Genius Projects

genius-projects

labor pain

In the U.S., few options for pharmacologic pain relief are available. Currently at Jefferson Einstein Montgomery we only have two options available to women desiring relief from pain—IV opioids and epidural anesthesia. While effective in relieving pain, these options may be contraindicated in some women or not readily available. Delay in pain relief or suboptimal relief can cause undue suffering to women. By offering a third option, Nitrous Oxide, we can provide an additional mechanism to provide relief which would enhance patient satisfaction. Furthermore, patient mobility is maintained with nitrous oxide which optimizes the fetal positon in labor, reducing the risk of C-section.

“We really do pride ourselves on giving our patients all kinds of options. We want them to be satisfied and comfortable, but have good, healthy births as well.” – Kathy Murtin, Labor & Delivery Nurse

Not all mothers want to give birth unmedicated; others don’t want an epidural or IV pain medications. It’s also a challenge to manage pain with recovering opioid use dependent mothers on methadone maintenance.

Nitrous oxide fills that gap. It’s safe, quick, and effective. It doesn’t affect baby or mom like IV pain medicine, making them sleepy or impacting contractions. There are no known effects on breastfeeding either. It can also be administered to patients with a history of drug or methadone use, reducing their anxiety of using medications while alleviating pain.

“It’s been a really great feeling knowing I’ve been giving money to support colleagues and their projects. Now, I’ve become part of it and received funding for a project I’m passionate about.” – Kathy Murtin, Labor & Delivery Nurse

With funding from Albert Einstein Society (AES) and its generous donors, the team purchased two machines which administer the gas. The grant also included funds to train the nursing staff to operate the equipment, identify which patients qualify for nitrous, and instruct patients on the use of gas during labor and delivery.

Jefferson Einstein is the first teaching institution in the area to offer teachings for managing labor pains during child birth.

Project Leader: Michelle Barcus
Staff: Daryl Stoner, MD, Michelle Djevarian, and Melissa Hewitt
Jefferson Einstein Montgomery – OB/GYN

Neuro-Resource Facilitation for Marginalized and Underserved Populations with Acquired Brain Injury, 2018 IPAC Grant
brain injury treatment

The Community Re-Entry Program at Drucker Brain Injury Center at MossRehab is working to make traumatic brain injury (TBI) a societal conversation among Philadelphia nonprofit and government agencies. Thanks to a grant from the Albert Ein­­­stein Society (AES), Neuro-Resource Facilitation is now being offered to and connecting more TBI survivors with treatment and rehabilitation services.

TBI survivors are more likely to be involved in the criminal justice system than peers their same age. They’re often misdiagnosed with mental health problems, incarcerated for impulsive or destructive behavior caused by their injury, or never receive the treatment they need. Approximately 60.25% of adult offenders reported having at least one head injury.

Brain Injury Therapists Gillian Murray, DSW, LSW, CBIS, and Claire Sitarz are training area professionals who work with marginalized and underserved persons, especially victims of intimate partner violence (IPV) and ex-offenders (EO), to identify and screen clients they serve who demonstrate symptoms of TBI. For example, a TBI might complicate how a survivor acts while on parole or their behavior in a courtroom or with authority.

“There’s no way we would’ve been able to do this work without AES”

brain injury treatment

“IPV dwells in these shadow places,” explains Sitarz. “It happens when no one is around or seeing it, and neither the victims nor their aggressors are seeking help. So, we thought, how do we reach these people to let them know there is help? We want to help them understand what they’re experiencing could be caused by an undiagnosed TBI.”

The first step to understanding is to create awareness and train staff who work with prison populations and those who have experienced IPV. Sitarz and Dr. Murray, who is also a case manager, have trained hundreds of providers affiliated with the corrections system in Philadelphia, mental health services, social work staff, and others to understand this underserved community and help them get the healthcare they need and deserve.

AES provided the funding needed for both Sitarz and Murray to train professionals and share available resources.

“Einstein is committed to their employees, and AES is a wonderful example of that commitment,” Murray says. “They understand how important it is to support employees seeking to develop best practices and innovative ways to better serve our community. A lot of patients we see here really need our help. The fact that there is a resource offering the flexibility and opportunity for employees to launch projects like this is unique.”

Breastfeeding is the gold standard when it comes to infant nutrition.

Women who receive breastfeeding support in the first days and weeks after hospital discharge are more likely to nurse their babies longer and with a greater feeling of success. But, the lack of accessible support after hospital discharge causes a dramatic drop-off in breastfeeding.

It all started with a seed of an idea, and then AES gave us the opportunity to continue to grow. – Dr. Irigoyen

 

With a grant from the Albert Einstein Society (AES), Dr. Irigoyen and her team, including Meredith Zaroff, NP established the Einstein Lactation Center, the first breastfeeding resource center in the city of Philadelphia. This comprehensive consultation, training, and resource center supports breastfeeding women in the Einstein community, including patients, employees, and area residents.

Working side-by-side Einstein physicians, Gazda coaches and supports patients with common breastfeeding concerns: milk supply, low or slow weight gain for baby, nursing premature infants or twins, pumping, and mother returning to work.

In less than a year, Gazda’s already had more than 400 encounters between visits and follow-ups. The center offers individual and group counseling support at convenient “drop-in” times right around the corner from Einstein Philadelphia’s Ob/Gyn Clinic, enabling moms to take care of themselves and babies in one visit.

Outpatient Lactation Services, 2017 IPAC Grant

A radical prostatectomy is the gold standard for treatment of localized prostate cancer.  Although an effective treatment, sexual dysfunction and urinary incontinence are common side effects that can be very stressful for patients undergoing this surgery.  PDE5 inhibitors, a type of medication that can help improve sexual dysfunction, and absorbent pads, which can help control a patient’s urinary incontinence during the day, are common treatments to help patients cope with these side effects.  These treatments are readily available to most patients, but for patients in underserved communities with poor access to care, they can be costly.  The goal of this study is to provide these resources and investigate if patients residing in underserved communities will benefit from receiving these resources.

With help by the Albert Einstein Society (AES) and Einstein Healthcare Network.

Primary Investigator: Eric M. Ghiraldi, DO
Mentor: Serge Ginzburg, MD, FACS
Department: Urology
Einstein Medical Center Philadelphia

At Trappe Pediatric Care, we propose a model to improve access to mental health care for patients. There is a national call to integrate care in a fragmented system. The number of children and adolescents seeking services has been increasing. Only 15-25% receive specialty care.  Utilizing established models, we seek to achieve a medical home that incorporates mental health needs in the Einstein system.  Through the creation of a team, there would be resource coordination and information dissemination. A program will be built with preventative screening, peer training, and patient education.  Patient tracking and follow-up will assure care.

Project Leader:  Mariam Mahmud, MD
Staff: Gail Bedell / Don Brogan, MD / Bobbie Hylinski / Maria Jones
Trappe Pediatrics – Collegeville

Integration of advanced technology mediated gait training in regulated inpatient clinical practice will promote higher quality, higher intensity training at early post stroke, provide objective measures to rate progress and optimize training protocol for patients and increase community discharges.

Project made possible by the Albert Einstein Society, MossRehab and Einstein Healthcare Network.

Project Leader:  Ning Cao, MD
Staff: Kelly Donahue / Karen Emery / Amanda Charles
MossRehab – Physical

Persons with Aphasia Training Dogs (PATD) Program, 2017 IPAC Grant

People with post-stroke aphasia have difficulty recalling words and may also have difficulty putting together grammatically correct sentences or understanding what is said to them.

“Einstein really encourages people to use their imaginations to come up with projects and programs that benefit the people we serve.”

“Often, people with aphasia become quite skilled at using what you might think of as pragmatic or nonverbal communication,” says Sharon Antonucci, PhD, Director of the MossRehab Aphasia Center. “[When they need to], they use tone of voice, facial expression, changes in intonation, or gestures to communicate their meaning.”

A dog lover with obedience training experience, Dr. Antonucci noticed these characteristics might make people with aphasia ideal candidates for working with animals.

“Dogs don’t care about the words,” she says. “They care about tone of voice, gestures, and facial expressions.”

From there she thought, “Why not give those with aphasia opportunities to practice their communication skills by taking a dog through a basic obedience course?”

With a grant from the Albert Einstein Society (AES), the Aphasia Center launched a pilot program, led by Dr. Antonucci, that teaches center participants techniques for training their pets. It’s an innovative, 6- to 8-week therapy program that brings together clients and their dogs to learn one skill per week.

During the program, Dr. Antonucci works with clients to train their dog to understand and respond to cues, such as SIT or STAY. She measures progress on dog training and assesses any change in their self-reported quality of life using the Assessment for Living with Aphasia.  Six months later she follows up to see how things are going with the individual, how well their dog has learned the skills, and how they’ve progressed toward their goals.

The opportunities are endless, she says—from health, wellness, and psychosocial benefits that come from interacting with dogs, to the practice of communication and learning a skill that may be new to them.

“It’s great seeing people’s faces light up, how happy and engaged they are working with their animal”.

“I’ve realized how much ‘flexing’ of cognitive and communication skills the training provides—problem-solving and thinking about what they’re doing, what’s working, or what needs to be tweaked in their communication.”

The training is working, she says. Several participants, now at the 6-month mark, have continued working with their dogs to train them to do things beyond what was learned during the program. They’re taking on the skills and principles acquired in the program and expanding them.

Dr. Antonucci recently partnered with the Pennsylvania Society for the Prevention of Cruelty to Animals (PSPCA) so people with aphasia without a dog or without a dog that’s eligible for training can still participate in the program—a benefit to both the participant and the shelter animal. She’s also submitted a National Institutes of Health grant for a scientific study of the program and its outcomes, none of which would have been possible without support from AES.

“How many people have the opportunity to work for an organization that supports innovation in such a concrete and real way?” Dr. Antonucci asks. “Einstein really encourages people to use their imaginations to come up with projects and programs that benefit the people we serve.”

Impacting Health and Wellness of Emergency Residents

The purpose of this study is to determine whether a brief mindfulness intervention can decrease physician level of burnout in Emergency Medicine residents.  Mindfulness intervention is a structured program that used mindfulness meditation and practices to reduce negative effect and improve vitality and coping.  The program is based upon a systematic procedure to develop an enhanced awareness of moment-to-moment experience and has shown to be effective in reducing anxiety, depression and stress.  The physician workforce is facing a critical epidemic of burnout rates, with Emergency Medicine physicians reporting some of the highest levels.  The goal of this project is to provide Emergency Medicine residents in our institution with an hour-long group mindfulness stress reduction session and self-guided audio recordings of brief mindfulness

Primary Investigator: Elizabeth Datner, MD, Chair, Emergency Medicine
Einstein Medical Center Philadelphia