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Ersne Eromo, MD, MBAInstructor in Anesthesia, Anesthesia, Critical Care, and Pain MedicineInstructor in Anesthesia, Harvard Medical School
Dr. Eromo graduated with a BS in Biology from the University of California, Los Angeles in 2003 (magna cum laude and Phi Beta Kappa) and completed a combined MD/MBA program in 2009 at the David Geffen School of Medicine at UCLA (Alpha Omega Alpha) and the UCLA Anderson School of Management. Upon graduating from medical school, she completed a surgical internship at the Harbor-UCLA Medical Center in Torrance, California before moving to Boston, Massachusetts where she trained in anesthesiology in the MGH Department of Anesthesia, Critical Care, and Pain Medicine. She completed residency in September 2013 and has been on the faculty at MGH since October 2013. As staff, Dr. Eromo has been involved in all aspects of resident education and is currently co-coordinator for curriculum design for the Basic Board Review sessions for anesthesiology residents and the clerkship director for Harvard Medical Students. She is also on the MGH anesthesiology department’s Education Committee and the Clinical Competency Committee. As of July 2014, Dr. Eromo is a Simulation Fellow with the MGH Learning Lab and the American College of Surgeons and has been heavily involved in the in-situ intra-operative team simulation training for crisis management at MGH.
Project Abstract: “A “Gap”–driven Crisis Event Simulation Curriculum for Anesthesiology Residents”
Anesthesiologists are expected to independently manage perioperative crisis events that occur infrequently, but can have catastrophic consequences. Nevertheless, increased safety in anesthesia, resident duty hour restrictions, variability in informal teachings at the time of a real-life crisis events, and heightened ACGME requirements for closer supervision have reduced the resident’s level of involvement and degree of independence in the care of patients during crisis events. Thus, anesthesiology residents’ experiences with such events in training can be highly variable. In this project, Dr. Eromo seeks to characterize the anesthesiology residents’ exposure to both real and simulated perioperative crisis at the time of graduation. She believes that understanding what residents experience during their training will help shape education designed to enhance residents’ ability to effectively and independently manage perioperative crisis events. The specific goals of this study are the following: (1) conduct a survey of anesthesia senior residents to objectively determine experience (real or simulated) with managing rare perioperative crisis; (2) create an online profile for each resident that specifically identifies which rare perioperative event he/she has or has not managed; and (3) develop an on-demand simulation curriculum that will allow a more tailored approach to simulated exposure of critical perioperative events that residents have not managed. If successful, the results of this proposed project will significantly impact the way crisis management is taught in Anesthesiology residency programs across the United States. It may also have implications for potential use in practice re-entry (i.e. those with extended absence from clinical practice who wish to return) and maintenance of certification.
Alejandro Rauh-Hain, MDInstructor in Obstetrics and Gynecology, Division of Gynecologic OncologyInstructor in Obstetrics and Gynecology Harvard Medical School
Dr. J. Alejandro Rauh-Hain is a Gynecologic Oncologist on staff at the Massachusetts General Hospital. He was born and raised in Mexico City, Mexico and received his medical degree from Universidad Panamericana School of Medicine. After graduating from medical school in Mexico, he worked as a research fellow at the Massachusetts General Hospital. For two years he conducted basic science research in the laboratory and performed clinical studies looking for biomarkers for early detection of preeclampsia. Afterwards he was accepted in the combined Obstetrics and Gynecology Residency Program at the Massachusetts General Hospital and Brigham and Women’s Hospital. Following residency, he completed a fellowship in Gynecologic Oncology at the Massachusetts General Hospital. Currently, he is an Instructor of Obstetrics, Gynecology and Reproductive Endocrinology at Harvard Medical School. His interests include the surgical treatment of gynecologic malignancies and the management of rare gynecologic tumors. He is also interested in descriptive and intervention research studies conducted in real-world clinical settings that may possibly reveal the effectiveness of strategies to reduce well-documented disparities in gynecological cancer care access, utilization, and associated clinical outcomes.
Project Abstract: Trends in First-line Treatment and Spending on Care for Women with Epithelial Ovarian Cancer
This investigation seeks to utilize a large and unique database to determine the direct medical cost of ovarian cancer treatment and related complications, and to estimate contribution of different treatment modalities and health care services to total spending of women undergoing initial surgical and medical treatment for ovarian cancer. We will identify patient, treatment, and discharge factors associated with unplanned readmission to identify opportunities for potential care redesign for this population of women. Furthermore, claims data will be used to examine health care expenditures, including spending on chemotherapy and chemotherapy-related hospitalizations. The last decade has seen an explosion of investigations evaluating the role of targeted/biologic therapies given concurrently and/or as maintenance therapy in ovarian cancer. Although these agents are frequently used, they have associated toxicities and have not been shown to improve overall survival. Thus, the incorporation of these novel agents may be increasing cost of care without impacting outcomes. We will analyze the changes in management of women with ovarian cancer over time and its impact in complications and cost. These insights will not only characterize the patterns of care in the United States, but provide the opportunity for care redesign and outcome improvements for women with ovarian cancer. Finally, this investigation will identify disparities in the primary treatment of patients with ovarian cancer.
Tanishia Choice, MDAssistant Physician in PsychiatryInstructor in Psychiatry, Harvard Medical School
Dr. Tanishia Choice completed her fellowship in Child and Adolescent Psychiatry at MGH/McLean hospitals in June 2014 and is a new addition to the faculty at MGH. She is clinically active in the Child Psychiatry Outpatient, Child CBT, Think:Kids and MCPAP clinics at MGH. Dr. Choice has a strong commitment to education of clinicians and the community and her primary academic interest is in reducing disparities in care for mental illness. Toward this end, Dr. Choice was awarded the American Psychiatric Association’s Public Psychiatry Fellowship where she served on the Council for Minority Mental Health and Health Disparities. She also developed a community project working with religious organizations in African-American communities to reduce stigma of mental illness and increase access of care. For her work, Dr. Choice has received recognition for teaching and community outreach including excellence in medical student education and outstanding resident in general psychiatry. Dr. Choice is continuing her work in education of the community by serving as a Lead Trainer for the Program in Education, Afterschool, and Resiliency (PEAR) at McLean Hospital, a program that works to identify and support at-risk youth in the community.
Abstract: A New Curriculum for Enhancing Pediatric Mental Health Treatment in Primary Care Settings
The National Comorbidity Survey Replication found that half of all psychiatric disorders in adults started by the age of 14 and prospective studies have shown a cumulative incidence of 61% for specific psychiatric disorders by the age of 21. Due to the low availability of child psychiatrists, many children and adolescents do not receive timely psychiatric care and those who do often go to their primary care clinicians. Currently there are approximately 6,500 child psychiatrists involved in patient care versus 49,000 pediatricians involved in patient care and nearly seven million kids who have a diagnosable mental illness. Most of these illnesses are in the mild to moderate range and treatment of these children in primary care settings is a reasonable response to the shortage of child psychiatrists. Data from the Massachusetts Child Psychiatry Access Project (MCPAP) showed that half of the primary care physicians surveyed felt uncomfortable diagnosing and treating mental health disorders. The proposed curriculum is designed to improve primary care clinicians’ comfort with independently assessing, diagnosing, and treating mild to moderate mental health disorders in the pediatric population. The curriculum will cover
25 topics in child psychiatry chosen by preference from pediatricians and pediatric residents. The curriculum will have three components: 1) eight cased-based, educational videos/podcasts with commentary from a child psychiatrist explaining basic psychiatric interview and technique, identifying psychiatric signs and symptoms in the pediatric patient and an overview of treatment options, 2) Online and easily accessible treatment algorithms specific for basic psychiatric treatment in pediatric primary care with criteria for referral to psychiatry and 3) lectures/seminars on mental health topics chosen by primary care and pediatric residents.
Arturo Saavedra, MD, PhD, MBAAssistant in DermatologyMedical Director, Medical Dermatology UnitAssistant Professor of Dermatology, Harvard Medical School
Dr. Arturo Saavedra is board-certified in dermatopathology and dermatology. He is an Assistant Professor of Dermatology at the Harvard Medical School, Medical Director of the Medical Dermatology Unit and Vice-Chairman for clinical affairs at the Massachusetts General Hospital. He also attends at the MGH Cancer Center. Dr. Saavedra received a combined doctoral and medical degree from the University of Pennsylvania, with specialized training in Pharmacology, after graduating Magna Cum Laude from Harvard College with a degree in Biological Sciences. He completed residency training in Internal Medicine at the Brigham and Women’s Hospital, where he also served as Chief Resident. He is a graduate of the Harvard Combined Dermatology Residency Training Program and a fellowship trained Dermatopathologist. Because of his combined training, he specializes in the diagnosis of complex medical problems with particular attention to Graft-versus-host disease, HIV and severe drug reactions such as toxic epidermal necrolysis. He has published his original findings regarding the dermatopathology of these disorders in multiple journals, including the Journal of the American Academy of Dermatology. He is also an editor on Fitzpatrick’s Color Atlas and Synopsis of Clinical Dermatology, one of the most widely read textbooks in Dermatology. He has received several research grants as well as teaching awards, locally and abroad.
Abstract: Evaluating the effect of isotretinoin in T-regulatory cell function in adverse cutaneus drug eruptions
The immunologic mechanisms that lead to the development and progression of severe drug reactions in skin are poorly understood. Also termed adverse cutaneous drug eruptions (ACDEs) in the literature, these reactions are rarely actively treated. Because shared molecular targets have not been elucidated among various drug culprits, these are often treated by simply discontinuing the culprit drug. The Agency for Healthcare Research and Quality, United States Department of Health and Human services, estimates that over 770,000 people are injured or die each year in hospitals, costing upward of $5.6 million per hospital. A potential correlation between the types of cells that infiltrate skin tissues (immunophenotype) in biopsies from patients with adverse cutaneous drug eruptions (ACDEs) and clinical severity of disease has not been studied. Such studies may lead to identification of a common “effector” cell type responsible for the development of these reactions, which may in turn lead to targeted therapies. In these experiments we aim to: (1) test the hypothesis that a lower number of skin-directed regulatory T cells (Tregs), as opposed to those found in peripheral blood, predisposes patients to developing ACDEs in vivo, and also thereby explaining the greater incidence of these reactions in HIV (+) patients compared to seronegative patients; (2) confirm the ability of isotretinoin to induce proliferation of Tregs in vitro; (3) test the hypothesis that increasing the proportion of Tregs in vivo with the use of isotretinoin may potentially treat ACDEs.
Doreen DeFaria Yeh, MD, FACCAssistant in Medicine, Cardiology DivisionInstructor in Medicine, Harvard Medical School
Dr. Doreen DeFaria Yeh received a Bachelor of Science in Biology at Duke University and Doctor of Medicine at the University of Massachusetts Medical School. She completed Internal Medicine Residency at the Massachusetts General Hospital, and Cardiology and Echocardiography fellowships at the University of California, San Francisco as well as advanced training in in Adult Congenital Heart Disease. She received the American Heart Association National Clinical Research Award to support the study of endothelial function in patients with aortic coarctation. In 2012 Dr. DeFaria was selected as one of the American College of Cardiology's Emerging Faculty, the Brian A. McGovern Memorial Award from the MGH Department of Medicine for Excellence in Clinical Teaching in Cardiology, as well as the Eleanor and Miles Shore Fellowships for Scholars in Medicine at Harvard Medical School in 2012. She serves as an Assistant in Medicine in the MGH Cardiovascular Division, Assistant Professor in Medicine at Harvard Medical School and is Associate Director of the MGH Adult Congenital Heart Disease Program and Co-Director of the MGH Pregnancy and Cardiovascular Disease Service. She holds the position of Subspecialty Education Coordinator in Cardiology for the Department of Medicine Internal Medicine Residency Program as well as co-Chair of the Department’s Intern Selection Committee. She Co-Directs the annual Adult Congenital Heart Disease Board Review Course, MGH Adult Congenital Heart Disease CME Course and MGH Cardiovascular Disease and Pregnancy Course for Fellows. Her clinical focus is Adult Congenital Heart Disease and Echocardiography as well as cardiovascular disease and pregnancy.
Title of Project: Redefining Adult Congenital Heart Disease Education in Massachusetts
Due to major advances in congenital heart surgery and pediatric intensive care over the past sixty years, the number of adults living with congenital heart disease (ACHD) has risen sharply. Currently, in the US there are more adults living with congenital heart disease than children and the ACHD population is expected to increase by 5% per year. As a result of this rapid growth, the number of ACHD hospital admissions more than doubled between 1998 and 2005 and health care expenditures have markedly increased. Paradoxically, cardiology fellows and general adult cardiologists express that ACHD remains a major area of weakness, or is a “black box” in cardiology and are uncomfortable managing these patients without subspecialty support. Adult Congenital Heart Disease didactic and clinical experiences for cardiology fellows vary widely. National in-service training scores demonstrate lowest overall performance by adult cardiology fellows on congenital heart topics, achieving only approximately 50% correct. Few programs offer advanced ACHD training, and the number of specially trained physicians is unlikely to meet projected workforce requirements as this population grows and ages. Deficiencies in adult cardiology fellow and staff education in the face of a growing ACHD population and rapidly rising admission rates must be urgently addressed in our core cardiology training. With the support of the Clinician Teacher Development Award I am working towards accomplishing three goals: 1.) Creating a comprehensive Adult Congenital Heart Disease (ACHD) curriculum for MGH general core cardiology fellows and external fellows rotating at MGH for ACHD experience, leading to improvement in in-service exam scores 2.) Developing a set of innovative ACHD reference tools for hand-held devices for general cardiologists and general cardiology fellows at institutions without specialized ACHD resources 3.) Developing an ACHD echocardiography curriculum and reference guide for advanced echocardiography fellows and sonographers in Massachusetts.
Jocelyn Carter, MD, MPHAssistant Physician in Medicine, General Internal Medicine Division, Academic Hospitalist ServiceInstructor in Medicine, Harvard Medical School
Jocelyn Carter, MD, MPH, obtained her BA from Harvard University in 2001 and her MD from the University of Illinois at Chicago College of Medicine in 2006. She completed her medical residency training at Dartmouth-Hitchcock Medical Center, Lebanon, NH in 2009. In 2011, she completed a Leadership Preventive Medicine Fellowship at Dartmouth-Hitchcock Medical Center and received her Masters in Public Health from The Dartmouth Institute for Health Policy and Clinical Practice in Lebanon, NH. Jocelyn joined the Academic Hospitalist Service within the Department of Medicine at the Massachusetts General Hospital in July 2011. Her clinical research at MGH currently includes implementation of inpatient care-centered innovations focused on improved care transitions as a part of a Commonwealth Fund/ Institute for Healthcare improvement sponsored national initiative (STAAR). Recently, Jocelyn was honored to receive the 2012 Clinician Teacher Development Award (CTDA) sponsored by the MGH Center for Diversity and Inclusion/MGPO. With the CTDA, Jocelyn looks forward to studying readmission patterns and designing clinically based interventions that address peri-hospitalization quality gaps and lead to reduced readmission rates. She also enjoys serving as a preceptor for second year medical students enrolled in the Harvard Medical School Preceptor- Doctor II course and on the Department of Medicine’s Internship Selection Committee. Jocelyn is also a member of the Massachusetts Medical Society, the American Medical Association and is currently serves as a Harvard University Alumni Association mentor.
Abstract: Reducing 30-day Hospital Readmissions in an Academic Medical Center
The major project focus is the study of readmissions patters to reduce readmissions on the MGH Academic Hospitalist Service. In the era of health care reform and increasing emphasis on higher quality healthcare at lower costs, the importance of care delivery during and after hospitalizations has been magnified. With over 13 million hospitalizations driving $102 billion in health care costs in 2004, rates of hospitalization have become a measure of keen interest. In 2004, there were 2.3 million hospital readmissions (19%) among Medicare enrollees within 30 days of a previous discharge generating over $17 billion in health care costs. Up to $12 billion of these costs (70%) have been attributed to preventable rehospitalizations. The discovery and validation of meaningful interventions and analytic tools structured to reduce hospital readmissions and meet the needs of hospitalized populations remains understudied and additional resources are needed to create valuable solutions. Primary aims of this project include (1)validating an analytic tool that can be used to identify patients with increased risk for 30 day readmission; (2) characterizing the effect of interventions involving primary care providers and also accepting providers of patients at increased risk for readmissions at skilled nursing and rehabilitation facilities; and (3) examining the effect of patient-centered interventions for patient for patient at increased risk for readmissions. The results of this work are expected to contribute to protocols that may be provide critical insights and improved strategies of reducing hospital readmissions locally and nationally.
Luana Marques, PhD [PHS IS2]Director, Community Psychiatry PRIDE, Massachusetts General HospitalAssistant Professor of Psychology in Psychiatry, Harvard Medical School
Dr. Luana Marques is the Director of Community Psychiatry Program for Research in Implementation and Dissemination of Evidence-Based Treatments (PRIDE) at Massachusetts General Hospital (MGH). She is also an Assistant Professor of Psychology in Psychiatry at the Harvard Medical School. Dr. Marques completed her PhD in Clinical Psychology at the State University of New York (SUNY) at Buffalo and her clinical internship in the Cognitive Behavioral Track (CBT) at Massachusetts General Hospital/Harvard Medical School in 2007.
Dr. Marques' major clinical and research interests include the implementation and dissemination of evidence-based treatments in diverse, low-income settings. Specifically, she is interested in reducing mental health disparities for individuals in communities across Massachusetts by bridging the gap between scientific innovation and real-world clinical practice. Dr. Marques received a Multicultural Affairs Office (MAO) award from MGH for Clinician-Teacher Development, from which she is working to develop an evidence-based teaching program at MGH Chelsea HealthCare Center for clinicians who are actively treating patients with posttraumatic stress disorder (PTSD). This teaching curriculum is being developed and piloted, keeping in mind the unique challenges faced in community mental health settings. Dr. Marques is also funded by a K23 award from the NIH, which funds a concurrent study examining the dissemination and implementation processes of cognitive processing therapy (CPT), an evidence-based treatment for PTSD, in English and Spanish at MGH Chelsea. Dr. Marques is an active member of the Association of Behavior and Cognitive Therapies, the Anxiety and Depression Association of America, and the International Society for Traumatic Stress Studies.
Abstract: Creating a Teaching Program for Evidence Based Therapy for PTSD in Community Mental Health: Bridging the Science-Practice Gap
The core aim of the proposed teaching plan is to bridge the science-practice gap, by creating a community participatory teaching program that is designed to teach an empirically-based treatment, namely Cognitive Processing Therapy (CPT), to clinicians who are actively treating patients diagnosed with posttraumatic stress disorder (PTSD) at the MGH-Chelsea Community Mental Health Center (MGH-Chelsea). PTSD is a highly prevalent disorder and is associated with significant individual and societal burden. Empirically based treatments (EBTs) for PTSD, such as CPT, have demonstrated efficacy and effectiveness. However, efforts to implement EBTs for PTSD in CMHCs have been largely ineffectual due, in part, to complex barriers to implementation. One such barrier is the lack of integration between academic medicine and clinical practice in the "real-world." Often, even cutting-edge teachers and researchers fail to bring their knowledge into the typical practice settings, which in turn contributes to the average of 10 years gap between advances in science and practice in the clinic. The current project proposes to decrease the science-practice gap by applying the candidate's clinical, teaching and research expertise to develop a means of effectively teaching cognitive processing therapy to community mental health workers (CMHWs) to ultimately improve clinical outcomes for patients suffering from PTSD. This CTDA award will allow the candidate to create a novel teaching curriculum designed to bring EBT to community care settings.
Erica Wilson, MDAttending Physician in Medicine, Division of Palliative Care Instructor in Medicine, Harvard Medical School
Dr. Erica Wilson obtained her BA in Computer Science and Chemistry from Mount Holyoke College and her MD from the University of California San Francisco. She completed her internal medicine and chief residencies at Cambridge Hospital in Cambridge, MA. She received subspecialty training in the Harvard Palliative Medicine Fellowship and then joined the Massachusetts General Hospital Palliative Care service as an attending in September 2009. She currently is an instructor in Medicine at Harvard Medical School. Her interests include medical informatics, patient safety, cross cultural medicine and Palliative Medicine for the underserved. Her research focuses on Palliative Medicine for the homeless. She enjoys teaching and learning and spending time with her son. Received the CTDA for her project entitled: Dying Without a Home: understandingand responding to disparities in palliative and end of life care among the homeless.
Abstract: Dying Without a Home: understanding and responding to disparities in palliative and end of life care among the homelessThe field of Palliative medicine strives to improve the quality of life of patients and their families facing life-threatening illness, through the prevention, assessment and treatment of pain and other physical, psychosocial and spiritual problems. Social inequity, especially poverty, is a major risk factor for people to experience both suffering and premature death. These very populations also have limited access to quality palliative and end of life care. There is a dearth of research to inform the development education, advocacy, public health and clinical innovation in these areas.
We will conduct semi-structured interviews of (3) homeless patients receiving end of life care at the Barbara McInnis House (BMH) in Boston. Interviews will focus on their experiences and the quality of care received as well as their attitudes and concerns about end of life to determine themes and the unique issues involved in dying without a home. We will conduct a chart review of the previous 3 patients who received end of life care and died at the BMH. We will enroll 20 terminally ill homeless patients receiving care the BMH and administer a survey about their attitudes and EOL concerns.Using the combined clinical expertise of the Palliative Care Service (PCS) at Massachusetts General Hospital (MGH) and (BHCHP), we will create a curriculum and clinical protocols for providing palliative and end of life care to the homeless. Using the results of this work and the expertise within the MGH PCS in international palliative care, we will extend the Harvard Palliative Medicine Fellowship (HPMF) to also focus on the provision of care to marginalized patient populations such as homeless individuals and those in developing countries.
See more about previous recipients
For more information, please contact:
Elena Olson, J.D.Executive Director, Center for Diversity and InclusionMassachusetts General Hospital55 Fruit Street, BUL 123Boston, MA 02114Phone (617) 724-3831
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