Leaders from across eastern North Carolina came together for the Vision 2023 event hosted by NC East Alliance at the East Carolina Heart Institute on the Brody School of Medicine campus on Jan. 13 to collaborate on workforce development solutions for the region.

Titled “The Power of Possibility: Envisioning the Future of Rural Regional STEM Education,” the event focused on education and job training for the next generation of regional leaders. This served as the first planning meeting for the STEM East Network which aims to improve education, professional learning, workforce development and economic development in the East.

Dr. Michael Waldrum, chief executive officer at ECU Health and dean of the Brody School of Medicine at East Carolina University, is an NC East Alliance Executive Board member and said he believes the health system’s partnership with NC East Alliance is crucial to advancing the mission of ECU Health and the Brody School of Medicine.

“I’ve been on economic development company boards for over 25 years, and I always say if you really want to improve the health and well-being of a community, you have to drive economic development and if you want to drive economic development, you have to educate people,” Dr. Waldrum said. “It’s really a global perspective – regional transformation and promoting communities involves creating economic opportunities, educating future generations and providing great health care services.”

The event had representation from 29 school systems and 14 community colleges from across eastern North Carolina and the morning session centered on creating an “Industry in School” Alliance that brings together school districts, community colleges and industry in a collaboration designed to bolster the region’s workforce.

Mark Hamblin, chairman of the NC East Alliance, said this new initiative is an important next step for the organization and the region as a whole.

“A couple years ago we were wondering what was next for this organization and when we came together to develop this initiative, it made so much sense because a regional approach is so important to all of us,” Hamblin said.

The STEM East Network steering committee will develop regional solutions to help educators become transformative stakeholders in the regional economy. This will include training educators, from elementary school through college, to better understand the industry and workforce needs of the region. As a result, students will have an increased awareness of jobs available in the region.

A key vision for the program is to keep high school graduates in the region for work and further education while the ultimate goal is to encourage eastern North Carolina’s homegrown workforce to stay and serve in communities across the region.

Dr. Waldrum said for rural health care specifically, this initiative is much needed to develop a strong workforce of future regional leaders.

“In health care we need a strong workforce,” Dr. Waldrum said. “Before the pandemic, workforce was a major issue with massive shortages on technicians, nurses and physicians primarily in rural communities. So we focused on how we could recruit and retain our workforce and provide access to care for a vibrant, rural community. Having a group like this come together and help us in that sector with STEM education and economic development is something that I really want to thank everyone here for making happen.”

Forward thinking and grassroots efforts are helping shape a better future for eastern North Carolina and working together is the best way to impact the region far and wide. ECU Health is excited to partner with industry leaders and elected officials, joining forces on regional initiatives like the STEM East Network to promote positive change in the communities we serve.

Community

Leaders of Pitt County’s Health Sciences Academy are working hard to give students the real-life skills needed to succeed in the work world—thus fueling the talent pipeline for our state’s employers.

While labor shortages have been prevalent across all industry sectors in recent years, it has been particularly acute in the health care industry and even more so in our state’s more rural communities. However, for Pitt County, this program has brought a tangible solution for training the next generation of health care talent in the Greenville area.

The Health Sciences Academy is a curriculum program, which was created to expose and prepare Pitt County high schoolers who wish to pursue a health care-related career after graduation.

Photo Courtesy of NC Chamber

During high school, students participating in the program complete a minimum of six courses that prepare them for various health careers. As part of their program experience, students can participate in job shadowing, mentoring, internships, medical research opportunities, career exploration, and volunteering at ECU Health. In addition to ECU Health, the school system works in tandem with East Carolina University Division of Health Sciences, Brody School of Medicine, the ECU Dental School of Medicine, Pitt Community College, Eastern Area Health Education Center, and the Greenville-Pitt County Chamber of Commerce.

“When people think of health care, they think of doctors and nurses,” said Reed Potts, Health Sciences Academy Coordinator. “Doctors and nurses only make up 30% of the health care workforce, so there are many more jobs out there that the kids do not know about.”

The program, which began in 2000, currently has approximately 1,000 student enrollees, and works with high school students exploring all pathways including two- and four-year colleges, trade school, the military, and others. Potts expressed pride that 30 members of the program’s current cohort will be first-generation college students.

“Seeing a career firsthand — you’ll know whether or not it’s for you,” said Lisa Lassiter, director of workforce development at ECU Health. “We had a student who was set on being a labor and delivery nurse, but after a firsthand experience through Health Sciences Academy, she adamantly decided it was not for her anymore. That’s valuable too, because if she hadn’t had that opportunity, she never would have known until her junior year of college during clinicals.”

Potts said that standalone career nights are extremely beneficial to recruiting future students into the program because they can touch, see, and feel medical equipment and talk to staff about potential careers firsthand. They are also now starting recruitment efforts even earlier among middle schoolers.

To participate in the Health Sciences Academy, students must maintain a 3.0 GPA, have a clean disciplinary record and complete 25 hours of volunteer hours per year. There are also two dedicated counselors that work directly with Health Sciences Academy students and travel to all of Pitt County high schools.

In this program, students learn many soft or durable skills, including leadership, critical thinking, accountability, and communication, and they also get other important training such as etiquette lessons, resume building, and ACT and SAT workshops.

Potts stated that there has been a major return on investment as this program expands the talent pipeline in the Greenville area. “Roughly 50% of the students who go through the Health Sciences Academy stay in the area and go to East Carolina University,” he said. “And we anticipate seeing that number go up even more.”

He also attested that every single student who goes through the program goes to a two- to four-year college, trade school or the military.

When asked what recommendations they would make to other counties looking to implement similar programs, both Potts and Lassiter discussed the importance of constant two-way dialogue between the health system and school system, to ensure the needs of both parties are being met.

“Having direct communication with the school system has been extremely beneficial because we can discuss what’s going great and how to mitigate certain challenges,” said Lassiter. “As a result, we have this very well-trained future pipeline.”

She also stated that many people may be turned off by the cost of a similar program but suggested that other schools and health systems can start small by using time as a resource or having exposure activities that do not cost money.

Read more on NCChamber.com.

Community | Featured

Windsor, N.C. – ECU Health is pleased to announce ECU Health Bertie Hospital has been named a 2022 Human Experience (HX) Guardian of Excellence Award® winner for physician engagement by Press Ganey, the global leader in health care experience solutions and services. This award is part of Press Ganey’s annual ranking of the top hospitals and health systems in the country, according to performance in physician engagement.

“It is an honor to receive this award on behalf of the dedicated team members who make ECU Health Bertie a top performing hospital for physician engagement,” said ECU Health Bertie Hospital President Brian Harvill. “It takes a dedicated group of individuals working together to care for a community. I could not be more proud of the ECU Health Bertie doctors, nurses and support staff who work tirelessly to provide excellent patient-centered care to those we are honored to serve.”

As a winner of the Press Ganey HX Guardian of Excellence Award®, ECU Health Bertie is in the top 5% of health care providers in physician engagement in the last year. Press Ganey works with more than 41,000 health care facilities in its mission to reduce patient suffering and enhance caregiver resilience to improve the overall safety, quality and experience of care.

“By putting their patients and workforce first each and every day, ECU Health Bertie Hospital is demonstrating their unwavering commitment to their employees and to the communities they serve,” said Patrick T. Ryan, chairman and chief executive officer, Press Ganey. “The caregivers at ECU Health Bertie have inspired us with the compassion, empathy and human connection they bring to the clinical healthcare setting. We are honored to partner with them as we celebrate their achievement.”

Team member engagement is central to how ECU Health creates positive experiences and delivers upon its mission to improve the health and well-being of eastern North Carolina. Per fiscal year data, ECU Health Bertie providers rated their engagement better than the national average in all five key engagement performance indicators: engagement, alignment, safety, resilience and diversity.

“As an organization dedicated to providing rural health care, ECU Health understands that exceptional patient experiences are created by compassionate, energized and engaged teams,” said ECU Health Chief Experience Officer Dr. Julie Oehlert. “This award from a globally recognized health care leader like Press Ganey is a testament to our whole team which goes above and beyond to overcome the challenges we face and ensure communities across our region have access to high-quality compassionate care they deserve.”

To learn more about ECU Health Bertie Hospital, visit ECUHealth.org/Bertie

Awards | Featured | Press Releases

Greenville, N.C. ECU Health’s EastCare team was awarded MedEvac Transport of the Year by the Association of Air Medical Services (AAMS) for their initial transport of East Carolina University freshman Parker Byrd and subsequent transports throughout his recovery. The EastCare air medical team, Steve Bonn, pilot, Henry Gerber, EMT, Milando Stancill, EMT, Leigh Ann Creech, communication technician, Jessica Rispoli, flight RN and John vonRosenberg, flight paramedic, accepted the award on Oct. 26 for their efforts rendering life-saving care to Byrd.

On July 23, 2022, Byrd, an incoming freshman and baseball player at ECU, was boating in a remote creek when his legs were cut by the propeller, resulting in severe trauma. A friend and teammate was able to pull him back in the boat and immediately applied a makeshift tourniquet. First responders on the scene recognized the severity of his injuries and requested air medical transport. The EastCare air medical team jumped into action, rendering life-saving trauma care on the flight to ECU Health Medical Center, the only Level 1 Trauma Center east of Raleigh.

“EastCare team members dedicate themselves to ensuring the people of eastern North Carolina who live in vast, rural areas have access to timely and life-saving care,” said Trey Labreque, director of EastCare. “Thanks to the quick actions of everyone involved, including Beaufort County EMS for their initial response and clear communications with the flight crew, the transition of care was quick and efficient, and the patient made it to the trauma center stabilized, which is our objective as a flight team. This award is testament to all EastCare team members who live the ECU Health mission.”

Quick actions by the flight crew dramatically improved Byrd’s vital signs prior to arriving at ECU Health Medical Center. Flight nurses administered plasma, blood products and treatment for traumatic hemorrhagic shock during the air transport. In the following weeks, due to the severity of injury, the EastCare team provided Byrd transportation to the wound care center twice daily, multiple times per week to receive specialized care and hyperbaric treatments at ECU Health’s Wound Healing Center.

“The EastCare team has been nothing but phenomenal to me,” said Byrd. “From day one, they were doing their job to the best of their ability. I want to thank each and every person on the EastCare team for what they have done for me.”

Byrd was discharged in mid-August, nearly one month after his injury. After 22 surgeries and a partial leg amputation, Byrd continues to undergo outpatient care and rehabilitation in his recovery process. Byrd plans to continue classes at ECU and practice with the baseball team while he undergoes rehabilitation.

Please join ECU Health in recognizing the EastCare team for their rescue of Byrd and their efforts to render emergency care to all patients across eastern North Carolina.

Awards | EastCare | Emergency & Trauma | Featured | Press Releases

Greenville, N.C. – Dr. Michael Waldrum, CEO of ECU Health and dean of the Brody School of Medicine at East Carolina University, assumed the role as chair of the Council of Teaching Hospitals and Health Systems (COTH) Administrative Board for the Association of American Medical Colleges (AAMC), effective Nov. 12, 2022. In addition to his chair role, Dr. Waldrum is also a voting member of the AAMC Board of Directors.

COTH members include CEOs, presidents, and other executives who lead the AAMC’s nearly 400-member teaching hospitals and health systems. They concentrate on issues specific to academic medicine, such as demonstrating its value and societal good; financing graduate medical education; funds flow and enterprise-wide mission alignment. Dr. Waldrum is a leading voice in advocating for policies promoting and enhancing academic health care and in particular, rural academic health care.

“Dr. Waldrum has clearly earned the respect of hospital executives and leaders in academic medicine across the country as he was selected for this leadership role by his peers,” said Rosha McCoy, MD, AAMC acting chief health care officer. “As an AAMC council, COTH is one of the crucial professional development groups for the association, bringing together the highest tiers of leadership from academic medical centers. Dr. Waldrum has shown a deep commitment to patients and communities, with a particular focus on rural communities, a passion for academic medicine, and an excellent ability to navigate tough challenges. We are thrilled to have him as chair of the COTH Administrative Board and look forward to working with him over the coming year.”

Health care in America faces significant and unique challenges and it’s even more difficult in rural areas of the country where 183 hospitals have closed their doors since 2005, according to a recent UNC Sheps Center report. The impacts of a global pandemic combined with a high burden of disease, vast geographical areas, traditionally underserved communities and a high reliance on government pay requires innovative solutions, difficult decisions and importantly, the need to develop and train health professionals committed to rural health care. In eastern North Carolina, academic medicine is how ECU Health strives to sustain quality rural health care now and into the future and achieve its vision to become the national model for rural health care.

“It’s an honor to work collaboratively with other leaders across the nation who are committed and passionate about academic health care,” said Dr. Waldrum. “I understand the important responsibility and opportunity I have to highlight and advocate for the future of health care in rural America. I appreciate my peers for entrusting me with the opportunity to bring my unique perspective to the AAMC Council of Teaching Hospitals and Health Systems.”

The AAMC leads and serves the academic medicine community to improve the health of people everywhere. Founded in 1876 and based in Washington, D.C., the AAMC is a not-for-profit association dedicated to transforming health through medical education, health care, medical research, and community collaborations.

Community | Featured

ECU Health Beaufort Hospital, a campus of ECU Health Medical Center, hosted free community health screenings, produce giveaways and educational information at its first fall harvest event at the new community garden and outdoor classroom on Nov. 18.

The community garden and outdoor classroom, located next to the ECU Health Wellness Center in Washington was made possible — in part — by a grant from the Robert Wood Johnson Foundation and the garden was developed by the ECU Health Patient Education team in collaboration with ECU Health Beaufort Hospital. Internal partners include the ECU Health Beaufort Hospital Food & Nutrition Services team, Community Health Improvement team, Volunteer Services, the Wellness Center, and Facilities & Properties.

“It has been wonderful working with such an innovative team,” said Tammy Thompson, director of Experience Engagement, Education and Design at ECU Health. “They have been true partners throughout entire process.”

Sowing the seeds for health and well-being

Over the summer, the garden started to take shape, resulting in 10 raised beds for vegetables, two large metal planters for herbs, fencing, a shed and space for community members to come together and learn outdoors. The hospital planted the first crops in September for the first harvest event.

Pam Shadle, director of Marketing, Community Outreach and Development at ECU Health Beaufort Hospital, said the opportunity to come together as a team and create something that will benefit the community has been a great experience.

“It’s been a labor of love since the creation of the idea,” Shadle said. “So many of our team members from various departments came together to make this happen, so it’s been a great opportunity for our folks to get involved and I really appreciate that.”

Shadle said the community garden and outdoor classroom is an integral addition to their community health improvement plan for Beaufort and Hyde county residents. While they already feel the great impact of existing programs on community health, the garden will help create new opportunities and help improve those established programs, Shadle said.

Beyond the harvest

The ECU Health Food and Nutrition Services team joined the event and shared easy-to-make recipes inspired by the garden’s produce — which includes vegetables and herbs like broccoli, collards, kale, lettuce, rosemary and thyme. Along with the opportunity to take home fresh, free produce, clinical teams were on hand to offer health screenings for community members, and the Wellness Center team shared information about lifestyle medicine and other services to support community wellness.

“It’s just a great complement to include these offerings because what we’re trying to do is not solely about food,” Dr. Thompson said. “We call these living-learning labs because of the interactive engagement to support healthy lifestyles. This is an opportunity for community members to receive a variety of information and resources for better health.”

ECU Health Chief Experience Officer Julie Oehlert, DNP, RN, said the garden is an important step in the community health work in eastern North Carolina.

“We’re so proud of the teams that made this garden a reality,” Dr. Oehlert said. “It’s going to benefit community members, team members and patients in the hospital and I think it’s really special for us to connect with the communities we serve in this way. We’re excited to offer something unique for Washington and Beaufort County and I know we’re going to learn so much from this project.”

Planning your visit

The garden will be open to community members from 9 a.m. to noon each Wednesday and Friday where any produce ready to be harvested will be distributed and other educational materials will be shared.

Community | Featured | Health News | Wellness

Learning your child is sick is devastating, in any language.

“He got sick when he was two years old,” Miguel Morales’ mother, Maria Martinez, said in Spanish. “His diagnosis was spelled LCH. It is one of the somewhat aggressive cancers. It was a very, very difficult process for him. Very painful for all of us to see my son suffer every day without being able to understand why he does not speak much.”

LCH, or Langerhans cell histiocytosis, is a rare form of cancer that most commonly appears in toddlers and children.

Complicating the diagnosis — the fact that English is a second language for Miguel, his mother Maria and their family.

“We take care of our patients that have are limited English speakers,” said Tania Elguezabal Christensen, Interpreter Services manager at ECU Health. “So we help them to navigate our health care system and we help them communicate with our providers, with our doctors and nurses about their health care.”

Tania and the Language Access Services team — which is comprised of interpreters and translators — help bridge an important gap for patients and families during a hospital stay. An integral part of a patient’s care team, they offer services for 240 languages and dialects across the ECU Health system.

“When we go to get medical treatment, we all want to understand what our diagnosis is and what the treatments are,” Elguezabal Christensen said. “When people don’t speak the language, it’s hard to understand all of that. That’s why it’s so important for us to be a conduit between patients and providers.”

Martinez said she was grateful for the assistance the Language Access Services team provided while her family navigated a challenging time.

“It was a very good thing for me,” Martinez said. “They have been very supportive during this long process with my son. They have helped me to better understand his situation, how to properly give the medications, and to clarify many doubts that I had with the doctors. Since I do not speak the language, they have been a very important source of support for me.”

One part of the journey that is easy to understand in any language, the milestone moment Miguel got to ring the bell at the James and Connie Maynard Children’s Hospital at ECU Health Medical Center. It’s a celebration of beating cancer, surrounded by the many teams who helped him along the way.

“For me it meant life, it meant opportunity, it meant opportunity to have my son with me,” Martinez said. “It meant everything. It meant that some of my worries about losing him were fading away. It meant that I could see him grow.”

Today, Miguel is a happy, typical 4-year-old boy. He loves to play and jump around, which was difficult for him to do while he was sick.

Martinez is grateful for the outcome — and for those who made it possible.

“Well, I thank everything, first to God and for giving us the opportunity to heal my son, to the entire doctor’s team, from interpreters, nurses, doctors, everyone who was there, the whole team because they really helped us a lot,” Martinez said.

Along with sharing her appreciation for her healthy son, Martinez also wants other parents to learn from her family’s experience.

“More what I would like to say is just my experience as a mother,” Martinez said. “I would tell people that are out there listening to me and mothers out there — ask questions. If someone tells you this is just an infection, keep digging and keep asking questions.”

Resources

Maynard Children’s Hospital

ECU Health Cancer Care

Pediatric Cancer and Hematology

Cancer | Children's | Health News

ECU Health Medical Center

Greenville, N.C. – After an extensive national search and interview process with stakeholders from across the organization, ECU Health is pleased to announce Trish Baise, DNP, RN, NEA-BC, FACHE as ECU Health’s first Chief Nursing Executive (CNE). Dr. Baise will officially join ECU Health on Jan. 1, 2023.

“The impact nurses have on patients and their loved ones – from their clinical expertise to delivery of compassionate care – is at the heart of all we do,” said Brian Floyd, chief operating officer, ECU Health. “The creation of the CNE position and the appointment of Dr. Baise to lead in this role allows our organization to innovate and collaborate to further build a nursing culture that helps recruit and retain talented nurses and care givers who are dedicated to serving our region.”

The CNE will serve as a catalyst and role model to advance nursing care, education, research, care delivery models and leadership across ECU Health’s ambulatory, outpatient and inpatient areas. In her role, Dr. Baise will be responsible for integration and coordination of the nursing practice for the health system.

Throughout her more than 30 years of health care experience, Dr. Baise has led forward-focused initiatives within nursing recruitment and retention, specifically within the areas of culture and experience. She also has proven expertise in designing and deploying quality initiatives that improve quality performance and create safer care environments for patients and team members.

In addition to her vast experience in care delivery, leading care teams and strategy development, her passion for and understanding of the importance of rural health care will help advance the organization toward our vision of becoming the national academic model for rural health care.

“I am honored to have the opportunity to pioneer the Chief Nursing Executive position at ECU Health,” said Dr. Baise. “ECU Health is a recognized leader in rural health care and the organization’s mission aligns with my professional values of providing high-quality care to communities in rural environments. I am constantly inspired by the difference nurses make in the lives of those they care for, and I look forward to working alongside the great nurses that live the ECU Health mission every day.”

Dr. Baise joins ECU Health from Atrium Health Cabarrus. Prior to her role at Atrium Health Cabarrus, Dr. Baise held various system leadership roles throughout her tenure at Ballad Health System (formally Mountain States Health Alliance and Wellmont Health Systems) – a 21-hospital health system including five teaching hospitals, in rural Tennessee for 11 years.

Nursing | Press Releases

By ECU News Services

Doctors, nurses, therapists — none can do their clinical jobs without facts: proof, by way of blood tests, X-rays and hands-on observations in order to determine a clear path forward to progress a patient to wellness.

The acute skills of observation and diagnosis are critical for the individual patient, but before health care providers can make clinical judgements and chart a path forward for their patients, health care as a whole needs facts. The facts that systemic health care requires comes in the form of research, which has given us modern medical wonders like antibiotics, MRIs, gene editing and thousands of other discoveries and inventions that have made historical medical death sentences into minor inconveniences.

The tradition of research in the pursuit of making health care better, particularly for those in rural and underserved communities in eastern North Carolina, is alive and well at East Carolina University and ECU Health. Here are a few examples of how Pirate researchers are improving lives one study at a time.

Women living with HIV

Dr. Courtney Caiola, an assistant professor at ECU’s College of Nursing and researcher focusing on women and HIV, said that that the HIV epidemic has made an insidious shift, from largely affecting urban populations in the epidemic’s early days to now having taken root in rural and underserved regions — eastern North Carolina has become a ready refuge for the disease.

The National Institute of Nursing Research has funded one of Caiola’s research projects that aims to find out how best to communicate with women living with HIV in rural settings, particularly for those without reliable access to high-speed internet connectivity.

Caiola is fighting an uphill battle, one complicated with social mores and community stigma for residents of rural and underserved area who are diagnosed with HIV.

“The epidemic has changed over the years, in good ways,” Caiola said. “People living with HIV are living really well now, but women living with HIV in the South have some of the highest rates of HIV infection but the lowest rates of viral suppression, which means that that they’re not engaged in care.”

Cultural barriers and social stigma often prevent many women in the South from seeking care, Caiola said. Women in a more urban setting might be able to visit an HIV clinic with little fear of disclosing her HIV status, but that isn’t necessarily the case when community members know which clinics serve patients living with HIV.

Caiola’s research partners well with an outreach and research project spearheaded by Dr. Leigh Atherton, an associate professor in the Department of Addictions and Rehabilitation Studies at ECU’s College of Allied Health Sciences.

Atherton endeavors to find ways to prevent the spread of HIV in rural North Carolina by encouraging those in high-risk substance use groups to seek treatment for their addictions. Atherton’s team partners with community-based HIV outreach groups and supplements testing supplies, which puts his counselors in direct contact with at-risk populations.

One of the highest hurdles to clear for researchers focused of HIV treatment and prevention in North Carolina is simply getting enough people to participate in the research.

“There’s something called courtesy stigma. A lot of women with HIV are mothers and they don’t want the stigma that they might experience to be passed on to their kids, so they tend to keep very low profiles and be a bit socially isolated,” Caiola said, which necessitated her team partnering with multiple other HIV researchers in North Carolina and across the South.

Initial research findings suggest there is no one-size-fits-all solution to communicating with HIV positive women in rural areas.

“As clinicians, the differences in the way people respond to their circumstances is often very clear, but in research, people are often grouped into broad demographic groups for the sake of generalizability,” Ciaola said. “In fact, two women with similar demographic profiles, like Black women living with HIV in a rural area, may have wildly different responses to dealing with HIV.”

Disease prevention

For Brody School of Medicine Drs. Greg Kearney and Doyle ‘Skip’ Cummings, health-related research orbits around overarching conditions that spiderweb across the body creating a cascade of adverse consequences — hypertension and environmental public health.

In order to find ways to address the high levels of hypertension in rural areas, Cummings is piloting a program, in collaboration with UNC-Chapel Hill and the University of Alabama, to test home health reporting technologies that can identify high blood pressure patterns and upload those readings into a computer system for a team of health care providers to evaluate.

“Instead of just one provider seeing a patient every three months or so in the office, we’ve got a team of people that are trying to stay on top of blood pressure values and recognize when a patient’s blood pressure patterns appear to be out of control, signaling the need for quick follow up, often by telephone or telehealth,” Cummings said.

In setting patients up with the telehealth devices being tested, researchers are using the in-person meetings as an opportunity to gather baseline information that can be used to identify some of the causes of hypertension in disadvantaged and rural communities.

“We’re using screening instruments during the baseline visit to look at the social determinants of health — food insecurities and transportation and housing instability,” among other data points, Cummings said.

Cummings, a Brody professor of public health and the Berbecker Distinguished Professor of Rural Medicine, said that the amount of data that the system transmits from a patient’s home to the central computer is so small that the team has had no problems thus far with getting data to the health care team.

“I just came back from two days of site visits out in the mountains in rural North Carolina and we took the blood pressure cuff with us,” Cummings said. “We drove all over the mountainous areas and tried the blood pressure cuff in multiple places, and we didn’t have any problems. Part of it is because that blood pressure value is a very small amount of data. It’s not like you’re sending a video or pictures.”

Kearney’s research is rooted in a desire to understand environmental and occupational impacts on human health, particularly asthma and the effects of chemicals and pesticides on farm workers.

Kearney, an associate professor of public health at Brody and founding director of the school’s Environmental and Occupational Health Program, is working with a toxicology researcher at UNC-Charlotte, who has developed a portable medical device that can be used to test for pesticides in human blood.

Kearney said that they have pilot tested the device with farm workers working with different crops.

“Because of the nature of their work, they are in the fields daily during the season, and are at high risk for exposure to pesticides,” Kearney said. “Some pesticides are quickly metabolized in the body’s systems, so a person who is exposed and located in a rural area may have difficulty getting tested right away. With a simple finger stick and a drop of blood, this device can quickly alert you to pesticide exposure.”

Last year, Kearney organized a team and worked with community partners to conduct a regional community health needs assessment for the eastern part of the state. The project included working with representatives across 33 mostly rural North Carolina County health departments and ECU Health.

This research is critical for not-for-profit hospitals, which are required by law to complete community health needs assessments every three years, to understand how to plan for health care investment.

“The community health needs assessment and outcomes is a very serious process,” Kearney said. “It provides a mechanism for hospitals and communities to come together and decide how to invest funding with community-based organizations to address the most pressing health care related problems in their communities.”

Fresh start

In eastern North Carolina, people with Type 2 diabetes are twice as likely to die as the rest of the state and the country.

Fresh Start, a research and outreach project established by Dr. Lauren Sastre, associate professor of nutrition science at the College of Allied Health Sciences, partners with free clinic members of the North Carolina Association of Free and Charitable Clinics across 11 counties in eastern North Carolina. The research and outreach program aims to prove is that diabetes can be controlled by layering previously disparate approaches to diabetes management — providing healthy food to those in need, teaching patients how to incorporate food and exercise into their lives and building accountability structures.

“I’m from North Carolina, and I don’t want to keep seeing that we have diabetes in this region that is out of control,” Sastre said. “There are problems that are hard to solve and this one isn’t hard to solve — it’s just whether or not we are actually going to do it.”

Sastre and her expansive interdisciplinary team of dozens of ECU students, trainers and researchers hope that through teaching patients healthy ways to cook and how to put structures for accountability in place, the Fresh Start program could help patients learn to more effectively manage their disease.

“The question we asked ourselves was, ‘Can these things that other people have done individually, that have shown some effect, complement each other and should the synergy be more impactful?’” Sastre said. “It turned out to be what we hoped it would be.”

The first challenge, exposed early in the research process, was to get to diabetes patients where they were. Sastre’s team found, through face-to-face engagement with patients, that many in rural communities have a very real lack of digital connectivity.

“Everything is done over the phone with health coaching, and we’ve even moved in-person classes to the evenings,” Sastre said. “A lot of our folks are considered the working poor and they make just enough to not have a lot of help and they can’t go to classes in the morning or afternoon.”

Sarah Elliott, a junior studying nutrition science and a Fresh Start volunteer, was heartened by the progress that her patients made.

“We have received really positive patient feedback from the group classes and the health coach experience. People are saying, ‘Not even my own family care as much about my health as my health coach did,’” Elliott said. “It has been impactful to see the difference that this is making in people’s lives.”

And what does the initial research of this integrated approach to diabetes management show?

A1C, one of the blood markers of the body’s control of blood sugar, will typically go down one to one and a half percent with Metformin, which is the standard medication that diabetics are put on initially. The Fresh Start program’s mean decline in just four months was 1.87 percent, which is significant accomplishment that Sastre credits to the program’s multi-layered approach to food and lifestyle management.

“The patients enrolled in our program, their blood sugar control improved for some almost double what it could with some medications,” Sastre said. “Our patients also had reduced hospital re-admission rates, so we know that the program is working. It’s addressing diabetes and improving quality of life. It’s making an impact on disparity.”

Brandon Stroud, a doctoral student, knows farming in eastern North Carolina. He grew up on a farm near Dunn and his grandfather worked several hundred acres of land close to where Stroud was raised.

Undergraduate students, Stroud said, are taught in classrooms the skills they will need to be effective in a hospital setting. Research skills students learn working with patients in the Fresh Start program helps them to evaluate the effectiveness of integrating the three pillars of the program, which makes book learning real.

“This is different than lab-based research,” Stroud said. “It’s community-engaged research, right? So, you’re working with many different partners out in the community — clinics, farmers and different organizations. It teaches us the life skills that we need to be beneficial moving forward whether we want to go into business or continue down a clinical route. The research validates our personal experiences when we are able to employ rigorous evaluation and report these meaningful outcomes.”

Community | Health News

By ECU News Services

The college and schools on East Carolina University’s Health Sciences Campus share a mission produce top-notch health care professionals to serve North Carolina.

A key component of that commitment is innovation in delivering education and patient care in the most rural and underserved communities, as well as rural health-focused courses, field work, research and programs that emphasize the need for better access across the state

ECU’s innovative rural health focused education is taking place across North Carolina, from nursing students caring for Alzheimer’s disease patients in the East to the rotations dental students complete community service learning centers in the mountainous western portion of the state.

Here’s a look at how the colleges and schools on ECU’s Health Sciences Campus are addressing North Carolina’s rural health care needs and challenges through education.

College of Allied Health Sciences

In the College of Allied Health Sciences, patient care includes valuable learning experiences for students on how to provide care in rural settings and for patients from rural communities. Rural health care is central to the school’s mission.

“Our students learn about the importance of transforming health care, promoting wellness and increasing access to health care for the people of eastern North Carolina,” said Dr. Leigh Cellucci, associate dean for academic affairs. “Students spend time with patients and clients from rural areas. They learn firsthand the importance of access to health care.”

ECU’s College of Allied Health Sciences is North Carolina’s largest allied health sciences college at a four-year institution. It has a fall 2022 enrollment of 1,481 students and boasts more than 10,000 alumni. Close to 75 percent of its graduates remain in North Carolina to work, with just over half of those working or living in eastern North Carolina.

The school’s clinics, including the Speech Language and Hearing Clinic, the Student-Run Physical Therapy Clinic, the new Student-Run Occupational Therapy Clinic and the Navigate Counseling Clinic see patients from rural areas of eastern North Carolina. Other initiatives created in the college are aimed at addressing health care challenges for special populations.

Rural health is a key component across the school’s departments in order to prepare students for careers anywhere they are needed.

“It is of critical importance that small hospitals in eastern North Carolina employ highly qualified clinical laboratory science professionals to work in their labs to provide better health care,” said Dr. Guyla Evans, chair of the Department of Clinical Laboratory Science. “The people of eastern North Carolina deserve this, and we accomplish this.”

Dr. Paul Bell, professor in the Department of Health Services and Information Management, said preparing students through curriculum and experience will enable them to better understand the importance of access in improving health care services.

“Health care administrators serve an important supportive role to ensure better health for the people who live in our rural communities, and our understanding that access to primary care, particularly preventive care, will improve our health is central to our mission of transforming health care delivery,” he said.

Physician Assistant Studies student Allision Priest said the college not only prepares students but provides them invaluable resources to assist patients that will be relevant into their future careers.

“[Our faculty are] not only inspiring us to work in those rural fields, but they’re also giving us resources to be able to help the people that are living in those places,” Priest said. “We’re really diving deep into health inequities and understanding food deserts.”

The Brody School of Medicine

The Brody School of Medicine educates students about the obstacles patients in under resourced must overcome to receive health care.

“The majority of the counties in this state are rural, so if we are going to proclaim to improve the health status of eastern North Carolina we have to be prepared to do so in a rural environment,” said Dr. Matthew A. Rushing, family medicine clinical assistant professor and assistant residency director.

The school values recruiting mission-fit students with a rural background, experience with underserved populations and a track record of community and service engagement.

Brody is over the 90th percentile nationally in graduates practicing in rural areas with 12 percent of graduates practicing compared to a national median of 4 percent, according to the AAMC Mission Management Tool. Brody also has the highest retention of graduates practicing in rural North Carolina counties five years after graduation among other medical schools in the state, according to the Sheps Center report on 2022 Outcomes of NC Medical School Graduates.

With more Brody graduates practicing in the state than any other medical school it is a testimony to the school’s mission, Rushing said.

“This work is more than important – it’s necessary, and this is where Brody education truly shines,” Rushing said.

Training for service in rural areas starts as early as the first year of medical school for Brody students, with a series of standardized patients whose stories are set in the rural communities of eastern North Carolina that first-year students encounter as they learn to conduct patient interviews as a first step in diagnosing patients.

First and second-year Brody students are offered a course on Society, Culture, and Health Systems that includes research project that focuses on county health systems. Students gather data on one county health system and population, use the data to examine the county’s COVID-19 response and develop and answer a research question related to the health system as it relates to course concepts.

“The purpose of this project is to bring the topics and concepts covered in our course to life a real and local way,” said Dr. Sheena Eagan, course director and assistant professor. “The project highlights the vast differences between rural, urban and suburban counties, reinforcing the idea that counties can be adjacent and yet have vastly different health systems contributing to disparities in health status.”

The course helps students examine the barriers to optimal health that residents face in rural North Carolina.

“Students examine the health care systems currently in place and determine if there are better ways to deliver quality healthcare to populations that are in these settings,” said Dr. Cedric Bright, interim vice dean and associate dean for admissions.

Second-year students also examine how to better address the lack of access from hospitals closing as well as private practices, and how that impacts preventive medicine and population health.

As they move into the third and fourth years, Brody’s Family Medicine Clerkship places students in community clinics where they see first-hand how rural physicians care for their patients. Students on their Family Medicine and Pediatric clerkship rotations spend up to half of their training in a rural, community setting. Medical students are assessed on their ability to communicate with patients in a caring, compassionate, and effective manner.

Students may choose from a variety of elective courses to gain exposure to a variety of medical specialties and explore individual interests. Students can participate in an elective led by BSOM faculty to serve rural communities in Zambia, which allows students to serve the needs of an international community. Students can also complete a combined Internal Medicine/Pediatrics Acting Internship at ECU Health Duplin Hospital or ECU Health Edgecombe Hospital.

“Rural medicine requires an element of ingenuity — patients living in rural areas have health care needs that are shaped by the resources they are (or aren’t) able to access easily in their communities,” said Emmalee Todd, a third-year medical student. “Even for those of us who will end up at large tertiary-care centers, understanding what goes into rural medicine can help us better serve patients coming from those areas.”

In the fall of 2021, Brody and ECU Health Medical Center (formerly Vidant Medical Center) launched a new Rural Family Medicine Residency Program to equip physicians with specialized training in caring for patients in rural and underserved communities.

Residents spend a majority of their first year of training at ECU Health Medical Center and ECU’s Family Medicine Center in Greenville before spending the next two years training in rural health care centers in eastern North Carolina.

The complete Brody experience provides an integrated curriculum focused on health systems science for all four years, adding to students’ foundation for practicing rural health by using an authentic, embedded approach to patient safety, population health and team-based care.

“Ultimately, we hope that from this curriculum, the next generation of leaders will arise to meet the needs of the people in eastern North Carolina,” Bright said.

Department of Public Health

The Department of Public Health at the Brody School of Medicine provides a strong foundation of understanding the challenges of rural health.

“The needs of rural people are distinctly different than those in urban or more urban communities,” said associate professor Dr. Ruth Little. “In order to successfully facilitate rural health improvements, this population has to be first understood.”

The department requires Master of Public Health students to take a course on Interdisciplinary Rural Health, which includes topics from the concentrations of epidemiology, health policy and leadership and community health and health behavior.

“In epidemiology, we lay the groundwork for rural and urban comparisons, ultimately demonstrating that for many health indicators rural communities suffer a higher burden of disease than their more urban counterparts,” said Dr. Nancy Winterbauer, associate professor. “In health policy and leadership, we examine reasons for these disparities, including the impact of race, access to health services and policy on rural health. Finally, the community health and health behavior concentration focuses on rural health improvement, especially in the areas of health behavior, community engagement and advocacy, evidence-based interventions and public health practice.”

Little said rural communities in the East have a bleaker health outlook than the regions in the middle and western portions of the state.

“It’s important to help our students not only understand this, but in addressing these health disparities, engage students with rural communities, providing opportunities for us to work together to improve population health,” said Little.

Student Brandon Stroud said the curriculum in rural health is preparing him to be able to think critically to solve problems in rural communities.

“Often, these counties have a much lower median income compared to their urban counterparts, there are fewer healthy food resources, recreational spaces, less health care providers and limited access to specialty care,” he said. “All these factors simultaneously cause higher incidence of chronic illnesses and poor health outcomes. That is why it is so critical we learn about these issues, how rural health care systems are working to address them and urge more public health practitioners and health care providers to serve them.”

The College of Nursing

ECU’s College of Nursing graduates close to 79 percent of nurses employed in North Carolina, with 39 percent serving eastern North Carolina. Nearly 60 graduates chose to work in one of the state’s 40 most distressed counties, as designated by the North Carolina Department of Commerce.

Specific nursing courses and programs encourage students to gain exposure to health care settings where they will care for patients from every life situation.

“In community health, we ensure that our students are prepared to take care of patients in all environments,” said Lesha Rouse, clinical instructor. “In this course, the student will complete a Community Service Learning Project (CSLP), expanding perspectives of ‘health care’ from the individual, acute care focus to a population-, community-based focus.”

Nursing students at every level receive instruction and experience caring for patients in rural settings.

“Students are training in a number of ways, including traditional lecture and course content as well as through experiential and simulated learning,” said assistant professor Dr. Stephanie Hart. “This is particularly important relative to practice in rural areas, where students are exposed to the realities of the social determinants of health — the primary drivers of population health outcomes.”

Hart said undergraduate students prepare to enter clinical rotations in rural areas by learning about the social determinants of health and the unique needs of rural communities.

“They build upon their knowledge of rural health through their participation in a windshield survey of an eastern North Carolina county, which provides them with the opportunity to drive around the county making observations of community members and their environment,” she said. “From there, they continue to explore these communities in detail through review of the county community health needs assessment and engaging with community members and key stakeholders to gather insight into community strengths and needs.”

The majority of undergraduate students, including those in traditional BSN and accelerated BSN programs, complete an 85-hour clinical rotation in community health or community-based settings to further add to their experience in rural areas.

“They are able to successfully integrate into the clinical learning environment, where they not only learn more about the unique needs of the individuals and communities served by these agencies, but they are afforded several opportunities to apply course objectives in practice,” Hart said.

She added that ECU’s College of Nursing and one of its partnering clinical agencies, 3HC Home Health and Hospice Care, Inc., received funding from the Hospice and Home Care Foundation of NC to participate in a pilot project designed to address the shortage of home care nurses across North Carolina, particularly in rural areas.

“This project resulted in new approaches regarding the training, recruitment and integration of newly graduated RNs into home health and hospice agencies,” Hart said.

The college has also received funding from Eastern AHEC for the last several years to develop new clinical training sites for nursing students, most of which are situated within rural, underserved Tier 1 or Tier 2 counties.

Hart said these programs and curricula offer students exposure to prepare them to work in those same settings as professionals.

“When we train health care professions students to work with and understand community health and rural health care, we aim to eliminate these gaps by facilitating recruitment and retention efforts of health care professionals in rural areas, reduce workforce shortages and increase diversity in our workforce,” she said.

The college also has a Health Resources and Services Advanced Nursing Education Workforce grant that allows the college to train a select number of advanced practice registered nurse students to care for patients in rural and underserved areas, including patients who are farmers, loggers and fishers — occupations prevalent to North Carolina that also present industry-specific health hazards. The program, APRN Rural and Underserved Roadmap to Advance Leadership (RURAL) Scholars Program, includes a graduate-level course in agromedicine with practical experiences with the farming community.

“Students are provided generous stipends to participate in the program, which includes instruction in rural health and health disparities, clinical practice in rural and underserved communities and training in telehealth and telepsychiatry,” said Dr. Pamela Reis, associate professor and interim Ph.D. program director in the College of Nursing.

So far, 47 students have graduated from the program and are providing care in these communities across North Carolina; there are 17 students in the current cohort.

Dr. Michelle Skipper, director of the doctor of nursing practice program, said educating nurse practitioners to the needs of rural patients is critical for the transformation of the region’s health care delivery.

“We can recruit nurses from rural communities, train them as primary care clinicians, and return them for long-term service to the community which already trusts them,” Skipper said. “Receiving care from a nurse practitioner is ultimately an ideal choice in small towns, not simply a ‘consolation prize’ because other health care professionals don’t want to live and work there.”

Dr. Donna Roberson, professor and director of the Alzheimer’s Disease and Related Disorders, Carolina Geriatric Workforce Enhancement program grant, said it is crucial to educate nurses about the aging population and some of the diseases that are more prevalent among older adults.

“As our eastern North Carolina citizens age, their risk for dementias like Alzheimer’s Disease increase,” she said. “Most are living in their communities and are cared for by family caregivers. Their health care providers (medical doctors, nurse practitioners and more) need to have a good understanding of what the person living with dementia experiences and what their family has to manage.”

Community | Health News