When members of the multidisciplinary head and neck cancer (HNC) team raised concerns about their already vulnerable patients receiving disjointed care that resulted in delayed treatment and added stress, staff across departments joined forces to assess the HNC services and to implement quality improvement strategies.
Through a gap analysis, a SWOT (strengths, weaknesses, opportunities, threats) analysis, and experience surveys given to both clinicians and patients, the team — including Deb DeMille, MS, RD, a nutrition counselor at the Abramson Cancer Center at PAH, and Meredith Pauly, MA, CCC-SLP, a speech-language pathologist — identified three main gaps: wait times and delays, patient education, and coordination across the continuum of care.
In response, they have reduced wait times to align with benchmarks; updated scheduling, monitoring, and discharge protocols; created standardized educational resources for patients and staff; and hired a nurse navigator. Services continue to be regularly assessed by a disease-based team for head and neck cancer patients. “The changes we’ve made and continue to make are possible because of the collaboration of our diverse team,” Pauly said. “Surgeons, oncologists, social workers, supportive care staff — this initiative was driven by frontline staff, and it’s something we all believe in and are proud of.”
Prioritizing Patients’ Wishes
Rather than focusing on hard data, clinical nurse education specialist and “storyteller” Philip Landis, DNP, RN, CEN, RN-BC, discussed his experiences with family presence during resuscitation in the Emergency Department.
Landis recalled a situation in which an elderly patient suffering cardiac arrest underwent CPR in the ED while Landis stayed with the patient’s daughter and explained what was happening. When he asked her about advanced directives, she explained that she’d made a promise to never let her mother end her days in an ICU and confirmed that her mother never wanted to receive CPR. Rather than overriding the patient’s end-of-life wishes, Landis immediately shared this with the care team, and they watched the patient pass away with dignity while her devastated, but grateful daughter held her hand.
“This experience underscores how easily patients’ wishes can fall through the cracks of good intentions. Family presence during resuscitation may not always be appropriate, but it’s certainly the best practice to offer during end-of-life decisions,” Landis said. “When we include families in the process and listen, we can find the holistic even in the hectic ED.”
Trauma, Therapy, and Juvenile Detention
PAH provides resources to help community members of all ages manage their mental health conditions — but what if someone in juvenile detention can’t visit Pennsy for treatment? For Sean Snyder, LCSW, MSW, a clinical social worker at Hall-Mercer Community Behavioral Health Center, the answer is offering trauma-focused cognitive behavioral therapy (TF-CBT) and targeted case planning in a detention setting.
Young people involved with the justice system are often caught in a vicious cycle of trauma. They report higher rates of traumatic exposure and post-traumatic stress disorder (PTSD), and these experiences can prompt delinquent behavior, followed by incarceration in a detention center full of new stressors. To support these youth, Snyder implemented a TF-CBT model in the Philadelphia Juvenile Justice Services Center. The impact was clear: more than 60 percent of the participants who completed the program no longer had clinically significant scores on the Child PTSD Symptom Scale.
“After my presentation, I received a lot of comments from staff who found this work really eye-opening,” he said. “I’m really happy that the hospital is recognizing and promoting scholarship, and especially that I had the chance to highlight Hall-Mercer and this under-researched population.”