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ChristianaCare Hospitals Earn Top Patient Safety Rating From Leapfrog Group
ChristianaCare’s Christiana Hospital, Union Hospital and Wilmington Hospital have each received an ‘A’ grade in the Spring 2025 Leapfrog Hospital Safety Grade, a national distinction that recognizes ChristianaCare’s achievements in protecting patients from harm and providing safe health care. “At ChristianaCare, patient safety is our highest priority and an essential part of our mission of service to the community,” said Kert Anzilotti, M.D., MBA, system chief medical officer and president of the Medical Group of ChristianaCare. “We are incredibly proud of this achievement. “This ‘A’ grade is not just a letter; it’s a testament to the hard work and passion of our caregivers, who strive every day to ensure our patients receive the highest quality care and feel safe throughout their journey with us.” The Leapfrog Group assigns an ‘A,’ ‘B,’ ‘C,’ ‘D’ or ‘F’ grade to hospitals across the country based on over 30 performance measures reflecting the prevention of errors, accidents, injuries and infections. This Leapfrog recognition comes on the heels of multiple other recent quality and safety awards that ChristianaCare has received, including: • ChristianaCare was recognized as one of the best hospitals in the nation by Money in its 2025 hospital rankings, making it the only hospital in Delaware to achieve this distinction. • ChristianaCare is ranked by Newsweek among the World’s Best Hospitals and rated by U.S. News & World Report as the No. 1 hospital in Delaware. • ChristianaCare earned the Beacon Award for Excellence from the American Association of Critical-Care Nurses (AACN) for three of its intensive care units: the Medical Intensive Care Unit (MICU), the Surgical Critical Care Complex (SCCC), and the Transitional Surgical Unit (TSU) at Christiana Hospital in Newark, Delaware. • ChristianaCare is the only four-time Magnet-designated health care organization in Delaware, recognized for continued dedication to excellence and innovation, high-quality patient care and experience, nurse engagement and work culture.
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.”
Researchers laying the groundwork to eventually detect cerebral palsy via blood test
At the University of Delaware, molecular biologist Mona Batish in collaboration with Dr. Robert Akins at Nemours Children Hospital, is studying tiny loops in our cells called circular RNAs — once thought to be useless leftovers, but now believed to play an important role in diseases like cancer and cerebral palsy (CP). This is detailed in a new article in the Journal of Biological Chemistry. What are circular RNAs? They’re a special type of RNA that doesn’t make proteins but instead helps control how genes are turned on and off. Because they’re stable and can be found in blood, they may help doctors detect diseases more easily. So what’s the connection to cerebral palsy? CP is the most common physical disability in children, but right now it’s diagnosed only after symptoms appear — there’s no clear-cut test for it. Batish and her team are trying to change that. Working with researchers at Nemours Children’s Health, Batish discovered that in children with CP, a certain circular RNA — circNFIX — is found at much lower levels in muscle cells. This RNA normally helps the body make an important muscle-building protein called MEF2C. When circNFIX is missing or low, MEF2C isn’t made properly, which may lead to the weakened, shorter muscles seen in CP. This is the first time researchers have shown a link between circular RNAs and human muscle development in cerebral palsy. Why does this matter? If scientists can confirm this link, it could lead to: Earlier and more accurate diagnosis of CP using a simple blood test New treatments that help improve muscle development in affected children Batish’s ultimate goal? To create a test that can spot CP at birth — or even before — giving kids a better shot at early treatment and a higher quality of life. To speak to Batish, contact mediarelations@udel.edu.
The £1.25m study, being led by the University of Derby, is trialling antiviral medications as a treatment for symptoms of long COVID Professor Ian Maidment from Aston Pharmacy School is the lead pharmacist and will provide support for the clinical trials It is estimated that more than 2m people in the UK and more than 144m globally live with long COVID Professor Ian Maidment, at Aston Pharmacy School, is the lead pharmacist on a groundbreaking research project looking to find a treatment for symptoms of long COVID, which is being led by the University of Derby. The £1.25m trial, which is the first of its kind in the UK, is exploring whether antiviral medications can be used as an effective treatment option for patients diagnosed with long COVID. It is estimated that more than 2m people in the UK and more than 144m globally live with long COVID and almost a quarter of sufferers have had their symptoms for more than two years. Symptoms are broad and include extreme fatigue and breathlessness, palpitations, and brain fog. The trial, which began in September 2024, is part of a wider programme of groundbreaking research being led by the University of Derby. Involving 72 patients, the research is trialling the use of an antiviral drug that can be given to those admitted to hospital because of a COVID-19 infection. As most people experience a community infection and are not hospitalised, they do not have a way to access this medication. By taking the drug out of the acute admission setting, the researchers are hoping to see whether it can help those living with long COVID and alleviate some of the symptoms that they are living with. During the trial, patients undergo a series of assessments at the University of Derby’s specialist facilities before attending the hospital to receive the antiviral drug intravenously for five consecutive days, delivered in collaboration with experts from University Hospitals of Derby and Burton NHS Foundation Trust. Researchers from the University of Exeter are also involved, and the study is being managed by the University of Plymouth’s Peninsula Clinical Trials Unit. Professor Maidment will provide support for the clinical trials. Patients recruited in Exeter will undertake detailed body scans, which will be analysed to check if the antiviral medication has reduced inflammation, which may occur in people with long COVID. Mark Faghy, professor in clinical exercise science at the University of Derby and the study lead, said: “The impact long COVID has on the lives of patients is huge. For many, it can be debilitating, interfering with work, family life, and socialising, and millions are suffering across the world. Yet, at present, there are no confirmed treatments for the condition. Five years on from the start of the pandemic, long COVID remains a significant health and societal challenge, which is why this project is so important. “This is an ongoing project with various phases and is still in its infancy, but we are excited to have taken the first steps to hopefully improve the quality of life for those living with long COVID.” Professor David Strain, clinical lead based at the University of Exeter Medical School, said: “There is a clear need for people living with long COVID and we hope from this study we can see a reduction in the symptoms people experience. It will be an ongoing project with various phases, but we are excited to be taking the first steps to improve patients' quality of life.” Professor Ian Maidment, Aston Pharmacy School, said: “We need clinical trials to develop new and effective treatments for long COVID. Pharmacy support is critical for the successful delivery of these studies.” Over the past four years, Professor Faghy and his team at the University of Derby have conducted a series of international studies to explore the impacts of acute and long COVID, looking to understand the causes and contributing factors of long COVID by bringing clinical insight together with the lived experience of patients.
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.
“There was a guy standing at the end of my hospital bed that I didn’t know,” recalled Brandon Younce. “I’ll never forget this. He had a shirt on that said ‘Got Narcan.’ He introduced himself as Aaron from Voices of Hope. He said he was a peer recovery specialist, and he asked me, ‘Hey, man, are you ready to go to treatment?’” This encounter took place before the peer recovery specialist program at Voices of Hope formally partnered with ChristianaCare’s Union Hospital and the Cecil County Health Department in 2023 to grow the program into the robust offering it is today. For Younce, the program has meant not only a path to reaching and maintaining his own sobriety: It has also allowed him to become a specialist himself. And for the over 600 patients assisted through the program in fiscal year 2024, 440 of whom were connected to long-term recovery treatments, the program has meant receiving a chance at healing under the stewardship of peers who have themselves experienced addiction and recovery. Emily Granitto, M.D., of Emergency Medicine at Union Hospital, said that the process “works really seamlessly: We have a discussion with a patient and say ‘hey, we have someone available. Would you like to talk to peer recovery and see what we can do to help?’ Then a specialist comes, and they talk through the resources and options.” By having the specialist located in-hospital and ready with resources at the patient’s bedside, said Granitto, the chances for a patient’s successful transfer to long-term treatment are much higher than if the patient is expected to fend for themselves upon discharge. “We’re able to address their substance abuse concerns and tie it all into their visit here in the Emergency Department. That opportunity may not necessarily arise otherwise in the community — so offering it here and providing that olive branch can be a good bridge to the next step,” she said. The need for programs like these has never been more urgent. According to a 2022 Community Health Needs Assessment report from ChristianaCare and the Cecil County Health Department, Cecil County’s “drug poisoning death rate” is nearly double the statewide rate and triple the national average. Services like the peer recovery specialists at Union Hospital are a critical lifeline for many. Harnessing the Power of Lived Experience The peer recovery specialist program currently places 10 trained peer specialists at Union Hospital to provide supportive coverage for patients admitted to the emergency room in active withdrawal or with a history of addiction. “The peer program at Union Hospital is the perfect example of what is possible when you harness the power of lived experience and strong community partnerships,” said Health Officer Lauren Levy, JD, MPH, of the Cecil County Health Department. “The collaboration between caregivers and the peer workforce has been integral to strengthening linkages to care and improving health outcomes for people with substance use disorder.” In collaboration with caregivers — including doctors, nurses and social workers — these specialists help to support patients and to connect them with longer-term treatment and rehabilitation options within and outside of ChristianaCare. They’re present and available at the hospital from 8:30 a.m. to 1 a.m., seven days a week. Doctors and nurses who work alongside peer recovery specialists can pair patients with specialists based on patients’ needs; some patients are admitted in active withdrawal, whereas for others, a need for treatment comes up as part of their intake. “What the peers do is really very magical because they can connect to the patient,” said Lisa Fields, manager for community engagement on ChristianaCare’s Cecil County campus, “They can tell their story to the patient and say, ‘This is where I have been. I do understand.’” Partnerships Support People in Need Voices of Hope, with a primary mission of supporting addiction recovery for Maryland residents and their families, trains peer specialists alongside the Cecil County Health Department, another vital partner in the peer recovery specialist program. Training requires 500 hours in the role and 25 hours of supervision from a registered peer supervisor. Peer recovery specialists provide a form of connection that is unique and impactful for someone struggling with substance use disorder: empathy informed by personal experience. For Erin Wright, Voices of Hope’s chief operations officer, this partnership has enabled all the involved providers to build a unique, vital community to support people in need of help. “The opposite of addiction is connection,” she said. “I’ve had doctors come to my peers, and say, ‘How did you just do that?’ A peer can walk in the room and, in 20 minutes, walk out and say, ‘Listen, here’s the plan.” Back in 2019, Younce’s emergency-room encounter with Aaron led to a treatment plan that included rehab, which led to his graduation from treatment and ongoing sobriety, which then led to his decision to become a peer recovery specialist himself and eventually, he hopes, a social worker. “It’s very surreal,” he said, “working at Union Hospital and actually telling patients, like, ‘I know how you feel. I’ve been in this position.’” Recovery Support Through Project Engage in Delaware ChristianaCare’s commitment to supporting patients with substance use disorders is systemwide. Project Engage, a vital initiative serving ChristianaCare’s Newark, Wilmington and Middletown campuses, aids patients struggling with alcohol or drug use by providing early intervention and referrals to substance use disorder treatment. Peer recovery specialists engage with patients in the emergency department and at the bedside, helping them understand their substance use and offering treatment options. Since 2012, Project Engage has served more than 13,000 patients and conducted over 27,000 patient engagements, with more than 60% of these engagements resulting in referrals to community treatment at discharge.
Aston University collaboration to develop injectable paste which could treat bone cancer
A £110k grant from Orthopaedic Research UK is to help to conduct the work Study is a collaboration with The Royal Orthopaedic Hospital Researchers to use gallium-doped bioglass to produce a substance with anticancer and bone regenerative properties. Professor Richard Martin Aston University is collaborating in research to develop an injectable paste which could treat bone cancer. The Royal Orthopaedic Hospital has secured a £110,000 grant from Orthopaedic Research UK to conduct the work. The project will see researchers at the hospital and the University use gallium-doped bioglass to produce a substance with anticancer and bone regenerative properties. If proved effective it could be used to treat patients with primary and metastatic cancer. Gallium is a metallic element that when combined with bioactive glass can kill cancerous cells that remain when a tumour is removed. It also accelerates the regeneration of the bone and prevents bacterial contamination. A recent study led by Aston University found that bioactive glasses doped with the metal have a 99 percent success rate of eliminating cancerous cells. Dr Lucas Souza, research lab manager at the hospital’s Dubrowsky Lab is leading the project. He said : “Advances in treatment of bone cancer have reached a plateau over the past 40 years, in part due to a lack of research studies into treatments and the complexity and challenges that come with treating bone tumours. Innovative and effective therapeutic approaches are needed, and this grant provides vital funds for us to continue our research into the use of gallium-doped bioglass in the treatment of bone cancer.” Professor Richard Martin who is based in Aston University’s College of Engineering and Physical Sciences added: “The injectable paste will function as a drug delivery system for localised delivery of anticancer gallium ions and bisphosphonates whilst regenerating bone. Our hypothesis is that this will promote rapid bone formation and will prevent cancer recurrence by killing residual cancer cells and regulating local osteoclastic activity.” It is hoped the new approach will be particularly useful in reducing cancer recurrence and implant site infections. It is also thought that it will reduce implant failure rates in cases of bone tumours where large resections for complete tumour removal is either not possible, or not recommended. This could include incidents when growths are located too close to vital organs or when major surgery will inflict more harm than benefit. It could also be used in combination with minimally invasive treatments such as cryoablation or radiofrequency ablation to manage metastatic bone lesions. Dr Souza added: “The proposed biomaterial has the potential to drastically improve treatment outcomes of bone tumour patients by reducing cancer recurrence, implant-site infection rates, and implant failure rates leading to reduced time in hospital beds, less use of antibiotics, and fewer revision surgeries. Taken together, these benefits could improve survival rates, functionality and quality of life of bone cancer patients.” Other members of the team include the hospital’s Professor Adrian Gardner, director of research and development and Mr Jonathan Stevenson, orthopaedic oncology and arthroplasty consultant, Dr Eirini Theodosiou from Aston University and Professor Joao Lopes from the Brazilian Aeronautics Institute of Technology. ENDS About the Royal Orthopaedic Hospital NHS Foundation Trust The Royal Orthopaedic Hospital NHS Foundation Trust is one of the largest specialist orthopaedic units in Europe, offering planned orthopaedic surgery to people locally, nationally, and internationally. The Trust is an accredited Veteran Aware organisation and a Disability Confident Leader. Ranked 8th in the 2024 UK Inclusive Top 50 Employers list, the Royal Orthopaedic Hospital is the highest-ranking NHS organisation for its commitment to diversity and inclusion. The Royal Orthopaedic Hospital has a vibrant research portfolio of clinical trials, observational studies and laboratory studies exploring new treatment options, new approaches in rehabilitation and therapy, and new medical devices. This research is delivered by our researchers and clinicians spread across the Knowledge Hub, our home for education and research, and the Dubrowsky Regenerative Medicine Laboratory, a state-of-the-art lab opened in 2019. About Aston University For over a century, Aston University’s enduring purpose has been to make our world a better place through education, research and innovation, by enabling our students to succeed in work and life, and by supporting our communities to thrive economically, socially and culturally. Aston University’s history has been intertwined with the history of Birmingham, a remarkable city that once was the heartland of the Industrial Revolution and the manufacturing powerhouse of the world. Born out of the First Industrial Revolution, Aston University has a proud and distinct heritage dating back to our formation as the School of Metallurgy in 1875, the first UK College of Technology in 1951, gaining university status by Royal Charter in 1966, and becoming The Guardian University of the Year in 2020. Building on our outstanding past, we are now defining our place and role in the Fourth Industrial Revolution (and beyond) within a rapidly changing world. For media inquiries in relation to this release, contact Nicola Jones, Press & Communications Manager on 07941194168 or email: n.jones6@aston.ac.uk
Villanova Nursing Professor Addresses Overlooked Roles in Mental Health Care
Mental health crises, such as suicidal ideations or attempts, present profound challenges, not only for the individuals experiencing them, but also for the families and professionals who provide care. Parents, in particular, often find themselves stepping into the role of a primary healthcare provider when a child returns home from mental health inpatient treatment. Guy Weissinger, PhD, MPhil, RN, the Diane Foley Parrett Endowed Assistant Professor of Nursing at Villanova University’s M. Louise Fitzpatrick College of Nursing, explores the complex challenges parents face during these delicate situations and how the healthcare system can better prepare them for these responsibilities. Dr. Weissinger’s research also emphasizes the need to rethink how educators train and support healthcare providers involved in mental health care and suicide prevention. In a recent conversation, Dr. Weissinger shared insights into his research, the unique roles that parents and nurses have in managing mental health crises and the steps needed to create a more holistic and inclusive approach to care. Q: A large part of your research examines the parents of youth who are experiencing mental health crises. What challenges do parents face when tasked with providing ongoing healthcare for their children who might be facing these issues? Dr. Weissinger: There’s been a lot of recent work looking at how parents can be better supported in any kind of health crisis as their child is experiencing it. At the end of the day, a physician, therapist or nurse practitioner (NP) can support a patient with their clinical expertise in the hospital, but when those patients return home, the responsibility most often falls on the parent to continue that care. If we're then requiring parents to act as case managers and healthcare providers for their children, how can we best equip them to fill those roles? Q: How does a parent’s role in managing a child’s mental health crisis differ from the roles of a physician or therapist? Dr. Weissinger: I studied family intervention science, which looks at both the individual and family processes that may be related to adolescent suicide risk or any other mental health concern, so I like to ask the question: what is this person's role in their family system? Parents oftentimes have a particular role in the family system, and when there's any kind of mental health crisis, that role may have to change: how they act, what tasks they perform, etc. I’m studying the role transition of a parent during a suicide crisis—what are their struggles and what are parents identifying as their big needs? I’m finding that a lot of parents are feeling really alone or shameful in some way, and then they’re using their own money, time or social resources to try to provide care for their child. This often happens because they feel like the mental health system is not providing the support they need to take on that role, so they’re trying to figure out what to do on their own. Q: An additional part of your research surrounds the role of a nurse practitioner in suicide crises. What are some of the findings from your recent research with nurse practitioners (NPs) about their suicide prevention education? Dr. Weissinger: The findings, which will soon be published, are really interesting because they’re very mixed. I went out and asked NPs what they were taught about suicide prevention and when they were taught it as part of their education and training. Some said that their primary care education integrated suicide prevention as a focus of the curriculum. Others mentioned that they didn’t learn about it in their undergraduate or master’s programs, but they’re still expected to know about suicide prevention as part of their job responsibilities. It’s important to highlight these discrepancies and how we need to think about adapting nursing education to include these important topics. Q: What are some of the overlooked responsibilities and challenges of nurses in managing adolescent mental health? Dr. Weissinger: A large percentage of primary care visits are currently conducted by nurse practitioners, and now suicide screenings are expected to be a standard of practice in primary care visits, even though some NPs don't have that specific training. NPs are often left out of consideration and conversation around best practices related to suicide prevention, so we need to make sure that anyone who's conducting these screenings surrounding suicide has the training and the preparation to do so. It's a difficult conversation for NPs to have, especially when they’re working with kids and families. Q: Why is suicide prevention important to study from a nursing lens? Dr. Weissinger: So much mental health research lumps together groups or only studies psychologists and physicians, so a lot of people who provide mental health services or do suicide prevention screenings are left out of these studies. For example, nurses provide a majority of the discharge education on what parents are expected to do at home when a child leaves the hospital—whether that’s administering injections for a child with diabetes or making a house safer for preventing self-harm. Most of the time, a nurse is walking parents through next steps, answering questions and checking in on patient progress. It’s not the psychologists who evaluated the child, or the physicians who decided that the individual needed to be inpatient, it’s the nurses who are providing those points of contact. Q: What do you hope is the main takeaway from your work surrounding mental health and suicide crises? Dr. Weissinger: Suicide is a really complex thing to address, and it needs to be a conversation that isn’t looking for a silver bullet. It’s a conversation that asks the questions: how do we improve the mental health care system? How do we get primary care providers trained and involved in these discussions? How do we best prepare family members to support individuals who are struggling? Not all researchers need to work on every part of this, but it needs to be a total, all-encompassing effort.
The Staff Wellbeing (SWell) project was carried out in conjunction with Birmingham Children’s Hospital and NHS England Paediatric critical care (PCC) staff experience high levels of moral distress, post-traumatic stress disorder and burnout Two simple, low-resource wellbeing sessions can be delivered by staff for staff without specialist training. The Staff Wellbeing (SWell) project, led by Aston University researchers in collaboration with Birmingham Children’s Hospital and NHS England, has developed two simple, easy-to-deliver sessions to improve the wellbeing of staff in paediatric critical care (PCC) units in UK hospitals. PCC staff are known to experience high levels of moral distress, symptoms of post-traumatic stress disorder (PTSD) and burnout, but often feel little is offered to help them with their mental health. The SWell team at Aston University, led by Professor Rachel Shaw from the Institute of Health and Neurodevelopment, realised following a literature review that there are no existing, evidence-based interventions specifically designed to improve PCC staff wellbeing. Initial work by SWell identified the ‘active ingredients’ likely to create successful intervention designs. Together with a team from NHS England, the Aston University researchers set up the SWell Collaborative Project: Interventions for Staff Wellbeing in Paediatric Critical Care, in PCC units across England and Scotland. The aim of the project was to determine the feasibility and acceptability of implementing wellbeing interventions for staff working in PCC in UK hospitals. In total, 14 of the 28 UK PCC units were involved. One hundred and four intervention sessions were run, attended by 573 individuals. Professor Shaw said: “The significance of healthcare staff wellbeing was brought to the surface during the COVID-19 pandemic, but it’s a problem that has existed far longer than that. As far as we could see researchers had focused on measuring the extent of the problem rather than coming up with possible solutions. The SWell project was initiated to understand the challenges to wellbeing when working in paediatric critical care, to determine what staff in that high-pressure environment need, and what could actually work day-to-day to make a difference. Seeing PCC staff across half the paediatric critical care units in the UK show such enthusiasm and commitment to make the SWell interventions a success has been one of the proudest experiences in my academic career to date.” The two wellbeing sessions tested are low-resource and low-intensity, and can be delivered by staff for staff without any specialist qualifications. In the session ‘Wellbeing Images’, a small group of staff is shown images representing wellbeing, with a facilitated discussion using appreciative inquiry - a way of structuring discussions to create positive change in a system or situation by focusing on what works well, rather than what is wrong. In the ‘Mad-Sad-Glad’ session, another small group reflective session, participants explore what makes them feel mad, sad and glad, and identify positive actions to resolve any issues raised. The key ingredients in both sessions are social support – providing a psychologically safe space where staff can share their sensitive experiences and emotions without judgement, providing support for each other; self-belief – boosting staff’s self-confidence and ability to identify and express their emotions in response to work; and feedback and monitoring – encouraging staff to monitor what increases their stress, when they experience challenging emotions, and what might help boost their wellbeing in those scenarios. Feedback from staff both running and participating in the SWell interventions was very positive, with high satisfaction and feasibility ratings. Participants like that the session facilitated open and honest discussions, provided opportunities to connect with colleagues and offered opportunities for generating solutions and support. One hospital staff member responsible for delivering the sessions said: “Our staff engaged really well, and it created a buzz around the unit with members of the team asking if they could be ‘swelled' on shift. A really positive experience and we are keeping it as part of our staff wellbeing package.” The team concluded that even on busy PCC units, it is feasible to deliver SWell sessions. In addition, following the sessions, staff wellbeing and depression scores improved, indicating their likely positive impact on staff. Further evaluations are needed to determine whether positive changes can be sustained over time following the SWell sessions. The work was funded by Aston University Proof of Concept Fund and NHS England. Donna Austin, an advanced critical care practitioner at University Hospital Southampton paediatric intensive care unit, said: “We were relatively new to implementing wellbeing initiatives, but we recognised the need for measures to be put in place for an improvement in staff wellbeing, as staff had described burnout, stress and poor mood. SWell has enabled our unit to become more acutely aware of the needs of the workforce and adapt what we deliver to suit the needs of the staff where possible. Staff morale and retention has been the greatest outcomes from us participating in the SWell study and ongoing SWell related interventions.” Read the paper about the SWell interventions in the journal Nursing in Critical Care at https://onlinelibrary.wiley.com/doi/10.1111/nicc.13228. For more information about SWell, visit the website.
Nona’s Story: HomeHealth Nurse Visit Leads to Life-Saving Care
Elena Gomez, RN, wears the dark blue scrubs of a ChristianaCare nurse, but Nona Lerza sees her as even more. “I call you an angel,” said Lerza, who credits Gomez with saving her life. Gomez, a ChristianaCare HomeHealth case manager, regularly visited Lerza, at her home in Middletown, Delaware, to check her blood pressure after a hospitalization. One day in February, with bad weather on the horizon, Gomez phoned Lerza to see if she could stop by for a check-in. That call – and Gomez’s persistence – turned out to be lifesaving. During her visit, Gomez found Lerza’s blood pressure was high – high enough to warrant emergency care. Lerza wasn’t eager to return to the hospital. But she trusted Gomez, and the strength of that connection convinced Lerza to heed Gomez’s advice and head to the emergency department. After arriving by ambulance, Lerza underwent quadruple bypass surgery at Christiana Hospital. Her cardiology team agreed – Gomez saved her life. Fully recovered, Lerza is now back to living independently in her home. “There aren’t enough words in the dictionary to say all she did for me,” Lerza said. “She closed my house up. She did everything for me that night and I can’t thank her enough. It seems very hollow to say thank you. But if she hadn’t come, I don’t know where I’d be today.” For Gomez – a second generation nurse – working as a HomeHealth nurse gives her the chance to build lasting relationships with patients. “We are here for the community; we are here for our patients; we are here for the families,” she said, “and we will do everything in our power to help them get better.”
