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The ChristianaCare Hospital Care at Home program, a national leader in providing acute care in a place most familiar to patients – their own homes – has reached a new milestone with more than 1,000 admissions since opening in December 2021. ChristianaCare’s innovative program enables patients with common chronic conditions, such as congestive heart failure and diabetes complications, as well as infections like pneumonia, to receive hospital-level care at home through virtual and in-person care provided by a team of physicians, nurse practitioners, paramedics and others. Technology kits deployed to patient homes ensure round-the-clock access to a health care professional, along with twice daily visits from caregivers, medication deliveries and mobile laboratory services. “This program is a wonderful example of how ChristianaCare is building a better health care system and meeting people’s health care needs through innovation, collaboration and an unwavering commitment to providing the very best care for the people we serve,” said Janice E. Nevin, M.D., president and CEO of ChristianaCare. “We are proud to be at the forefront of hospital care at home nationally, through the collaboration with leaders like Sen. Tom Carper of Delaware, who has championed this new model of care at the federal level; Medically Home, which partnered with ChristianaCare to help us design a program that best meets the needs of the communities we serve; and our own health professionals – we call them caregivers – whose expert care and coordination make this all possible. Together, we are creating health so that people can flourish.” ‘Just amazing’ for patients Patients are evaluated for the hospital care at home program when they come to Wilmington or Christiana hospital emergency departments. Those who can be treated at home receive a technology kit that connects them to the command center, powered by the ChristianaCare Center for Virtual Health. With a touch of a button, they can access an expert team of ChristianaCare doctors and nurses. But hospital care at home isn’t just virtual care—the technology supports an entire care team that works inside the patient’s home and remotely to provide optimal support at all times—just like in a hospital. Patients connect with their health care team with just the touch of a button. Carol Bieber, whose 98-year-old father, Bill, has been a hospital care at home patient, sees the difference it makes for him to wake up in his own bed, sit in his own living room and still get the care he needs to get better. "The whole hospital care at home experience is really calm and easy and familiar to him," said Bieber, who lives in Newark. “My dad is a people person, so to be able to connect with everybody who comes in to see him or talk to him on the screen is just amazing.” Innovative solutions for in-home care ChristianaCare’s Hospital Care at Home program was developed in 2021 after the Centers for Medicaid & Medicare Services (CMS) began the Acute Hospital Care at Home waiver program to allow Medicare beneficiaries to receive acute-level health care services in their home. U.S. Sen. Tom Carper, who represents Delaware, worked to pass the bipartisan Hospital Inpatient Services Modernization Act in 2023 that extended this program. Last month. Sen. Carper introduced the bipartisan At Home Observation and Medical Evaluation (HOME) Services Act that would expand this lifesaving and cost-saving program. “Hospital at Home – which grew out of the COVID pandemic – was an opportunity for us to meet seniors where they are,” Sen. Carper said. “It has delivered positive outcomes, higher patient satisfaction, and saves money. That is why when this program was about to go away with the end of the COVID public health emergency, I joined my colleagues across the aisle to extend the program for two more years. Today, especially as we celebrate the success of the program in Delaware with ChristianaCare, I’m encouraged that we can further extend that program!” Sarah E. Schenck, M.D., FACP, executive director of the ChristianaCare Center for Virtual Health, said the hospital care at home program has yielded lower readmission rates than brick-and-mortar hospitals. In addition, patient experience scores are about three times higher than the national average for a traditional hospital experience. Options like Hospital Care at Home give patients the care they need in the space they want, said Dr. Sarah Schenck, executive director of ChristianaCare's Center for Virtual Health. “We’ve been conditioned to believe that care only happens within the four walls of a hospital. For our patients who have loved ones at home or their pets, a favorite chair or favorite food, they’re now able to have all of that as they heal,” Schenck said. “Once our patients have experienced this, what we hear from them is that they are truly grateful.” Promoting healing – at home Helping patients recover in their homes also has been transformational for caregivers who get to see a different side of their patients and better understand what they need to successfully recover. “I can’t express how much I enjoy the patients and their families,” said Heather Orkis, a paramedic with the hospital care at home program. Patients aren't the only ones who enjoy the experience of Hospital Care at Home - so do the health care professionals who care for them. “To be able to enjoy the family and see these people get better in their own homes, with their families, their grandkids, their dogs, their cats – it’s just a completely different kind of medicine.” For Bill Bieber’s family, hospital care at home is more than health care. “It’s just the best thing ever,” Carol Bieber said. Families appreciate the frequent interactions with members of the Hospital Care at Home team.
#Expert Podcasts: CARF Accreditation is a process, not an event
Recently, CARF International's Michael Johnson sat down with Simplifyance™ for a great conversation of all things accreditation. The podcast link is provided below. Simplifyance™ had the privilege of speaking with Michael Johnson, Senior Managing Director of Behavioral Health for CARF International. We delved into the world of accreditation, discussing its immense value, the supportive process for organizations during surveys, and uncovering key best practices. CARF is renowned for its commitment to ensuring excellence in healthcare delivery and service outcomes. Michael shared valuable insights into the accreditation process and shed light on how CARF assists organizations in achieving survey success. Michael emphasized the importance of person-centered care, evidence-based practices, and fostering a culture of accountability and learning. These elements are crucial in driving positive outcomes and delivering compassionate, effective care to those in need. And if you're a interested in knowing more about accreditation or the work CARF International does — let us help with your questions. Michael Johnson is Senior Managing Director of Behavioral Health at CARF and is an expert in treatment strategies for mental health and substance use disorder. View his profile below to arrange an interview today.
Ask the Expert: What is the impact of the Francis Scott Key Bridge on the supply chain?
Early in the morning on March 26, 2024 a super freighter lost complete power and struck a support column on the Interstate 695 (I-695) resulting in catastrophic collapse of the bridge. This will limit shipping until salvage and cleanup operations are completed. The shutting down of the port will have a direct impact on the economy of Baltimore at a rate of over $200 million of cargo passing through the port every day. Dr. David Rollins, a supply chain expert and an assistant professor in the Rader School of Business at Milwaukee School of Engineering, provides insight into the industrial, consumer and fiscal impact of the Key Bridge collapse. "The port’s major exports are coal, automobiles, and light trucks, while it imports goods like sugar, cars, light trucks, heavy farm and construction machinery, minerals, and fertilizer. The shipping methods employed by the port of Baltimore include containerized units, break bulking, and roll-on roll-off for automobiles, trucks, and machinery. "The impact on the global supply chains will be negligible from the standpoint that the ports of Philadelphia and Norfolk are poised to accept international shipping vessels and have the capacity for the extra traffic. The supply chain for coal and automobiles will be disrupted in the short term as the traffic of both international cargo ships and railcars will be rerouted to the other ports. Materials loaded on ships scheduled to depart after March 26th will likely be held until the salvage and cleanup are completed. However, if a customer needs expediting services, materials may be shipped through air cargo or rerouted to another port for shipment. "A supply chain requires three elements to be successful: The logistics and transportation of physical goods, which is a short-term issue for Baltimore. An information channel, if executed properly supply chain and logistics managers shipping through the Port of Baltimore have rerouted goods to either Norfolk, VA or Philadelphia, PA, the two closest ports. The transfer of funds for both goods and services, which has a limited impact on the supply chain compared to the potential impact on the city of Baltimore’s economy. "Prior to COVID-19, the information exchange part of supply chains was mostly overlooked. Improved communication will help render the bridge collapse a minor issue in the global supply chain. "One domestic issue will be the time and distance between the seaports and the supplier’s location or the destination of the products. From the Midwest, the largest source of automobile suppliers, rail shipping requires extra lead time but will keep transportation costs low. If producers ship via truck, the increase in mileage to the closest port, Philadelphia, is 56 miles resulting in an increase in fuel cost per shipment of approximately $34.461. "The Key Bridge incident will result in the rerouting of traffic via Interstate 95 (I-95) through Baltimore. I-95, which travels through the Fort McHenry tunnel to downtown Baltimore will be highly congested during commuting times resulting in slower deliveries. Interstate 895 (I-895), traveling through the Harbor tunnel, also provides another. Both routes will only add a couple of miles for goods movement. Hazardous material trucking will not be allowed through the tunnels and will be required to take I-695 around the west and north side of the city. This route is 14 miles longer than the Francis Scott bridge route. "Typically, semis get around 6.5 miles per gallon of diesel fuel2. Increasing the costs for the logistics and trucking companies. Based on the load capacity of a semi-trailer at 48,000 pounds, the increase in fuel expenditures will have a negligible effect on the cost to consumers. "The resilience of the supply chain has improved in the past couple of years due to lessons learned during the COVID-19 pandemic. The extent to which supply chain managers have grown and adopted changes will determine the ultimate effect the Francis Scott Key Bridge had on the supply chain." Dr. Rollis is available to speak with media about the impact the Key Bridge collapse will have on the supply chain. Simply click on his icon below to arrange an interview. ### 1Estimated fuel costs based on mileage from Chicago to the port with an estimated truck mileage of 6.5 per gallon at a price of $4.00 per gallon. 2Motorask.com, supported by the U.S. Bureau of Transportation Statistics. The BTS did not have data after 2021, but the website Motorask.com used the higher mileage which is used in the calculation.
Opening up supply chain blockages in the wake of the Baltimore bridge collapse
The impact of the Baltimore bridge collapse on supply chains is as massive as it is obvious. Finding the solutions to repairing the damage is not so simple, according to Bintong Chen, professor of operations management at the University of Delaware. Pain points include the loss of a major access point to a busy port and international car and truck shipping; a significant dent in commercial trucking (especially hazardous material transportation); and a strain on civilian commuting. Chen offers two solutions: Clear the water way first and quickly so that shipping will resume normally. This is the first priority and should not take long. Develop a plan to re-route traffic, as it will take four to five years to build a bridge to replace the Francis Scott Key Bridge. He proposes the following traffic changes: Divert all commercial trucking flow to William Preston Lane Jr. Memorial Bay Bridge. Reduce or remove the toll for night trucking in order to spread the truck flow and reduce the congestion. Reduce or remove the toll for the Baltimore tunnel at night for civilian commuting for the same purpose. To schedule an interview with Chen, visit his profile and click on the contact button or reach out to the UD Media Relations team.
With the Port of Baltimore all but closed, how will the supply chain be impacted?
Following the incident of the container ship crashing into the Francis Scott Key Bridge at the Port of Baltimore and the bridge collapsing, there are now some supply chain concerns. While they may not be felt right away by consumers, there are a number of businesses that will be affected by it. Rick Franza, PhD, professor in Augusta University's James M. Hull College of Business and an expert on operations and supply chain management, said one immediate impact is where container ships will be diverted to for offloading. The Port of Baltimore is a major shipping hub and ranks first among U.S. ports for autos and light trucks. Now those ships will have to find other ports to unload their goods, which becomes a logistical problem as much as anything. “Most ports on the East Coast are at 70% to 80% capacity, which is where you want to be. You don’t want to have much more than that, but they’re going to have to,” said Franza. “It could affect a good bit of the eastern half of the United States.” Ports in Savannah, Charleston and New York, among others, will have to become the destination for those currently sitting outside Baltimore and those en route from around the world. The good news, Franza said, is that most foreign car manufacturers have plants in the United States so it will likely only affect those consumers looking for a certain brand or even a specific model. Baltimore is also one of the furthest inland ports and has the best rail service coming from it. The outbound goods coming off the ships will now face more of a transportation hurdle when they are diverted to another port. “It’s not just the capacity of the port, that’s one thing, but it’s also their capacity of the outbound items,” he said. “It may be more trucks are needed, and new routes are needed to move inventory. It now becomes a whole different set of providers for the trucks because it’s no longer the people in Baltimore.” Franza added companies will also have to decide which distribution centers they may want to use, whether it’s closer to the area they serve or closer to the port. All those factors affect where the items from overseas end up. While it’s not a good scenario, at the end of the day, he feels the consumer likely won’t see much of an impact. “First of all it’s going to take a while before we see any effect on certain things,” Franza said. “The bad news for inflation is that it’s going to raise the cost of transportation for the goods coming off the ships. Will businesses absorb the cost or pass them along to consumers?” Looking to know more? Then let us help. Richard Franza, PhD, is available to speak with media about trending issues like inflation, small business and the economy – simply click on his icon now to arrange an interview today.
MEDIA RELEASE: Voting for the CAA Worst Roads campaign is now open
Tired of swerving around potholes? Are you worried about your safety as a cyclist or pedestrian? Voting is now open in Ontario for the annual CAA Worst Roads campaign, and CAA South Central Ontario (CAA SCO) is giving citizens the opportunity to voice their concerns about the bad roads in their communities. "Our research shows that 65 per cent of members don't feel enough is being done to fix the roads," says Teresa Di Felice, assistant vice president government and community relations, CAA SCO. "This is causing a variety of concerning driving behaviours, including swerving to avoid potholes, slowing down for bad spots, and some even changing their route altogether to avoid a bad road. We encourage all Ontarians to vote for their Worst Roads and join the community of drivers, cyclists, transit riders and pedestrians committed to improving and actively working to help make our roads safer for all." Those surveyed say they spent $852 on average to repair their vehicle. According to a survey conducted by CAA SCO, 84 per cent of members worry about the state of our roads, with 42 per cent experiencing vehicle damage due to poor roads. Despite this, 82 per cent pay out of pocket to repair their vehicles, while only four per cent file a claim with insurance, and nine per cent forgo repairs altogether. "Either because of affordability or availability, many people are holding on to their cars a little longer these days; the last thing they want is expensive repair bills on an already stretched household budget. While inflation rates are cooling, many of us are dealing with a higher cost of living, making the investment in roads and supporting infrastructure more important than ever," adds Di Felice. Vehicle damage caused by potholes can range from $500 to over $2,000, with the average repair by those surveyed costing $852. "We know that the campaign works and that decision-makers are listening. Since its inception in 2003, we have seen road repairs move up and budgets prioritized. The CAA Worst Roads campaign has been a vital platform for Ontarians to nominate and vote for roads they believe need urgent attention. It covers issues like congestion, potholes, road signs, and traffic light timing for pedestrian and cycling safety." Ontario's top 10 list is verified by the Residential and Civil Construction Alliance of Ontario (RCCAO) and their members, including the Greater Toronto Sewer and Watermain Contractors Association (GTSWCA), Heavy Construction Association of Toronto (HCAT), and the Toronto and Area Road Builders Association (TARBA). "RCCAO is a proud partner and supporter of this year's CAA Worst Roads advocacy campaign, giving Ontarians a platform to raise awareness about the state of vital road infrastructure in their communities," said Nadia Todorova, executive director of RCCAO. Nominations for the Worst Roads campaign can be submitted online at www.caaworstroads.com from March 27 to April 19. Once the nominations are collected, CAA will reveal the top 10 worst roads in the province to the public. CAA conducted an online survey with 2,753 CAA SCO Members between January 10 to 19, 2023. Based on the sample size and the confidence level (95 per cent), the margin of error for this study was +/- 2 per cent.
The Implications of the Collapse of Baltimore's Key Bridge: Insights from a Civil Engineer
The early morning collapse of Baltimore's Francis Scott Key Bridge is leaving experts and area residents alike in disbelief. Michael Chajes, a professor in the civil and environmental engineering department at the University of Delaware, is the go to person to speak on what happened and what this means for the future of this bridge. Chajes's expertise includes forensic engineering, specifically unearthing the root causes of engineering failures, such as bridge collapses. He has participated in the evaluation and testing of numerous major bridges and structures including the Brooklyn-Queens Expressway, Ben Franklin Bridge, Chesapeake City Bridge, Lock Gates on the Erie Canal and several historic trusses and polymer composite bridges. He is also the former Delaware Engineer of the Year. He is a civil engineer and has been speaking to the likes of CNN today about this bridge collapse. He is available and ready to chat if you'd like to connect with him. Chajes has been speaking with networks like CNN about the bridge collapse and is available for comment. He can be reached by clicking his "View Profile" button.
Rethinking Caregiving Support for the Sandwich Generation
The "sandwich generation" refers to adults who are simultaneously caring for their children as well as older parents or relatives. This places unique strains on caregivers, who must balance their family responsibilities with work and their own self-care. As Guy Weissinger, PhD, MPhil, RN, the Diane Foley Parrett Endowed Assistant Professor at Villanova University's M. Louise Fitzpatrick College of Nursing, notes, many feel like they are being "shortchanged" on both sides—unable to fully support their children or their aging relatives. The result is stress, guilt and difficult decisions about how to allocate limited time and resources. "Hard decisions are also a psychological tax," Dr. Weissinger says. "You have to use the resource of time and brain energy to weigh the options, so it compounds on itself every time they intersect. And that's complicated and hard." These challenges have only increased due to larger societal shifts, according to Melissa O'Connor, PhD, MBA, RN, FGSA, FAAN, the M. Louise Fitzpatrick Endowed Professor in Community and Home Health Nursing in the College of Nursing. "For the first time in the history of the world, older adults will outnumber children in the United States by 2035," said Dr. O'Connor. This rise in numbers of older adults foreshadows a looming caregiving crisis, as more seniors will require care without enough nurses and family caregivers to meet the need. The sandwich generation can also feel overwhelmed due to lack of training in managing complex care needs. As Dr. O'Connor states, there is "no caregiver school"—instead it's "baptism by fire." Learning wound care, managing feeding tubes, giving medications and handling dementia behaviors on the fly can take an emotional toll. Caregiver stress and burnout have also been linked to declines in physical and mental health, and financial strain, as well as increased elder abuse (though unintentional), she says. Dr. O'Connor believes that home health services can serve as a critical resource for supporting overwhelmed sandwich generation caregivers. Home health nurses, aides, therapists and social workers can provide skilled care, educate family members, assess safety and coordinate services. "Home health can make or break someone's success at staying home,” Dr. O'Connor says. "It can also make or break the stress levels of patients and caregivers. If caregivers have support, they can do a really good job." However, misconceptions about home health care persist. Many do not understand what home health services entail or worry about strangers entering their home. Although refusing home health may seem like the safer option to some, the consequences of caregivers trying to provide care without assistance can be dire. Isolated and overwhelmed caregivers who don't have support oftentimes end up seeing their older adult parents experience health declines that necessitate nursing home placement, which takes a financial toll on families as well. From Dr. Weissinger's perspective, the caregiving crisis is a "family and a systems issue." "This is a systematic problem, so we need policy changes at the state, national and organizational levels to address it. We can't solve society-level problems through individual responses," he says. Supporting caregivers and easing this crisis will require policy changes at the highest levels along with a societal shift in how we view and assist caregivers. Though individual families feel the squeeze, truly addressing the caregiving crisis demands broad, systemic solutions. With an aging population, the need for action in the form of policy change is more urgent than ever.
Research finds video games improve mobility for children with autism
University of Delaware professor Anjana Bhat has a long history of finding creative ways to keep autistic children engaged with the added benefit of improving their flexibility and gross motor skills. She’s used dance and play in the past but is now testing video games to see if they’re a viable intervention to promote movement in this population. Bhat and her team in the Move to 2 Learn Innovation Lab at UD's STAR Campus have been using Ring Fit on Nintendo Switch to help children with autism get their daily dose of exercise. “Children love video games, and they’re fun,” said Bhat, professor of physical therapy in UD's College of Health Sciences. “But there’s also a lot of evidence that video games with an exercise component have positive effects on cognition, social interactions and general physical activity levels.” She added that children with autism have a predilection for technology with a love of computers and robots, but exergaming hasn’t been studied in this population. “Technologies that have been tested and studied in children with autism mainly target sedentary functions that look at improvement in executive function and decision-making, but not necessarily exergaming,” Bhat said. “Exergaming has been studied in older populations and healthy children, but not so much in children with autism, so this study is unique.” After testing the intervention on a dozen children with autism over eight weeks, the consensus is that it works. “I’ve never seen anything grab their attention so much. Across the board, this tool is far more engaging than any other tool we’ve used before, including music and movement, yoga, general exercise, and outdoor play, which do not always work for every child,” Bhat said. “With exergaming and the variety of content that exists, most children remain engaged, and that’s what’s so unusual about this intervention compared to past interventions.” Games like tennis, volleyball, badminton, golf, sword fighting and bowling focus on the upper extremities, while soccer focuses on the lower extremities. Bhat receives accurate measures of improvement in a child’s ability through accelerometers in the video game controllers. “This is one place where children with autism shine,” Bhat said. “Their visual learning and sensory enhancements help them excel. This gives them a sense of self-efficacy and self-assurance that — they’re good at this,” she said. “It also gives them a sense of connection to the community because they can make friends and feel empowered. Video games are a great equalizer.” Bhat’s innovative pilot study was funded through a $50,000 award from the donor-created Maggie E. Neumann Health Sciences Research Fund, which targets research and innovation that aims to improve the lives of people with disabilities. Equipped with data from this study, Bhat hopes to expand access to the intervention and test it in the community. It’s already available at D-Fit Plus, an inclusive fitness center in New Castle that aims to help those with special needs explore fitness to build social skills and confidence, grow cognition, and manage stress. “It’s relatively low cost,” Bhat said. “Another advantage of this intervention is that you don’t need a highly skilled person present to work the intervention because the game leads the activity, making it accessible if embedded in the community.” This also provides a social outlet for the child’s parents. “Community settings bring a sense of connection for the child’s parents, who are always looking for community-based activities, and many environments aren’t suitable for children with autism,” Bhat said. “Many environments are too noisy or distracting. Exergaming removes those barriers and allows the child to engage with the game and maybe another partner.” Bhat’s previously published research has shown that 80% of people with autism face motor challenges. Her research is so compelling that she’s made a case to change the definition of autism to include motor impairments so those on the spectrum can get the proper physical therapy or gross motor interventions that could dramatically improve their quality of life.
Cancer Diagnosis and Prevention Breakthroughs | Media Advisory
With two cancer diagnoses in the Royal family - cancer is regrettably a trending topic but also a vitally important one for everyone. In the ongoing battle against cancer, recent advancements in diagnosis and prevention offer promising avenues for both medical practitioners and the general public. With cancer being one of the leading causes of death globally, developments in this field not only hold significant importance for healthcare but also for individuals and families impacted by the disease. Here's why this matters and potential story angles: Why it Matters: Health Impact: Improved diagnostic tools and preventive measures can lead to earlier detection and more effective treatment options, potentially saving lives. Economic Implications: The economic burden of cancer treatment on individuals, families, and healthcare systems underscores the importance of preventative measures and early detection. Public Health: Addressing cancer at the diagnostic and prevention stages contributes to broader public health initiatives, reducing the overall incidence and mortality rates. Story Angles: Breakthrough Technologies: Explore innovative diagnostic technologies such as liquid biopsies or AI-driven imaging systems transforming cancer detection. Lifestyle and Prevention: Investigate lifestyle factors, from diet and exercise to environmental exposures, and their role in cancer prevention. Genetic Research: Cover advancements in genetic testing and personalized medicine, offering insights into individual risk factors and tailored prevention strategies. Access to Care: Examine disparities in access to cancer screening and prevention measures, particularly among underserved communities. Survivor Stories: Highlight stories of individuals who have benefited from early detection or preventive interventions, offering hope and inspiration. Policy and Advocacy: Discuss the role of policy initiatives and advocacy efforts in promoting cancer prevention strategies and ensuring equitable access to screening and diagnostic services. Connect with an Expert about Cancer Diagnosis and Prevention Breakthroughs For journalists seeking research or insights for their coverage about Cancer Diagnosis and Prevention Breakthroughs here is a select list of experts from our database. To search our full list of experts, visit www.expertfile.com Anna McDaniel Dean of the College of Nursing – University of Florida Jorge Cortes Director, Georgia Cancer Center – Augusta University Nicholas J. Petrelli Bank of America endowed medical director of the Helen F. Graham Cancer Center and Research Institute – ChristianaCare Katherine Reeves Professor of Epidemiology and Associate Dean of Graduate and Professional Studies, School of Public Health and Health Sciences – University of Massachusetts Amherst Nicole Onetto Deputy Director and Chief Scientific Officer – Ontario Institute for Cancer Research Photo Credit: National Cancer Institute
