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ChristianaCare has once again been recognized by the American Association of Critical-Care Nurses (AACN) for its exceptional complex care. The AACN has awarded the Beacon Award for Excellence to three intensive care units at Christiana Hospital in Newark, Delaware: the Medical Intensive Care Unit (MICU), the Surgical Critical Care Complex (SCCC), and the Transitional Surgical Unit (TSU) Beacon Awards honor critical-care nursing units that demonstrate exceptional patient care, improved patient health outcomes, a supportive work environment and opportunities for collaboration. The Beacon Award is widely considered to be the most prestigious award in critical-care nursing. “The Beacon Award shines a light on individual nursing units for their commitment to providing critically ill patients with exceptional care and evidence-based practices,” said Danielle Weber, DNP, MSM, RN-BC, NEA-BC, chief nurse executive at ChristianaCare. “These awards reflect nursing excellence and commitment to exceptional health outcomes, an outstanding work environment and superior patient experience.” AACN President Jennifer Adamski, DNP, APRN, ACNP-BC, CCRN, FCCM, applauds the commitment of the caregivers at ChristianaCare for working together to meet and exceed the high standards set forth by the Beacon Award for Excellence. These dedicated healthcare professionals join other members of our exceptional community of nurses, who set the standard for optimal patient care. “The Beacon Award for Excellence recognizes caregivers in outstanding units whose consistent and systematic approach to evidence-based care optimizes patient outcomes. Units that receive this national recognition serve as role models to others on their journey to excellent patient and family care,” Adamski said. Consecutive successes Each of these units has received multiple Beacon Awards. • The MICU has been continuously recognized as a Beacon unit since 2009. It is the sixth time that the MICU—Delaware’s first Beacon Award-winning unit—has received the national award, with four silver and two gold recognitions. The unit holds the most Beacon Awards in Delaware. • The SCCC received a silver-level award for the fourth time. • The TSU received a gold-level award for the first time, after receiving two silver-level awards. “For us to be designated for such a consecutive amount of time is a testament to the ongoing, intensive work that we do and the focus on excellence that we have,” said Carol Ritter, MSN, RN, CCRN, CNML, nurse manager for the MICU. “It’s an affirmation of the care that the nurses provide and the excellence that they bring every day, using advanced protocols and the latest technology and research.” Beacon-designated units are renowned for their healthy work environments and high morale, which results in strong relationships among the nurses and outstanding patient care. “Our nurses are committed to providing exceptional care and patient outcomes,” said Amanda Latina, MSN, MBA, RN, TCRN, nurse manager of the TSU and SCCC. “They embody what it means to be a critical-care nurse.” Of the seven Beacon Award-winning patient care units currently in Delaware, all are at Christiana Hospital in Newark. These include the Neuro Critical Care Unit (silver), the Cardiovascular Stepdown Unit 4E (silver), the Cardiovascular Critical Care Complex (three-time gold winner), the Transitional Medical Unit and the 3C Intermediate Medical Unit (both silver).

ChristianaCare Charts New Course With Nurse Robotics Research Fellowship
ChristianaCare, the first hospital system in the region to deploy collaborative robots, has once again broken new ground, this time with a nationally unique initiative that puts bedside nurses at the helm of robotics research and innovation. At a graduation ceremony April 30, ChristianaCare celebrated the first four clinical nurses completing the Nursing Research Fellowship in Robotics and Innovation — the first program of its kind in the nation. The fellowship was part of a larger three-year, $1.5 million grant from the American Nurses Foundation’s Reimagining Nursing Initiative. The grant supports ChristianaCare’s broader study on how collaborative robots impact nursing practice. Over eight months, nurses from different units and specialties participated in immersive research training and lectures designed to expand their knowledge, curiosity and professional growth. Their work culminated in national conference presentations and preparations for journal submissions. The inaugural Nursing Research Fellows in Robotics and Innovation are: Briana Abernathy, BSN, RN, CEN – case management, Christiana Hospital emergency department Elizabeth Mitchell, BSN, RN-BC – Christiana Hospital surgical stepdown unit Hannah Rackie, BSN, RN, C-EFM – Union Hospital maternity unit Morgan Tallo, BSN, RN, CCRN – Christiana Hospital cardiovascular critical care unit A ‘real seat at the table’ “When you create programs that empower nurses to lead, innovate and tackle meaningful challenges, you see real impact — not just in new skills and knowledge, but in job satisfaction, well-being and retention,” said Susan Smith Birkhoff, Ph.D., RN, program director of Technology Research & Education at ChristianaCare. “This fellowship is built on the belief that when nurses are given the space to learn and lead, they bring fresh ideas and collaborative solutions back to their clinical practice areas.” Created and led by Smith Birkhoff, the fellowship is a standout in the U.S. health care landscape: It gives bedside nurses the chance to step away from their daily routines and gain advanced research experience, an opportunity rarely available at the clinical level. While the fellowship directly trained four nurses, its reach extended well beyond thazt. Fellows shared what they were learning along the way, sparking wider interest in research across the health system. The research program was highlighted as a new knowledge and innovation exemplar in the latest evaluation by the American Nurses Credentialing Center, which in March awarded ChristianaCare its fourth Magnet designation — the gold standard for nursing excellence. Adriane Griffen, DrPH, MPH, MCHES, vice president of programs at the American Nurses Foundation, praised ChristianaCare’s responsiveness in shaping the program around nurses’ needs and building a model for future innovation. “What makes this fellowship stand out is its focus on giving bedside nurses a real seat at the table,” Griffen said. “When nurses are trusted to lead and have the right support, they develop solutions that are practical, sustainable and transformative. This fellowship shows how nurse-led innovation can grow from a local pilot into a model for improving care across the country.” Through the fellowship, nurses gained a deeper understanding of applying research methodology to advance robotics science at the intersection of nursing and hospital operations, which is groundbreaking and novel. “This is such an exciting and important moment for our profession,” said Danielle Weber, DNP, RN, NEA-BC, chief nurse executive at ChristianaCare. “Innovation is about improving care, easing the burdens on our teams and finding smarter ways to meet the complex needs of our patients. Tools like collaborative robots don’t replace the human touch, they help protect and elevate it.” Mitchell said she was initially intimidated when she saw the fellowship application because it had been years since she last engaged in formal research. Learning everything from literature reviews to abstract writing pushed her outside her comfort zone and gave her practical tools to take new ideas forward. The experience inspired her to return to school this fall to pursue a graduate degree. A ‘ripple effect’ “This fellowship reignited my enthusiasm for learning and gave me the skills and confidence to keep growing,” Mitchell said. “It’s been amazing to collaborate with other fellows and mentors, and I’m excited to apply what I’ve learned to improve patient care and strengthen our teams.” In addition to Smith Birkhoff, Kate Shady, Ph.D., RN, OCN, RN IV, served as a mentor to the fellows, bringing expertise from her hematology/oncology background. Kati Patel, MPH, provided key administrative coordination and support throughout the program. ChristianaCare continues its broader research into robotics integration, with findings from the multi-year collaborative robot study expected to be shared later this year. Shady said the fellowship is already influencing ChristianaCare’s nursing culture by expanding interest in research and evidence-based practice well beyond the initial group. The program’s ripple effect is helping build lasting infrastructure for nurse-led innovation across departments. “One of the most rewarding parts of this fellowship has been seeing these nurses step into new confidence and capability,” Shady said. “They began unsure about research, but by the end, they were reading studies, writing abstracts and mentoring peers — laying the groundwork for bigger change in how we advance nursing practice.” Learn more about nursing at ChristianaCare.

Taking ACT-ion for Quality Improvement
“Learning is a journey. It is continuous,” said nurse Hellen Okoth, MSN, CCRN, RN-BC, of the Transitional Surgical Unit. She was one of the learners on that journey through ChristianaCare’s professional development program Achieving Competency Today (ACT). ACT, a 12-week graduate-level program dedicated to health care improvement, will celebrate its 40th session in 2025. Some 1,000 caregivers have graduated from ACT and have tested some 140 innovative project ideas since the program’s launch in 2003. On April 9, three ACT teams presented their quality improvement projects at the John H. Ammon Medical Education Center on ChristianaCare’s Newark campus. Interdisciplinary, experiential learning programs like ACT create a rich and dynamic learning environment,” said Tabassum Salam, M.D., MBA, FACP, chief learning officer for ChristianaCare. “The emphasis on continuous improvement and real-world applications of the educational content sets our ACT graduates up for lifelong learning and repeated application of these new skills.” The ACT course is a collaborative experience that brings together learners from diverse disciplines to tackle real-world health care challenges. Participants learn from health system leaders and gain a broad perspective on health care through coursework. They work in teams to complete problem-solving projects from start to finish using the Plan-Do-Check-Act (PCDA) model of continuous improvement. Facilitators, who are experts in improvement science and team effectiveness, guide the teams through the process, ensuring that each project is meticulously planned and executed. ChristianaCare offers many professional development opportunities. Click here for careers and benefits. “The hands-on projects in ACT enable learners to innovate and test out solutions in settings that directly benefit patients, leading to better outcomes and a higher quality of care,” Salam said. The three most recent teams presented improvement research that has the potential to expand beyond their pilot stage to other areas of the health system. ‘Hush! For the Love of Health’ In “Hush! For the Love of Health,” an interdisciplinary team worked to reduce noise levels on the Cardiovascular Critical Care Unit (CVCCC) at Christiana Hospital. Their goal was to decrease ambient noise levels by 10 decibels during the study period. Intensive care units often experience noise levels that can exceed 80 decibels. A quiet environment is 30 to 40 decibels. Members of the “Hush” project found creative ways to reduce noise on an intensive care unit. Ambient noise refers to all sounds present in the background, which research shows can interfere with communication, concentration and comfort. In a hospital setting, these sounds may include alarms, conversations, announcement and pages and carts moving by. The team looked for opportunities to safely reduce the number of alarms sounding. By collaborating with Philips technology company to lower alarm volumes and eliminate redundant alarms, they reduced the number of alarms sounding from 10,000 to 3,000 daily and successfully decreased noise levels by 13 decibels, exceeding their goal. “It’s good for patients to have a quiet environment and it fights alarm fatigue for caregivers,” said Dylan Norris, a pre-medical student from the University of Delaware and participant in the ACT course. ‘Show Up and Show Out’ Reducing the no-show rate among patients in primary care practices improves health outcomes and conserves resources. In “Show Up and Show Out: Boosting Patient Attendance in Primary Care,” the project team aimed to reduce the incidence of no-show appointments at the Wilmington Adult Medicine (WAM) practice by 10%. The “Show Up and Show Out” project team used personalized communication outreach to patients to encourage keeping their primary care appointments. “Our literature review showed that personal relationships with providers are one thing that can encourage people to attend appointments,” said team member Christi Karawan, MS, BSN, CCRN-CSC. The key to their problem-solving strategy was using a secure messaging platform for automatic appointment reminders specifically for WAM that were personalized with the provider’s name and thanking the patients for letting WAM be a part of their healthcare team. Other steps on the road to success were signage around the practice encouraging patients to update their contact information and calls from office assistants and medical assistants to unconfirmed patients the day prior to their appointments. The team achieved a 9.5% reduction in no-shows, just shy of their goal, over a two-week period. An office assistant who participated in the pilot said, “Outreach has been helpful not only in getting people in but in getting people to reschedule or cancel. We can catch it before it becomes a no-show.” ‘Magnetic Efficiency’ To address delays in patient transport from MRI testing at Newark campus, an ACT team created a new communication workflow to directly connect patient escort dispatch to the MRI charge technician. The ACT team aimed to decrease patient wait times following MRI completion for stretcher transport back to patients rooms by 25% — and “a bold goal,” said one colleague — during the study period. The “Magnetic Efficiency” team identified a new workflow to get patients back to their hospital rooms faster after MRI testing. Using Vocera wearable communications tools, the team created a thread for direct communication between Escort Dispatch caregivers and MRI charge technicians. Also, when an Escort transporter dropped off a patient for an MRI, the transporter asked MRI staff if any patients were ready to go back to their rooms. These changes in communication and empowerment consolidated transports and led to a 17% reduction in wait time during the two-week pilot. “We don’t want people to work harder,” said team member Tim Kane, BSN, RN. “We wanted to avoid preventable delays.” Both teams expressed satisfaction and improved communication with the new process and they expressed interest in continuing the process after the pilot ended. Future forward The ACT course has a rich history, originating from a specific initiative piloted by the Robert Wood Johnson Foundation with ChristianaCare among the early adopters along with Harvard University, the University of Pennsylvania, Johns Hopkins University and Beth Israel Deaconess Medical Center. Through the years, ChristianaCare ACT team members have seen their projects live on both as permanent changes throughout the health system and, more personally, in their professional growth. “I was able to enhance my creativity, organizational and problem-solving skills,” said Starr Lumpkin, a staff assistant who was on the “Hush” team. “This was a pivotal journey for me.” ChristianaCare is growing its program to develop a pipeline for the next generation of health professionals, said Safety and Quality Education Specialist Claire Rudolph, MSM, CPHQ. “We have a varied group of learners and facilitators who are making an impact on health care quality, cost and safety.” Dylan Norris was the first participant from a new partnership with the University of Delaware for pre-med students to get quality improvement experience. “I have learned so much about what goes into a quality improvement project. Buy-in from the stakeholders is key in implementing any new project successfully,” she said. “I have also learned about the importance of the initial research that goes into creating a new project and how much pre-planning goes into it.” Closing the event, Clinical Effectiveness Officer Christian Coletti, M.D., MHCDS, FACEP, FACP, called on the ACT graduates to use their newfound “superpowers” — “vision, seeing the future, catching something before it breaks. “It’s not a glitch in the matrix,” he said. “You are the most important people at the bedside – hearing the alarms going off or the stretchers piling up. Work to identify problems and move toward solutions in your own microenvironments. Pass on your powers with reckless abandon.”

Daylight Saving Time: Baylor Sleep Expert Offers Suggestions to Help Adjust to the Change
Daylight saving time, with its one-hour spring forward at 2 a.m. Sunday, March 12, may seem like a small shift of just a single hour, but on a societal level, it has startling effects, says Baylor University sleep researcher Michael Scullin, Ph.D., associate professor of psychology and neuroscience and director of the Sleep Neuroscience and Cognition Laboratory at Baylor. So what are the consequences of this one-hour time shift on our sleep quality and how can we quickly adjust when springing our clocks forward? "Many people not only lose that single hour of sleep," Scullin said, "but also have difficulty over several subsequent nights adjusting their circadian rhythms to the new bed-wake time schedules." For example, parents who have routine bedtimes for their children experience difficulty for the whole family because children will not want to (or be able to) go to bed one hour earlier than their body is used to. "When you couple this bedtime difficulty with the fact that most people have morning school and work schedules that require them to wake up at a set time," Scullin said, "it becomes clear that ‘springing forward’ has a larger consequence than skipping a single hour." The consequences of the spring daylight saving time shift are well documented. Researchers have observed changes in cognitive functioning, increased driving accidents, moodiness and willingness to punish others for mistakes. "Researchers have also documented that acute sleep loss and circadian dysregulation lead to an increase in cardiovascular events," Scullin said. "If someone's cardiovascular health is ‘borderline’ then the springtime shift can be the factor that precipitates a stroke or a myocardial infarction (heart attack)." Scullin offers some simple suggestions to anticipate and adapt to the spring forward shift: Adjust in advance. About a week before the "spring forward," go to bed 15 or 20 minutes earlier each day. Avoid long naps during the day. If you need a nap, take it earlier in the day and for no more than 20 minutes. Bring on the sunlight. Getting more natural sunlight in the morning hours is very beneficial in resetting our biological clock. In some cases, evening melatonin also can help people to adapt to the time change. Scullin has published numerous studies focusing on sleep and brain function, including the connection between sleep and creativity, musical “earworms” and their effect on sleep and how writing a to-do list before you turn in for the night can help you get better sleep. In fact, Scullin was named Baylor’s inaugural Newsmaker of the Year in 2018, after his “to-do list” research was widely covered by media outlets, including ABC’s Good Morning America, TODAY.com, USA TODAY, Discover, LiveScience, HealthDay, BBC Radio and many more, reaching an international circulation and viewership of nearly 1 billion people. Looking to interview or chat with Michael Scullin? Simply click on his icon now to arrange an interview today.

Annual Healthy Georgia Report looks at public health in the Peach State
The fourth edition of the “Healthy Georgia: Our State of Public Health” report has been released by the Institute of Public and Preventive Health in Augusta University’s School of Public Health. Within the 64 pages of the report is a snapshot of how healthy Georgians are compared to citizens across the 12 states that make up the Southeastern Region (Alabama, Arkansas, Florida, Georgia, Kentucky, Louisiana, Mississippi, North Carolina, South Carolina, Tennessee, Virginia and West Virginia) and the entire United States. The 2025 edition addresses 31 health topics and has been expanded this year to include multimorbidity; long COVID-19; HIV, chlamydia, gonorrhea and syphilis infection rates; opioid and methamphetamine drug use; suicides; and vaping. Biplab Datta, PhD, assistant professor in the Department of Health Management, Economics, and Policy in SPH, heads up the team of IPPH faculty and staff who create the report each year. Datta credits Jen Jaremski, research associate, and Kit Wooten, public health analyst, with handling much of the work of bringing the report to life. Together, Jaremski and Wooten collected and organized all of the needed assets and organized the 64-page document, preparing it for print and the web. “Every year we strive to present data in a way that policymakers may find helpful in making policy choices,” Datta said. “There are several new topics that were added to this year’s report and some of those are concerning for the state of Georgia, particularly the communicable diseases like HIV, chlamydia, gonorrhea and syphilis. High prevalence rates of these conditions in Georgia, compared to the rest of the U.S. and the Southeastern Region, warrant attention of the public health community.” Georgia has the second-highest rate of HIV infections in the U.S., fourth-highest rates of gonorrhea, sixth-highest for chlamydia and 13th for syphilis. Something that is also new in this year’s report is a comparison of numbers from 2019, or before the COVID-19 pandemic began, compared to after the pandemic for certain conditions. Also coming out of the pandemic, the report looks at how long COVID has affected Georgians, with the state ranking 24th in the nation for rates of long COVID. According to the U.S. Centers for Disease Control and Prevention, long COVID is defined as a chronic condition that occurs after COVID-19 infection and is present for at least three months. On top of looking at comparisons between Georgia and the Southeast and the nation, Datta noted a clearer picture is starting to emerge concerning the difference in urban and rural areas within the state. “For several chronic conditions, like hypertension, diabetes and multimorbidity, we clearly see a striking difference between rural and urban residents of Georgia,” Datta said. Hypertension affects 44.1% of adults in rural Georgia compared to 35% in urban areas, while diabetes affects 17.5% of adults in rural Georgia compared to 12.3% of those in urban areas. Hypertension and diabetes are major risk factors for cardiovascular disease, which affects 12.2% of adults in rural areas compared to 8.3% of adults in urban areas of Georgia. “Hypertension and diabetes are the major risk factors for heart disease, which is the leading cause of death in the U.S. and worldwide, so these are some concerning numbers to see,” Datta said. Multimorbidity, which is when a person has multiple chronic conditions, including obesity, asthma, chronic obstructive pulmonary disease, depression, kidney disease, diabetes, hypertension, high cholesterol, cardiovascular disease, cancer, skin cancer and arthritis, affects 57.4% of adults in rural Georgia compared to 49% of adults in urban areas of the state. These rates are significantly lower than the rest of the Southeast but on par with the rest of the country. When comparing Georgia to the U.S. national average, adults in Georgia have lower rates of cancer and methamphetamine use but higher rates of childhood asthma and adult obesity. At the same time, rates of adult asthma and adult obesity among Georgians were comparable to the averages seen in the Southeast. Interestingly, while adult health insurance coverage was significantly lower than the U.S. national and Southeast Regional averages, the child health insurance coverage in Georgia was comparable to both national and regional averages. The Healthy Georgia Report is the only report of its kind in the state Looking to know more or connect with Biplab Datta, PhD? Then let us help. Dr. Datta is available to speak with media regarding this important topic. Simply click on his icon now to arrange an interview today.

Researchers race to detect Alzheimer's sooner using $3.9M grant
Too often, people learn they have Alzheimer’s disease when it’s too late. The changes in the brain that lead to the disease manifesting with symptoms have already been occurring for decades. Researchers at the University of Delaware will attempt to detect the disease sooner through a new study that examines changes in the arteries and brain tissue in midlife adults in their 50s and 60s. The findings of this work, funded by a nearly $4 million grant from the National Institute on Aging (NIA), could identify the earliest mechanisms linking vascular aging to the loss of brain tissue integrity, leading to new targets for interventions aimed at preventing age-related cognitive impairment. “People who develop high blood pressure or stiffening of the aorta and carotid arteries in midlife are at a much higher risk for developing cognitive impairment or dementia in late life,” said Christopher Martens, the principal investigator of the study. Martens, an associate professor of kinesiology and applied physiology in UD's College of Health Sciences and director of the Delaware Center for Cognitive Aging (DECCAR), is working closely with Curtis Johnson, an associate professor of biomedical engineering in the College of Engineering and leader of the neuroimaging biomarker core within DECCAR, on research funded by a nearly $4 million grant from the National Institute on Aging (NIA), a division of the National Institutes of Health (NIH). “A lot happens as we age, so we’re aiming to pinpoint the timing and exact mechanisms that cause these changes in midlife adults,” Martens said. This latest grant extends DECCAR’s ongoing Delaware Longitudinal Study for Alzheimer’s Prevention (DeLSAP), which seeks to study how risk and protective factors for dementia are related and change over time. Those eligible for DeLSAP could also meet the criteria for participating in the new study. In his Neurovascular Aging Laboratory, Martens studies mechanisms leading to the stiffening of arteries, while Johnson is specifically interested in measuring the stiffness of the brain. “As a person ages, the brain gets softer and breaks down, and we’re looking to see whether changes in arterial stiffness and patterns of blood flow in the brain cause this decline,” Johnson said. Changes in blood flow to the brain come from controllable factors. Smoking, cardiovascular health, diet and exercise all impact blood flow positively and negatively. “A lot of aging research is done at the end of life,” Johnson said. “We want to look at midlife and try to predict what happens later in life so we can prevent it.” While the brain gets softer with age, arteries get stiffer. “We hypothesize that midlife increases in stiffness in blood vessels cause damaging pulsatile pressure to enter the brain,” Martens said. “We believe this is one of the reasons we start to develop cognitive issues at an older age because the brain is exposed to increased pressure; that pressure is likely inflicting damage on surrounding brain tissue.” In Johnson’s Mechanical Neuroimaging Lab, researchers will use high-resolution magnetic resonance elastography (MRE) to determine where brain damage occurs and what specific brain structures may be affected. “From an MRI perspective, most researchers look at AD and other neurodegenerative diseases like multiple sclerosis with an emphasis on detection in a hospital setting,” Johnson said. “Using highly specialized techniques we’ve developed, we focus on the earlier side and how these changes progress into disease from the neuroscience side, emphasizing prevention.” Together, they’ll seek to learn whether arterial stiffness causes the kind of cognitive impairment seen in AD or whether the decline is associated with a loss in the integrity of brain tissue. “If we can prove arterial stiffness is playing a causal role in cognitive aging, that would provide further support for focusing on blood vessel health as an intervention for delaying AD or other forms of dementia versus solely focusing on the brain,” Martens said.

For the fifth consecutive year, ChristianaCare’s Center for Heart & Vascular Health has earned the premier recognition from The American College of Cardiology (ACC) – the HeartCARE Center National Distinction of Excellence award – for its commitment to comprehensive, high quality cardiovascular care. ChristianaCare was the first hospital system in Delaware and one of only a handful in the U.S. to attain this recognition when it was first awarded in 2020 from the ACC, a nonprofit medical association representing more than 50,000 cardiovascular specialists. “We are proud to be a regional leader for cardiovascular care with the most advanced medical, surgical and minimally invasive specialty care, technology and research,” said Kirk Garratt, M.D., medical director of ChristianaCare’s Center for Heart & Vascular Health. “Congratulations to our entire team and all who collaborate seamlessly to deliver care 24/7. As a result, those living in Delaware and neighboring states can receive the highest quality cardiovascular care from the Center for Heart & Vascular Health.” Hospitals that have earned an ACC HeartCARE Center designation have met a set of criteria, including participating in at least two ACC accreditation services programs, national cardiovascular data registries and targeted quality improvement campaigns designed to close gaps in guideline-based care. In addition to being a current recipient of the HeartCARE Center designation, ChristianaCare participates in the ACC’s chest pain MI with PCI (heart attack with angioplasty) and resuscitation accreditation, cath lab accreditation and the Society of Thoracic Surgeon database. “ChristianaCare has demonstrated its commitment to providing the community with excellent heart care,” said Deepak L. Bhatt, M.D., MPH, FACC, chair of the ACC accreditation management board. “ACC accreditation services is proud to award the Center for Heart & Vascular Health with the HeartCARE Center designation.” Hospitals receiving the HeartCARE Center designation have demonstrated their commitment to consistent, high-quality cardiovascular care through comprehensive process improvement, disease and procedure-specific accreditation, professional excellence and community engagement. ChristianaCare has proven to be a forward-thinking institution with goals to advance the cause of sustainable quality improvement. The Center for Heart & Vascular Health is among the largest, most capable regional heart centers on the East Coast. It is among the few centers in the region that integrates cardiac surgery, vascular surgery, vascular interventional radiology, cardiology and interventional nephrology in a single location. Its expert clinical staff performed nearly 200,000 patient procedures last year.

Wilmington Campus Receives $1 Million Donation From the Rocco A. and Mary Abessinio Foundation
ChristianaCare has received a $1 million gift from The Rocco A. and Mary Abessinio Foundation Inc. in support of ChristianaCare’s Wilmington Campus. “All families and communities deserve the excellent care that Wilmington Hospital and ChristianaCare provide,” said Rocco and Mary Abessinio. “It is an honor for our family to support the health and wellbeing of the Wilmington community.” The funds will support areas of greatest need, including the expansion of patient care initiatives aimed at reducing disparities in screening and treatment for cancer and cardiovascular disease in the city of Wilmington. “We are tremendously grateful to the Rocco A. and Mary Abessinio Foundation for their continued, generous support of the Wilmington Campus – a vital resource serving the greater Wilmington community,” said Janice Nevin, M.D., MPH, ChristianaCare president and CEO. “With their help, we are closing gaps in health disparities and improving health for everyone, including some of Delaware’s most vulnerable populations.” The Rocco A. and Mary Abessinio Foundation provided a $1 million gift in 2014 for the redesign and renovation of the health center, which was then named the Rocco A. Abessinio Family Health Center at Wilmington Hospital. The health center is home to three primary care practices and other programs and services that offer high-quality health care, wellness and preventive health visits for people of all ages, regardless of their income or ability to pay. “As a result of the Abessinio family’s longstanding partnership and investment in our mission of service, we are making significant progress in addressing disparities and building strong and healthy communities,” said LeRoi S. Hicks, M.D., MPH, FACP, campus executive director of ChristianaCare’s Wilmington Hospital. A Wilmington landmark in the heart of the city, the ChristianaCare Wilmington Hospital has been serving the diverse medical needs of the city and surrounding region for over 125 years. “Philanthropy is essential to ChristianaCare’s mission of service to our community, and we extend our heartfelt thanks and appreciation to Rocco and Mary Abessinio for their inspiring and visionary philanthropic leadership in support of the Wilmington Campus,” said Dia Williams Adams, MPA, vice president of philanthropy at ChristianaCare. “Their gift is a legacy that not only allows us to increase our ability to make a positive impact on patients and community, but honors the incredible work that our caregivers do every day.” For more information about ways to support ChristianaCare’s mission of service to the community, visit: https://christianacare.org/us/en/make-a-gift.

Healthy Environment, Healthy People: The Intersection Between Climate and Health
How is climate change influencing our health? Why does climate change have a greater impact on vulnerable populations and low-income people? How does the U.S. health care system affect the climate? How can health care systems improve their impact on the climate and the environment? ChristianaCare’s inaugural Climate and Health Conference addressed these topics and raised possible solutions at the John H. Ammon Medical Education Center on the Newark, Delaware, campus on April 12. At the conference, the common denominator was this: An unhealthy environment can lead to illnesses and deaths from air pollution, high heat, contaminated water and extreme weather events. Health systems, government entities, community organizations and individuals all have a role to play in decreasing these effects. “Climate, the environment and health care systems are intertwined,” said Greg O’Neill, MSN, APRN, AGCNS-BC. “We need to pay close attention to this relationship so we can improve health for everyone.” O’Neill is director of Patient & Family Health Education and co-chair of the Environmental Sustainability Caregiver Committee at ChristianaCare. Climate change and intensifying health conditions Negative health effects are so closely tied to the environments where people live, work and play that The Lancet called climate change “the greatest global health threat facing the world in the 21st century [and] the greatest opportunity to redefine the social and environmental determinants of health.” At the conference, speakers addressed specific areas of concern. Asthma. Air pollutants, while largely invisible, are associated with asthma. What’s more, people who live in urban areas with little green space are more likely to have uncontrolled asthma, said speaker Robert Ries, M.D., an emergency medicine resident at ChristianaCare. And there’s the rub, he said: When people with asthma spend time in green spaces, it may improve their health. “In Canada,” he said, “some doctors prescribe nature – two hours a week for better overall health outcomes. Could we do that here?” Heat-related illness. Temperatures worldwide have been rising, increasing the likelihood of heat-related health incidents. Heat waves may be harmful to children and older adults, particularly those who don’t have access to air conditioning, swimming pools or transportation to the beach, said speaker Alan Greenglass, M.D., a retired primary care physician. Children visit the emergency room 20% more frequently during heat waves. Weather-related illness. Climate change is causing more floods, which may result in respiratory problems due to mold growth; and droughts, which may threaten water safety and contribute to global food insecurity, said speaker Anat Feingold, M.D., MPH, an infectious disease specialist at Cooper Health. Stress and anxiety. Climate change can affect mental health, even leading to “solastalgia,” which is distress about environmental change and its effect on one’s home, said speaker Zachary Radcliff, Ph.D., an adolescent psychologist at Nemours. He encouraged clinicians in the audience to keep this mental health concern in mind when seeing patients as it may become more prevalent. Cardiovascular disease risk. Frequent consumption of red meat increases the risk of cardiovascular disease, the top cause of death in the U.S. It’s also unhealthy for the environment, said speaker Shirley Kalwaney, M.D., an internal medicine specialist at Inova. Livestock uses 80% of available farmland to produce only 17% of calories consumed, creating a high level of greenhouse gas emissions. By comparison, plant-based whole foods decrease the risk of cardiovascular disease and diabetes. They use only 16% of available farmland, producing 82% of calories consumed. This makes reducing red meat in our diets one of the most powerful ways to lower the impact on our environment. Health equity and the environment People in low-income communities are more likely to live in urban areas that experience the greatest impacts of climate change, including exposure to air pollutants and little access to green space, said speaker Abby Nerlinger, M.D., a pediatrician for Nemours. A Harvard study in 2020 demonstrated that air pollution was linked with higher death rates from COVID-19 — likely one of the many reasons the pandemic has disproportionally harmed Black and Latino communities. Similarly, access to safe, affordable housing is essential to a healthy environment, said Sarah Stowens, Ed.D., manager of State Policy and Advocacy for ChristianaCare, who advocated for legislation including the Climate Solutions Act, another bill that increased oversight regarding testing and reporting of lead poisoning and a policy to reduce waste from topical medications. Opportunities for change in health care Reduce emissions from pharmaceuticals and chemicals. These emissions are responsible for 18% of a health system’s greenhouse gas emissions. One way to reduce this number is for clinicians to prescribe a dry-powder inhaler (DPI) instead of a metered-dose inhaler (MDI) when applicable and safe for the patient and to give patients any inhalers that were used in the hospital at discharge if they are going home on the same prescription. Hospitals have opportunities to reduce greenhouse gases while caring for patients, said Deanna Benner, MSN, APRN, WHNP, women’s health nurse practitioner and co-chair of ChristianaCare’s Environmental Sustainability Caregiver Committee. The health care sector is responsible for 8.5% of U.S. greenhouse gas emissions, the highest per person in the world. U.S. greenhouse gas emissions account for 27% of the global health care footprint. One way to significantly reduce the carbon footprint is to use fewer anesthetic gases associated with greater greenhouse gas emissions, Benner said. Limit single-use medical devices. Did you know that one surgical procedure may produce more waste than a family of four produces in a week? Elizabeth Cerceo, M.D., director of climate health at Cooper Health, posed this question during her talk. Sterilizing and reusing medical devices, instead of using single-use medical devices, she said, may meaningfully reduce hospital waste. ChristianaCare’s commitment to healthy environments and healthy people As one of the nation’s leading health systems, ChristianaCare is taking a bold, comprehensive approach to environmental stewardship. ChristianaCare reduced its carbon footprint by 37% in 2023 by purchasing emission-free electricity. ChristianaCare joined the White House Climate Pledge to use 100% renewable energy by 2025, reduce greenhouse gas emissions by 50% by 2030 and achieve zero net emissions by 2050. ChristianaCare has created an Environmental, Social and Governance structure to help advance a five-year strategic plan that delivers health equity and environmental stewardship. Nearly 150 staff members have become Eco-Champions, an opportunity to be environmental change-leaders in the workplace. In 2023, ChristianaCare’s successful environmental stewardship included: Reducing our carbon footprint by 37% by purchasing emission-free electricity. Recycling 96,663 pounds of paper, which preserved 11,485 trees. Reducing air pollution by releasing an estimated 33,000 fewer pounds of nitrogen oxides and sulfur oxides through the use of a cogeneration energy plant on the Newark campus. Donating 34,095 pounds of unused food to the Sunday Breakfast Mission in Wilmington, Delaware. Donating 1,575 pounds of unused medical equipment to Project C.U.R.E., ChristianaCare’s Virtual Education and Simulation Training Center and Delaware Technical Community College. “In quality improvement, they say you improve the things that you measure,” O’Neill said in expressing goals for continued success. In looking ahead, said Benner, “I really hope that this conference is the catalyst for positive change with more people understanding how climate is connected to health, so that we can protect health from environmental harms and promote a healthy environment for all people to thrive.”

Managing Menopause: Mind-Body Solutions for Hot Flashes, Sleep and Well-Being
In recognition of World Menopause Day, Baylor psychologist shares research on hypnotherapy's beneficial effects in relieving hot flashes (Image credit: Rana Hamid via Getty Images) The natural aging process of perimenopause and menopause can create a wide range of symptoms for women, with hot flashes and poor sleep being the most frequently reported – and most disruptive – symptoms. World Menopause Day is recognized on Oct. 18, and one Baylor University researcher has been on a 20-year mission to identify safe and effective options to hormone replacement therapy (HRT) to help women find relief from hot flashes and improve sleep and well-being during the menopause transition. Gary Elkins, Ph.D., professor of psychology and neuroscience and director of the Mind-Body Medicine Research Laboratory at Baylor University, is among the nation’s leading researchers on hypnotherapy and mind-body approaches, including continued funding by the National Institutes of Health (NIH) to evaluate the efficacy of a self-hypnosis intervention to reduce hot flashes and improve sleep, as well as other outcomes. “It is important to recognize that hot flashes are a natural part of menopause,” Elkins said. “They are not caused by stress or personality but are due to the decline in estrogen that occurs naturally with aging.” Perimenopause (the hormonal transition leading up to menopause) and menopause (the cessation of menstrual cycles) is the natural aging process marked by the decline in the reproductive hormone estrogen and progesterone in women and can last anywhere from seven to 20 years. Menopause usually begins around age 52 or can result from breast cancer treatment or hysterectomies. Although HRT remains the most effective treatment for hot flashes, it is not appropriate for everyone. A major NIH study found that HRT led to an increased risk of breast cancer and cardiovascular disease in some post-menopausal women and breast cancer survivors. Elkins’ research is aimed at giving women choices for their own healthcare, including alternatives such as hypnotherapy. “While hypnotherapy is not widely understood by many people, it can regulate hot flashes and improve sleep by managing how temperatures are perceived and regulated in the brain,” Elkins said. “Hypnotherapy is a mind-body therapy, similar to mindfulness and guided imagery, that involves the focus of attention, a relaxed state and therapeutic suggestions.” Elkins’ research on hot flashes and sleep and hypnotherapy has been clinically shown to reduce hot flashes by up to 80%, more effective than any other hot flash management tool available, with the exception of HRT. He also has found that hypnotherapy, as a mind-body intervention, can reduce hot flashes to a degree comparable to HRT, improve sleep quality by over 50% and reduce anxiety while increasing well-being. “Hypnotherapy involves daily practice of 15-minute hypnotic relaxation sessions that teach your brain to adapt to your body’s changing hormone level. Mental images for coolness and control are used to empower women to take control of the two most troublesome menopause symptoms – hot flashes and sleep,” Elkins said. Elkins offers the following suggestions for women to empower them and help them find relief from hot flashes, anxiety and interrupted sleep. Remember that hot flashes are a normal part of the perimenopausal/menopausal transition, and the effects a woman experiences are real. Talk to your doctor about options that may work for you. Everyone is an individual, and it is important to find what works best for you. A combined approach of mind-body hypnosis therapy along with low-dose medications can be helpful for some women. It can be helpful to keep a daily diary of your hot flashes to monitor them. Get good sleep. Poor sleep and night sweats can make hot flashes worse. Be knowledgeable about things that have not been shown to work, such as fans, cold packs and certain herbs. Seek support from family and friends. Elkins has developed the Evia from Mindset Health App to give women easy access to hypnotherapy for hot flashes. The app comes with a free trial that delivers evidence-based hypnotherapy intervention for women during the menopause transition and beyond.