Experts Matter. Find Yours.
Connect for media, speaking, professional opportunities & more.
ChristianaCare Appoints Jennifer Moberg, DNP, Vice President of Emergency Services
Jennifer Moberg, DNP, MPA, RN, CPPS, NEA-BC, has been appointed vice president of Emergency Services at ChristianaCare. In this role, she will oversee the delivery of safe, high-quality, patient-centered care across ChristianaCare’s emergency departments and support prehospital services and trauma programs. Jennifer Moberg, DNP, has been appointed vice president of Emergency Services at ChristianaCare. Moberg has a strong track record of improving care quality, safety and caregiver engagement in complex health care settings. She has helped build more diverse teams, reduce staff turnover and lead major emergency department renovation projects. She has also worked to make patient care more efficient and improve safety for caregivers by strengthening security practices. Prior to joining ChristianaCare, Moberg served as director of Emergency Services at HealthPartners in Bloomington, Minnesota. She also worked as a senior advisor assessing and standardizing security protocols across hospitals and clinics. Earlier in her career, she spent more than 20 years at Abbott Northwestern, where she served as a critical care nurse and later as a patient care manager. Moberg earned a Doctor of Nursing Practice in executive leadership from Baylor University. She holds a Master of Public Affairs in nonprofit leadership from the University of Minnesota and a Bachelor of Science in nursing from Bethel University. She reports to Chief Nurse Executive Danielle Weber, DNP, MSM, RN-BC, NEA-BC.
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.
Hiring More Nurses Generates Revenue for Hospitals
Underfunding is driving an acute shortage of trained nurses in hospitals and care facilities in the United States. It is the worst such shortage in more than four decades. One estimate from the American Hospital Association puts the deficit north of one million. Meanwhile, a recent survey by recruitment specialist AMN Healthcare suggests that 900,000 more nurses will drop out of the workforce by 2027. American nurses are quitting in droves, thanks to low pay and burnout as understaffing increases individual workload. This is bad news for patient outcomes. Nurses are estimated to have eight times more routine contact with patients than physicians. They shoulder the bulk of all responsibility in terms of diagnostic data collection, treatment plans, and clinical reporting. As a result, understaffing is linked to a slew of serious problems, among them increased wait times for patients in care, post-operative infections, readmission rates, and patient mortality—all of which are on the rise across the U.S. Tackling this crisis is challenging because of how nursing services are reimbursed. Most hospitals operate a payment system where services are paid for separately. Physician services are billed as separate line items, making them a revenue generator for the hospitals that employ them. But under Medicare, nursing services are charged as part of a fixed room and board fee, meaning that hospitals charge the same fee regardless of how many nurses are employed in the patient’s care. In this model, nurses end up on the other side of hospitals’ balance sheets: a labor expense rather than a source of income. For beleaguered administrators looking to sustain quality of care while minimizing costs (and maximizing profits), hiring and retaining nursing staff has arguably become something of a zero-sum game in the U.S. The Hidden Costs of Nurse Understaffing But might the balance sheet in fact be skewed in some way? Could there be potential financial losses attached to nurse understaffing that administrators should factor into their hiring and remuneration decisions? Research by Goizueta Professors Diwas KC and Donald Lee, as well as recent Goizueta PhD graduates Hao Ding 24PhD (Auburn University) and Sokol Tushe 23PhD (Muma College of Business), would suggest there are. Their new peer-reviewed publication* finds that increasing a single nurse’s workload by just one patient creates a 17% service slowdown for all other patients under that nurse’s care. Looking at the data another way, having one additional nurse on duty during the busiest shift (typically between 7am and 7pm) speeds up emergency department work and frees up capacity to treat more patients such that hospitals could be looking at a major increase in revenue. The researchers calculate that this productivity gain could equate to a net increase of $470,000 per 10,000 patient visits—and savings to the tune of $160,000 in lost earnings for the same number of patients as wait times are reduced. “A lot of the debate around nursing in the U.S. has focused on the loss of quality in care, which is hugely important,” says Diwas KC. But looking at the crisis through a productivity lens means we’re also able to understand the very real economic value that nurses bring too: the revenue increases that come with capacity gains. Diwas KC, Goizueta Foundation Term Professor of Information Systems & Operations Management “Our findings challenge the predominant thinking around nursing as a cost,” adds Lee. “What we see is that investing in nursing staff more than pays for itself in downstream financial benefits for hospitals. It is effectively a win-win-win for patients, nurses, and healthcare providers.” Nurse Load: the Biggest Impact on Productivity To get to these findings, the researchers analyzed a high-resolution dataset on patient flow through a large U.S. teaching hospital. They looked at the real-time workloads of physicians and nurses working in the emergency department between April 2018 and March 2019, factoring in variables such as patient demographics and severity of complaint or illness. Tracking patients from admission to triage and on to treatment, the researchers were able to tease out the impact that the number of nurses and physicians on duty had on patient throughput. Using a novel machine learning technique developed at Goizueta by Lee, they were able to identify the effect of increasing or reducing the workforce. The contrast between physicians and nursing staff is stark, says Tushe. “When you have fewer nurses on duty, capacity and patient throughput drops by an order of magnitude—far, far more than when reducing the number of doctors. Our results show that for every additional patient the nurse is responsible for, service speed falls by 17%. That compares to just 1.4% if you add one patient to the workload of an attending physician. In other words, nurses’ impact on productivity in the emergency department is more than eight times greater.” Boosting Revenue Through Reduced Wait Times Adding an additional nurse to the workforce, on the other hand, increases capacity appreciably. And as more patients are treated faster, hospitals can expect a concomitant uptick in revenue, says KC. “It’s well documented that cutting down wait time equates to more patients treated and more income. Previous research shows that reducing service time by 15 minutes per 30,000 patient visits translates to $1.4 million in extra revenue for a hospital.” In our study, we calculate that staffing one additional nurse in the 7am to 7pm emergency department shift reduces wait time by 23 minutes, so hospitals could be looking at an increase of $2.33 million per year. Diwas KC This far eclipses the costs associated with hiring one additional nurse, says Lee. “According to 2022 U.S. Bureau of Labor Statistics, the average nursing salary in the U.S. is $83,000. Fringe benefits account for an additional 50% of the base salary. The total cost of adding one nurse during the 7am to 7pm shift is $310,000 (for 2.5 full-time employees). When you do the math, it is clear. The net hospital gain is $2 million for the hospital in our study. Or $470,000 per 10,000 patient visits.” Incontrovertible Benefits to Hiring More Nurses These findings should provide compelling food for thought both to healthcare administrators and U.S. policymakers. For too long, the latter have fixated on the upstream costs, without exploring the downstream benefits of nursing services, say the researchers. Their study, the first to quantify the economic value of nurses in the U.S., asks “better questions,” argues Tushe; exploiting newly available data and analytics to reveal incontrovertible financial benefits that attach to hiring—and compensating—more nurses in American hospitals. We know that a lot of nurses are leaving the profession not just because of cuts and burnout, but also because of lower pay. We would say to administrators struggling to hire talented nurses to review current wage offers, because our analysis suggests that the economic surplus from hiring more nurses could be readily applied to retention pay rises also. Sokol Tushe 23PhD, Muma College of Business The Case for Mandated Ratios For state-level decision makers, Lee has additional words of advice. “In 2004, California mandated minimum nurse-to-patient ratios in hospitals. Since then, six more states have added some form of minimum ratio requirement. The evidence is that this has been beneficial to patient outcomes and nurse job satisfaction. Our research now adds an economic dimension to the list of benefits as well. Ipso facto, policymakers ought to consider wider adoption of minimum nurse-to-patient ratios.” However, decision makers go about tackling the shortage of nurses in the U.S., they should go about it fast and soon, says KC. “This is a healthcare crisis that is only set to become more acute in the near future. As our demographics shift and our population starts again out, demand for quality will increase. So too must the supply of care capacity. But what we are seeing is the nursing staffing situation in the U.S. moving in the opposite direction. All of this is manifesting in the emergency department. That’s where wait times are getting longer, mistakes are being made, and overworked nurses are quitting. It is creating a vicious cycle that needs to be broken.” Diwas Diwas KC is a professor of information systems & operations management and Donald Lee is an associate professor of information systems & operations management. Both experts are available to speak about this important topic - simply click on either icon now to arrange an interview today.
Fast-striking and unpredictable, tornadoes pose major challenges for emergency planners
At least 20 U.S. states have been hit with tornadoes – some of them deadly – over the past week. Experts from the University of Delaware's Disaster Research Center can speak to the difficulty of drawing up plans in advance of tornadoes, which can develop quickly and unexpectedly, as well as a variety of topics related to storm preparedness, evacuations and recovery. Those experts include: Jennifer Horney: Environmental impacts of disasters and potential public health impacts for chronic and infectious diseases. Horney, who co-authored a paper on the increase in tornado outbreaks, can talk about how impacts on the morbidity and mortality that result from tornadoes. Tricia Wachtendorf: Evacuation decision-making, disaster response and coordination, disaster relief (donations) and logistics, volunteer and emergent efforts, social vulnerability. James Kendra: Disaster response, nursing homes and hospitals, volunteers, response coordination. Jennifer Trivedi: Challenges for people with disabilities during disaster, cultural issues and long-term recovery. Sarah DeYoung: Pets in emergencies, infant feeding in disasters and decision-making in evacuation. A.R. Siders: Expert on sea level rise and managed retreat – the concept of planned community movement away from flood-prone areas. To reach these experts directly, visit their profile and click on the contact button.
Aston University researcher to help uncover hidden impact of painkiller overuse among older people
The HOPE-AO project led by the University of Plymouth will look at the potential harms of overprescribed pain medication in older people in the UK Aston University’s Professor Ian Maidment will bring his expertise in pharmacy and work with patient groups on medicine optimisation The project has been funded by the National Institute for Health and Care Research (NIHR) A new study led by the University of Plymouth will explore chronic pain prescribing in older adults across the UK, with the aim of understanding whether current treatments and processes meet their needs. The HOPE-AO: Helping to Optimise Pain control in the Elderly experiencing Analgesic Overprescribing project is being supported by the National Institute for Health and Care Research (NIHR) and includes Aston University’s Professor Ian Maidment. It will investigate whether certain groups of the older population are more likely to have analgesic (pain relief) medication overprescribed to them, and any side effects or other harms these medications can pose if taken for long periods. It aims to identify alternative treatment solutions to reduce the use of unnecessary pain medicines, working with patients to develop a list of acceptable strategies that could be tested and implemented across the UK. Around 4m older people across the UK live with varying degrees of chronic pain as a result of conditions including arthritis, diabetes or frailty. While some people benefit from pain relief medicines, many end up receiving long-term repeated prescriptions – for medications ranging from paracetamol and ibuprofen to opioids and antidepressants – for weeks, months or years at a time. The project is being led by researchers from the University of Plymouth, working with colleagues at the University of Exeter, Aston University, University of Aberdeen and the North East London Foundation NHS Trust. It is funded by through a Programme Development Grant from the National Institute for Health and Care Research (NIHR). The project team comprises experts in the care of older people – including healthcare researchers, nurses, consultants, GPs, pharmacists and psychiatrists working across the UK – as well as medical statisticians and health economists. It also involves an advisory group of patients with lived experience of receiving repeat prescriptions for pain medication. During the project, the team will speak to patients aged 65 and over with a history of chronic pain for which they are taking, or have taken, medication and families who cared for and supported relatives with chronic pain. They will also speak to healthcare professionals who are either prescribing or supporting older adults taking medication for chronic pain management. Alongside this work, the team will analyse anonymised healthcare data to understand more about older adults who are prescribed medication for chronic pain. This includes patterns in prescribing, health and demographic factors associated with pain medication use, and potential health outcomes, and will help identify those likely to benefit most from support. Professor Maidment, from Aston Pharmacy School, will bring his expertise in pharmacy, medication use in day-to-day clinical practice and working with diverse groups of patients to support medication optimisation. He said: “From my experience in community pharmacy, the use of pain medicines is very common in older people. We need to work with older people to understand how we can help older people to use other potentially safer approaches.” Patricia Schofield, professor of clinical nursing at the University of Plymouth and one of the study’s chief investigators, said: “Very often, older people are told by a doctor that the most effective means of treating a health condition is through some form of pain relief. But they often don’t get any form of follow-up appointment and, as a generation, are less likely to seek one as they either feel pain is part of the ageing process or they don’t wish to be seen as a burden. The result is that they end up getting repeat prescriptions, potentially for pain medications they no longer need and also at significant cost to the NHS. “This study will give us a clearer understanding of the scale of the issue which we can use to develop ways of benefitting patients and their families, and the healthcare professionals working to treat and support them.” Victoria Abbott-Fleming MBE, founder of the charity Burning Nights CRPS Support, is the chair of the Patient and Public Involvement and Engagement group for the HOPE-AO study. It will be made up of several adults over the age of 65 who live with chronic pain and have received repeat prescriptions for pain medication. Victoria has herself lived for more than 20 years with a chronic pain condition, Complex Regional Pain Syndrome (CRPS), and set up Burning Nights to support those affected by it on a day-to-day basis and their families. She is also chair of the Expert Patient and Carer Committee at the British Pain Society. She said: “I’m excited to support this study that places the voices of older adults and their carers at the heart of pain management. All too often, those living with chronic pain – especially older adults – are prescribed medication without regular review or consideration of alternative approaches. This study is a vital step towards more informed and balanced care, helping ensure that older people living with chronic pain are not just treated, but truly heard and supported.”
Retro Appeal: Research Reveals the Reasons Behind Vintage Shopping in Turbulent Times
Why buy vintage? Reasons abound. It’s kinder to the environment. It’s usually cheaper. It’s back in style. But did you know it may also address a deep-seated psychological need for stability amid upheavals? Vintage consumption—that is, buying previously owned items from an earlier era—acts as a means to connect the past, present, and future. That connection across time can be reassuring, most especially in times of uncertainty. When you really want to buy a leather jacket that’s older than you are, it may be enlightening to consider the circumstances. This vintage insight reveals itself in research by Ryan Hamilton, associate professor of marketing at Goizueta Business School. In an award-winning article titled “Stitching time: Vintage consumption connects the past, present, and future,” Hamilton—along with coauthors Gulen Sarial-Abi, Kathleen Vohs, and Aulona Ulqinaku—uncovered why we may want to turn to something old when we perceive threats to our worldviews. Notably, multiple studies have shown thoughts of death to increase the appeal of items that have already stood the test of time. The Psychological Appeal of Thrifting In psychology, “meaning frameworks” are how we, as human beings, interpret and understand our lives as meaningful and valuable. Threats to our meaning frameworks—i.e., the pillars propping up our worldviews—can include thoughts of death, unsettling economic upheavals, and other existential challenges. In order to explore the effects of meaning threats on our preference for vintage, Hamilton and coauthors designed several studies. Their pilot test measured the physical health of nursing home residents. It then measured their preferences for vintage items, controlling for other variables. The results held up the researchers’ hypothesis: Vintage items—be they books, watches, bicycles, or luggage—were more strongly preferred over their modern versions by elderly participants in poorer health, presumably those most likely to have mortality on their minds. Six subsequent studies used different variables to see if the main hypothesis continued to hold up. It did, while at the same time revealing more information about the mechanisms at work. Ryan Hamilton Associate Professor of Marketing Death or Dental Pain In one study, for example, researchers prompted participants with death reminders. They had to contemplate and write about their own deaths to make sure mortality was top of mind. Researchers prompted a control group with reminders of dental pain. Both groups then answered a 12-question survey about their desire for structure (e.g., set routines and practices) at that particular moment. But there was another element in this study: contemplating wearing a watch from the 1950s. As predicted by the main hypothesis, death cues were associated with participants reporting that they desired more structure. The only exceptions was for those who imagined an old watch ticking on their wrists. Vintage consumption seemed to act as a buffer against unsettling thoughts of death for them. What is going on here? As noted above, the researchers theorize and show that vintage objects tend to connect our thoughts of the past, present, and future. These mental, intertemporal connections tend to be reassuring—“a hidden factor” in our preferences and choices, as Hamilton notes. More than Nostalgia One might think nostalgia—a sentimental longing for the past—could also be at work. Feeling nostalgic for one’s own past and social connections can buffer against meaning threats, as previous research has shown. But this paper was designed to tease out nostalgia. It focused on vintage’s connections across time regardless of one’s personal experiences. “This study allowed us to clearly show that people respond differently to something they believe to be old,” as Hamilton explains. “It’s not just something that has a retro look, which was one of my favorite aspects of this project.” Hamilton and his coauthors achieved this by having participants evaluate identical items thought to be genuinely vintage or replicas. And the results were robust. Retro replicas, which can prompt nostalgia, did not have the same psychological impact as items believed to be genuinely old. For instance, 20-year-olds who find a watch from the 1950s reassuring can’t feel nostalgic about the design personally. They can, however, feel a connection across time—and that came through in the study. Retail Therapy on the Rise? Hamilton’s research here follows his broader interest in consumer psychology, branding, and decision-making. “When we’re buying things, we may think it’s based on strict utility maximization. However, it also might be making us feel better in some way,” says Hamilton. Shopping can serve as an emotional management strategy—for better or for worse. Although it was outside the scope of this particular investigation (and all participants were over age 18), the insights gleaned here may help explain why 21st-century teenagers seem to be particularly avid “thrifters” these days. “I don’t want to overstate our findings. But it’s at least possible that the appeal of vintage for teenagers is boltstered by a sense of permanence and endurance that helps them during times of upheaval,” Hamilton says. It turns out a 30-year-old leather jacket might help its new owner feel better on many levels. So is it any wonder that vintage shopping is surging in uncertain times? Fashion magazines, such as Vogue and GQ, are following the vintage craze closely in 2024. Concern for climate change and the Earth’s finite resources may present two intertwined reasons to buy old things: those two things are environmental and psychological. If tumultuous times continue amid contentious elections, wars, and other threats, it seems safe to bet on vintage. Ryan Hamilton is associate professor of Marketing at Emory University - Goizueta Business School. If you're a journalist looking to know about this topic, simply click on his icon now to arrange an interview today.
Virtual reality training tool helps nurses learn patient-centered care
University of Delaware computer science students have developed a digital interface as a two-way system that can help nurse trainees build their communication skills and learn to provide patient-centered care across a variety of situations. This virtual reality training tool would enable users to rehearse their bedside manner with expectant mothers before ever encountering a pregnant patient in person. The digital platform was created by students in Assistant Professor Leila Barmaki’s Human-Computer Interaction Laboratory, including senior Rana Tuncer, a computer science major, and sophomore Gael Lucero-Palacios. Lucero-Palacios said the training helps aspiring nurses practice more difficult and sensitive conversations they might have with patients. "Our tool is targeted to midwifery patients,” Lucero-Palacios said. “Learners can practice these conversations in a safe environment. It’s multilingual, too. We currently offer English or Turkish, and we’re working on a Spanish demo.” This type of judgement-free rehearsal environment has the potential to remove language barriers to care, with the ability to change the language capabilities of an avatar. For instance, the idea is that on one interface the “practitioner” could speak in one language, but it would be heard on the other interface in the patient’s native language. The patient avatar also can be customized to resemble different health stages and populations to provide learners a varied experience. Last December, Tuncer took the project on the road, piloting the virtual reality training program for faculty members in the Department of Midwifery at Ankara University in Ankara, Turkey. With technical support provided by Lucero-Palacios back in the United States, she was able to run a demo with the Ankara team, showcasing the UD-developed system’s interactive rehearsal environment’s capabilities. Last winter, University of Delaware senior Rana Tuncer (left), a computer science major, piloted the virtual reality training program for Neslihan Yilmaz Sezer (right), associate professor in the Department of Midwifery, Ankara University in Ankara, Turkey. Meanwhile, for Tuncer, Lucero-Palacios and the other students involved in the Human-Computer Interaction Laboratory, developing the VR training tool offered the opportunity to enhance their computer science, data science and artificial intelligence skills outside the classroom. “There were lots of interesting hurdles to overcome, like figuring out a lip-sync tool to match the words to the avatar’s mouth movements and figuring out server connections and how to get the languages to switch and translate properly,” Tuncer said. Lucero-Palacios was fascinated with developing text-to-speech capabilities and the ability to use technology to impact patient care. “If a nurse is well-equipped to answer difficult questions, then that helps the patient,” said Lucero-Palacios. The project is an ongoing research effort in the Barmaki lab that has involved many students. Significant developments occurred during the summer of 2024 when undergraduate researchers Tuncer and Lucero-Palacios contributed to the project through funding support from the National Science Foundation (NSF). However, work began before and continued well beyond that summer, involving many students over time. UD senior Gavin Caulfield provided foundational support to developing the program’s virtual environment and contributed to development of the text-to-speech/speech-to-text capabilities. CIS doctoral students Fahim Abrar and Behdokht Kiafar, along with Pinar Kullu, a postdoctoral fellow in the lab, used multimodal data collection and analytics to quantify the participant experience. “Interestingly, we found that participants showed more positive emotions in response to patient vulnerabilities and concerns,” said Kiafar. The work builds on previous research Barmaki, an assistant professor of computer and information sciences and resident faculty member in the Data Science Institute, completed with colleagues at New Jersey Institute of Technology and University of Central Florida in an NSF-funded project focused on empathy training for healthcare professionals using a virtual elderly patient. In the project, Barmaki employed machine learning tools to analyze a nursing trainee’s body language, gaze, verbal and nonverbal interactions to capture micro-expressions (facial expressions), and the presence or absence of empathy. “There is a huge gap in communication when it comes to caregivers working in geriatric care and maternal fetal medicine,” said Barmaki. “Both disciplines have high turnover and challenges with lack of caregiver attention to delicate situations.” UD senior Rana Tuncer (center) met with faculty members Neslihan Yilmaz Sezer (left) and Menekse Nazli Aker (right) of Ankara University in Ankara, Turkey, to educate them about the virtual reality training tool she and her student colleagues have developed to enhance patient-centered care skills for health care professionals. When these human-human interactions go wrong, for whatever reason, it can extend beyond a single patient visit. For instance, a pregnant woman who has a negative health care experience might decide not to continue routine pregnancy care. Beyond the project’s potential to improve health care professional field readiness, Barmaki was keen to note the benefits of real-world workforce development for her students. “Perceptions still exist that computer scientists work in isolation with their computers and rarely interact, but this is not true,” Barmaki said, pointing to the multi-faceted team members involved in this project. “Teamwork is very important. We have a nice culture in our lab where people feel comfortable asking their peers or more established students for help.” Barmaki also pointed to the potential application of these types of training environments, enabled by virtual reality, artificial intelligence and natural language processing, beyond health care. With the framework in place, she said, the idea could be adapted for other types of training involving human-human interaction, say in education, cybersecurity, even in emerging technology such as artificial intelligence (AI). Keeping people at the center of any design or application of this work is critical, particularly as uses for AI continue to expand. “As data scientists, we see things as spreadsheets and numbers in our work, but it’s important to remember that the data is coming from humans,” Barmaki said. While this project leverages computer vision and AI as a teaching tool for nursing assistants, Barmaki explained this type of system can also be used to train AI and to enable more responsible technologies down the road. She gave the example of using AI to study empathic interactions between humans and to recognize empathy. “This is the most important area where I’m trying to close the loop, in terms of responsible AI or more empathy-enabled AI,” Barmaki said. “There is a whole area of research exploring ways to make AI more natural, but we can’t work in a vacuum; we must consider the human interactions to design a good AI system.” Asked whether she has concerns about the future of artificial intelligence, Barmaki was positive. “I believe AI holds great promise for the future, and, right now, its benefits outweigh the risks,” she said.
Hundreds of nurses and their colleagues at ChristianaCare gathered in a conference room at Christiana Hospital and listened through a livestream across the organization’s campuses and practices for an announcement they’ve been anticipating for many months. “For your commitment to nursing excellence and quality care, we are thrilled to recognize ChristianaCare with its fourth consecutive Magnet designation,” said David Marshall, JD, DNP, RN, chair of the American Nurses Credentialing Center’s Commission on Magnet Recognition. “This accomplishment is a powerful testament to your dedication to the nurses who practice there, the entire health care team, and — most importantly — the patients you serve.” Shouts erupted, balloons and streamers floated up and, in the happy commotion, there was even a little cowbell. As the only four-time Magnet-designated health care organization in Delaware, ChristianaCare has achieved this global recognition — the highest honor in nursing practice — for continued dedication to excellence and innovation, high-quality patient care and experience, nurse engagement and work culture. “Magnet designation recognizes ChristianaCare nurses are simply the best!” said ChristianaCare President and CEO Janice E. Nevin, M.D., MPH. “A fourth Magnet designation is an incredible achievement and reflects the vital importance and commitment of our nurses as we serve together with love and excellence.” ChristianaCare has more than 3,000 nurses, and they make up the largest segment of ChristianaCare’s workforce. ChristianaCare is the largest nonprofit organization and private employer in the state of Delaware. This most recent designation for ChristianaCare includes Christiana Hospital, Wilmington Hospital, ChristianaCare HomeHealth and Community Care Services, through early 2029. What it means to be Magnet “Our fourth consecutive Magnet designation means that our nurses and all of our caregiver colleagues have upheld the ANCC’s very high standards in patient care since our first recognition in 2010,” said ChristianaCare Chief Nurse Executive Danielle Weber, DNP, RN. “That is a long time to bring your ‘A’ game every day — through 15 years of change, including a pandemic — and to sustain growth in professional practice, innovation and culture. Magnet recognition raises the bar for patient care and inspires every member of our team to achieve excellence every day.” The Magnet Recognition Program — administered by the American Nurses Credentialing Center, the largest and most prominent nurses credentialing organization in the world — identifies health care organizations that provide the very best in nursing care, exceptional nurse engagement and professionalism in nursing practice. The Magnet Recognition Program serves as the gold standard for nursing excellence and provides consumers with the ultimate benchmark for measuring quality of care. The ANCC Magnet Recognition Program® has conferred Magnet status to less than 10% of hospitals and health systems in the United States. There are 621 Magnet-designated health organizations internationally. ChristianaCare was the first in Delaware to achieve Magnet designation, in 2010. For nurses, Magnet Recognition means education and development through every career stage, which leads to greater autonomy at the bedside. For patients, it means the very best care, delivered by nurses who are supported to be the very best that they can be. While Magnet is a nursing-led initiative, the designation reflects the work of caregivers across the organization. Magnet redesignation itself is a rigorous process. Health care organizations must reapply for Magnet status every four years and demonstrate adherence to the Magnet concepts for nursing excellence and engagement and measurable improvements in patient care and quality. The ANCC commended ChristianaCare on these exemplars: Advocacy for and acquisition of organizational resources specific to nurses’ well-being. particularly through the Nursing Integrative Care Program. An innovative strategy to address the shortage of certified registered nurse anesthetists in Delaware through a partnership program between ChristianaCare and Wilmington University to launch the state’s first Nurse Anesthesiology program. Outstanding nursing research engagement and growth of the nursing research enterprise especially through the Nursing Research Fellowship in Robotics and Innovation.
Nurse Scientist Susan Smith Birkhoff Makes Two Research ‘Firsts’ in Delaware
Susan Smith Birkhoff, Ph.D., RN, is making nursing history in the First State through the Delaware IDeA Network of Biomedical Research Excellence (INBRE). She is the first nurse scientist to be named an INBRE site principal investigator and she is the first nurse to receive the Seema S. Sonnad Mentor of the Year Award from INBRE’s Junior Investigator Network. INBRE is a collaborative network of Delaware academic, health care and research institutions, composed of ChristianaCare, Delaware State University, Delaware Technical Community College Nemours Children’s Health and University of Delaware. First nurse scientist to lead INBRE site As the INBRE site principal investigator at ChristianaCare, Smith Birkhoff will expand on the research network’s success at a large academic health center. In collaboration with the INBRE partners and the program manager, Kellie Patterson, BSN, RN, CCRP, she will leverage centers of excellence across ChristianaCare to host an exceptional student program, increase the health system's contributions to the pilot program pool and grow the visibility of INBRE across the enterprise. “Susan brings a terrific combination of skills to this role,” said Omar Khan, M.D., MHS, FAAFP, chief scientific officer for ChristianaCare and institutional representative on the INBRE steering committee. “She is a mentor, scientist and teacher, and her experience with INBRE and the state’s other premier research programs will ensure that we deliver the highest value for the Delaware community.” Smith Birkhoff leads and supports interprofessional research education, systemwide technology evaluation, and grantsmanship. She spearheads a diverse research program, encompassing areas such as robotics in health care, virtual reality in medicine and burnout in the nursing workforce. As program director of Technology Research & Education at ChristianaCare, she collaborates across the health system’s academic research enterprise to achieve both clinician- and patient-oriented research outcomes. “Susan is a wonderful colleague and she is a true researcher-educator,” said Neil Jasani, M.D., MBA, FACEP, chief academic officer for ChristianaCare. “She is a great fit for the work of Delaware INBRE as we advance ChristianaCare’s contribution to this essential research network.” She co-leads an innovative program to study the one of the first deployments of increasingly autonomous robots in a U.S. health care setting and directs the first Nursing Research Fellowship in Robotics and Innovation, housed at ChristianaCare. First nurse named Mentor of the Year Smith Birkhoff received the 2025 Seema S. Sonnad Mentor of the Year Award from INBRE’s Junior Investigator Network, nominated for her exceptional mentorship by ChristianaCare colleagues whom she mentored. Her nominators were: Kaci Rainey, MSN, RN, CEN, TCRN, an evidence-based practice specialist at ChristianaCare, and Briana Abernathy, BSN, RN, CEN, a nurse in utilization management at ChristianaCare and an inaugral nurse fellow in the Nursing Research Fellowship in Robotics and Innovation. “They say that if you are not at the table, you are on the menu. We are profoundly grateful that Dr. Smith Birkhoff selflessly provided us with a seat at the table and an overflowing feast of knowledge,” said Abernathy in presenting the award. “This knowledge has quenched our thirst for change and fueled our hunger for research and innovation, setting the stage for the rest of our careers.”
