Dartmouth MPH Practicums Address Key Issues in Healthcare
As we look forward to graduating the Class of 2022 in the online/hybrid MPH program this spring, we are proud to recognize the accomplishments of this talented group of healthcare leaders—who have successfully completed their field internships while maintaining their busy professional lives and working through another year of the pandemic.
Below, read about how three students have been applying their practicum experience to address some of the most pressing issues in healthcare and how their MPH training is informing their career goals.
Teammate Social Impact—Improving Employee Wellbeing in a Large Healthcare System
Nahshon Deering MPH’22
Nahshon Deering’s practicum work is centered on community health strategies that better provide for underserved populations.
As a facilities management group specialist at Atrium Health, a large health system based in Charlotte, North Carolina, Deering had the opportunity to use his workplace as his internship setting. For his project, he partnered with the newly formed social impact team housed in Atrium Health’s community health department.
To help meet Atrium’s mission of providing health, hope, and healing for all people within its region, Deering and his colleagues first focused on Atrium Health’s own employee population. They conducted a well-being survey with 490 teammates to assess their immediate social, mental, and professional well-being needs.
“The results opened our eyes to many of the social determinants that affect our teammates,” says Deering. “For example, 53 percent of teammates reported worrying about running out of food with no money to buy more. We were also able to collect data on the location of many of the neediest teammates, along with a measure of their household income. We then divided the team into four subgroups to address the findings.”
The group’s activities and accomplishments included evaluating current Atrium Health policy to provide recommendations on changes that would better benefit teammates; launching a “Help Now” platform that provides access to local crisis assistance, food pantries, and housing support and education; and expanding Atriums “Community Resource Hub" that allows teammates to enter their zip code to access social service programs.
The group anticipates that its ongoing work will enhance the well-being of teammates to improve their quality of life and plans to expand on its efforts to include the community of Charlotte.
In the future, Deering hopes to apply what he’s learned as a healthcare administrator to improve quality, access, and overall awareness of health disparities. “I look forward to changing the landscape of healthcare for the better,” he says.
Assessing the Value of Integrated Specialty Care Through Clinical, Financial, and Operational Outcomes
Julianna Maisano MPH’22
Julianna Maisano’s internship project focuses on determining the effectiveness of implementing integrated care into specialty settings, particularly those involving behavioral health services.
Nearly one in five adults live with a mental illness each year in the U.S., and an increase in the demand for behavioral healthcare has led to provider shortages, longer wait times, and forced redesigns to meet patient needs. Yet barriers and stigma still exist.
Previous research has found that integrating primary care and behavioral healthcare increases patient access to services and minimizes negative outcomes. However, integrating specialty care in a similar fashion is an emerging concept that requires further evaluation.
Working under the guidance of her preceptor, Dartmouth Institute alumna Dawn Zieger MPH’19, associate vice president of Psychiatry and Behavioral Health at Geisinger Health System in Danville, PA, Maisano completed a literature review to identify common impact metrics and outcomes.
She then surveyed Geisinger’s integrated specialty care team to determine current measures of integration and outcome tracking needs. She also distributed the survey to providers at Ochsner Health System (Louisiana) and Intermountain Healthcare (Utah).
“We were able to create a platform for providers across organizations to address the barriers and facilitators of integrated specialty care, and we developed a list of measures for assessing value across specialties,” says Maisano, who works as a research assistant at Yale University.
In addition to sharing survey results with the health systems, she is scheduling focus groups to discuss differences amongst specialties and organizations further and will also prepare a white paper on measurement-based care.
“Garnering the technical skills and experience of an MPH from Dartmouth has allowed me to understand and sharpen the skills I already have and apply it to larger and more diverse settings,” says Maisano. “Furthermore, my graduate internship at Geisinger has amplified my knowledge of healthcare system operations and has solidified my desire to pursue healthcare administration.”
Qualitative Analysis of Systemic Drivers of Burnout and Wellbeing Among Oncology Professions at D-HH’s Norris Cotton Cancer Center
Sasha Yanes MPH’22
Sasha Yanes’ internship work reflects the need for health systems to intervene on behalf of their clinical staff to identify drivers that reduce burnout and restore well-being—a key national priority of the Institute for Healthcare Improvement.
In our region, Norris Cotton Cancer Center (NCCC) is continually recognized as a high-quality cancer center, including recognition as the only cancer center in New Hampshire to be designated by the National Cancer Institute. However, burnout and turnover among staff have increased, resulting in an estimated 1,000 empty positions to refill across all clinical locations.
For her project, Yanes worked with the Promise Partnership, which focuses on
quality improvement initiatives for Dartmouth-Hitchcock Health and its oncology services. She conducted a thorough analysis of the results of a survey sent by the Partnership to staff in the spring of 2021—asking them what wasn’t working well, what could be improved, and any other information they wanted to share.
Yanes found the primary driver of burnout to be “lack of personnel resources,” and conversely, that “a sense of security and community,” primarily through collaboration, drove well-being.
“I learned that these interconnected drivers exist both at the micro and macro levels of the system,” she explains. “Many survey responses suggested that drivers of wellbeing largely exist among team members, whereas drivers of burnout are more systematic. We put an exorbitant amount of pressure on providers to deliver quality care and have yet to put systematic improvement initiatives in place to care for these providers.”
Yanes, who is based in New York and has a proven track record of success working at high-growth startups in the financial and healthcare sectors, says her applied practice experience has broadened her scope of interests. “I’m eager to identify solutions that satisfy provider and patient needs, improving both their experiences and their health outcomes,” she says.