The Business of Healthcare: Michael Dowling presents at CSI

Michael Dowling speaks to an audience at CSI

A Joint Presentation of the School of Business and the School of Health Sciences: Mr. Michael Dowling, the President and CEO of Northwell Health (formerly the North Shore-LIJ Health System) spoke at the College of Staten Island on Thursday, November 12, 2015, to an audience of students, faculty, College administrators, representatives from Staten Island University Hospital, and other members of the healthcare industry along with a member and staff from the New York State Assembly.

The event was organized jointly by the College’s Schools of Business and Health Sciences, and was oriented towards an examination of the growing intersection between these two domains.  A panel discussion followed Mr. Dowling’s presentation where representatives from the School of Business, the School of Health Sciences, the New York State Physical Therapy Association, and Staten Island’s District 63 added their own disciplinary contexts to the President’s remarks.
In her introduction of Dowling, Susan Holak, the Founding Dean of the School of Business, helped to contextualize the event for students and everyone in attendance:  “Healthcare expenditures in the US are on track to hit $3.2 trillion this year – that’s an average of $10,000 per person.  The industry is complex and sensitive to many forces.”  Dr. Holak added, “[healthcare] is one of the fastest growing business sectors worldwide,” that “encompasses a wide range of specialist areas across a broad spectrum of operations, including some that fall into the general domain of business.  It is that intersection that we are examining tonight, through a variety of lenses.”
An extremely engaging and interesting speaker, Michael Dowling addressed the impact of different types of legislation on the healthcare industry, as well as on the effect of ever-changing technologies on the way that patient care is delivered.  Dowling noted that expectations relating to the quality and types of service are affected not only by patients and their families, but also by developments and shifting directions in research as well as in legislative agencies – in addition to changes in the mission of a hospital itself.

Dean Hoak, President William Fritz, Assemblyman Michael Cusick, Michael Dowling, Dr. Maureen Becker

A panel of speakers representing several diverse perspectives took part in a discussion following Dowling’s remarks.  Interim Dean of the School of Health Sciences, Dr. Maureen Becker, collaborated with Dean Holak to invite panelists to contribute unique, disciplinary frames of reference.  Each was asked to open with a few words on their particular point of view before taking questions from the audience.  Michael Cusick, New York State Assemblyman, Dr. Soon Ae Chun, Professor of Information Systems and Informatics at the College of Staten Island, Michael Mattia, President of the New York State Physical Therapy Association, and Dr. Marie Giordano, Assistant Professor of Nursing at CSI – all illustrated the finer points of their own experiences and approached the issues raised by Dowling from their distinct perspectives.
The event highlighted how students at the College of Staten Island, regardless of their field of study, are able to take advantage of the world-class opportunities that are made available by the institution.

 

Live Actors Pose as Patients in Nursing Classrooms

Andrew Capizzo, currently working toward his MS in Adult Gerontology, performed the role of a Nursing student working with Standardized Patient Joe Daly, a local actor, who is portraying a transgender individual transitioning from male to female.

The ability of a clinician to develop a rapport with a patient, the skill to perform an organized physical examination, and the competency to gather an accurate and concise history is the hallmark of a successful clinician. To respond to this call, the College of Staten Island’s School of Health SciencesDepartment of Nursing has developed a Standardized Patient (SP) Program to assist CSI Nursing students in teaching and evaluating these important skills.

Developed by CSI Assistant Professor of Nursing Dr. June Como, the SP Program is currently being utilized by students enrolled in NRS 702: Advanced Health Assessment and Diagnostic Reasoning, a course that helps students develop advanced competencies in health assessment.

The Program enlists actors who are tasked to play the role of a patient undergoing a physical assessment for a fictional job. Nursing students are expected to complete a head-to-toe physical examination of the patient. Just prior to the simulation, which lasts 20 minutes and is video recorded for analysis, the students randomly choose two focused assessments out of several possibilities. The student proceeds to the examination room where a healthy adult SP in a hospital gown is awaiting examination.

According to Dr. Como, Standardized Patients are used all of the time for Nursing students; it’s just that the practice is rarely formalized. “We are always practicing our methods on family and friends,” she explained. “Now, at CSI, we have a formal way of assessing its effectiveness,” she said, emphasizing the value of using Standardized Patients as a tool to evaluate student ability.

Although the SP program at CSI is currently being used as a high-stakes assessment tool, the Nursing Department is hoping to make broader use of it for low-stakes assessment and training purposes. Dr. Como envisions the SP Program becoming as ubiquitous as classroom lectures being, “What will set CSI’s Nursing Department apart from similar programs.”

She added that, “Most importantly, it teaches the student how to interact with the patient,” explaining that this level of interactivity is usually learned on the fly, during a nurse’s early career. “This way, any mistakes made during the assessment can be fixed, and will not translate to a real-life scenario where a real patient’s health can be endangered.”

Graduate student Andrew Capizzo performs an exam on Standardized Patient Joe Daly.

During a short vignette, which the Nursing Department held to showcase the effectiveness of SP assessment, Andrew Capizzo, currently working toward his MS in Adult Gerontology, performed the role of a Nursing student working with an SP, Joe Daly, a local actor.

Daly, who played a major role in bringing the SP Program to CSI, due to his friendship with Dr. Como and previous work as an SP for NYC universities, was briefed before the vignette and told that he would be playing the role of a transgender individual transitioning to a female who is receiving a physical for a new job.

Dr. Como explained that having Daly play the SP role as transgender was integral to the training:  “It is our responsibility to provide healthcare to all people, including members of the LGBT community.”

Capizzo agreed and acknowledged that, “We treat and assess people from all walks of life and need to learn how to interact with whoever is sitting on that bed.”

Participants in the Program agree that it aids future nurses in being more understanding and sensitive of different individual needs from their healthcare provider. “It is up to us,” Dr. Como emphasized, “that we ensure the individual receives the highest level of care possible and the SP Program at CSI will benefit both nurses and patients in the long run.”

 

Travels to Ghana: Alumna Recalls How Study Abroad Program Prepared Her for Life’s Journey

Janett Perez in Ghana where she is serving two years as a health extension volunteer.

Ever since she was a young girl, Ledys Janett Perez ’13 knew that she had a passion for helping others. Now, after graduating from the College of Staten Island with a Bachelor of Science degree in Nursing, Miss Perez is finally living her dream. This February, the young CSI alumna traveled to Ghana, Africa as a member of the Peace Corps.

“I always had an admiration for people who would go to other countries to selflessly volunteer and immerse themselves in a different culture,” recalls the 25 year old, who was raised in Puerto Rico.

After graduating from CSI in May 2013, Perez accepted a full-time position at Maimonides Medical Center in Borough Park, Brooklyn as an intensive care surgical nurse. She started her Peace Corps application process in January 2015 and was accepted in March of the same year to travel to Ghana.  Her two-year appointment as a health extension volunteer in there begins in February 2016, and she couldn’t be more thrilled.

“My goal is to connect with the people there, immerse myself culturally, and build relationships with the people I’ll be serving,” commented Perez, adding that she attributes much of her inspiration to the programs and faculty at CSI.

Having studied abroad three times with the CSI Study Abroad Program, Perez confirms how these trips helped shape and prepare her for her exciting current endeavor. In 2013, she spent a month in Costa Rica with a now popular program at CSI, although she was part of this first group to go.  There, she studied nursing and Spanish.

Janett Perez

“This one of a kind experience gave me an introduction to what it would be like to serve other cultures around the world using the skill set I already had,” she said, stressing that she visited hospitals and clinics, and conducted home health visits there, similar to the work she will be doing in Africa. “This prepared me way in advance for this life-changing decision that I am making now,” Perez said before leaving for her trip.

She also studied Italian in Venice, Italy in 2009 and then Mandarin and Chinese business in China in 2011, both through CSI-sponsored study abroad programs.

Perhaps the biggest impression that CSI left on this young nurse, though, were the academics and student life that she found so inspiring.

“At CSI, many professors were so incredibly amazing and influential. I am honesty and truly in debt to them for life for opening my eyes to new experiences,” she said, commenting, in particular, on two professors: Dr. Marianne Jeffreys, Professor of Nursing, School of Health Sciences, and Dr. Phil S. Sigler, Associate Professor of Sociology.

Dr. Jeffreys was key in the young Nursing student’s academic career.

“She inspired me because she taught with so much passion. It fascinated me because she taught me a whole other side to nursing, which would bring me to where I am now,” said Perez. “I think she saw something in me and she guided me a lot from the time I took her class to this very day.”

The student also fondly remembers Dr. Sigler, her Marriage and the Family course instructor. Perez merely took the Sociology class because she needed to and had also heard positive feedback about the instructor. Her expectations for the class quickly changed, however, as Professor Sigler became another key player in her journey.

“People come out of nowhere and change your life completely,” she reflected, recalling her shock when she learned that her professor had walked across the United States and written a book about his experiences. “I said to myself, ‘that is crazy! Why would anybody do something like that?’  Then I got to talking to him and he said he learned about himself and what he was capable of more than in his whole life.”

In addition to study abroad and notable professors and mentors, Perez also stressed the importance of her student life affiliations. An active member and 2012 President of the Chi Alpha Christian Club, the student noted the importance of campus involvement.

“I really believe CSI is an amazing college, and if you take advantage of what is there, your options in life are limitless,” she said, adding that the Christian Club continues to support her efforts, even after graduation.

Her parting advice to CSI students is simple:  “When you feel that calling in life, go for it. Don’t be afraid!”

“There are so many people to meet and encounter at CSI, and it was so rewarding to be involved while managing classes, responsibilities, and a personal life,” said Perez, stressing that she never lived on campus, as the Brooklyn resident graduated before the CSI dormitories were completed.

Perez will land in Ghana’s main city, Accra, and spend her first three months there in an intensive training program, engaging in such things as language and cultural training. After three months, her strengths and specialties will be assessed and she will be assigned to a particular village; then she will find out where she is living, a hut or a house.

After the two-year appointment, Perez looks forward to possibly writing a book about her experiences in Ghana and returning to school for a Master’s in Nursing.

A few days prior to leaving for Africa, Perez chuckled, “I now get the same questions I asked Sigler years ago. ‘Are you crazy?’ I respond that life is a lot about taking chances and following your heart and your gut. Why am I doing it? My response is that it would be crazy not to do it!”

 

Barbara DiCicco-Bloom to be published in Sociology of Health and Illness

“The Benefits of Respectful Interactions: Fluid Alliancing and Inter-Occupational Information Sharing in Primary Care,” a paper by Barbara DiCicco-Bloom ,RN, PhD, Associate Professor with the Department of Nursing of the School of Health Sciences, will appear in the July 2016 issue of Sociology of Health and Illness, and online in April.  The co-author is Benjamin DiCicco-Bloom, visiting professor, Department of Sociology at Hamilton College,  New York.  A video is forthcoming.

Understanding the Electrical Pathways of the Nervous System via Trans-Spinal Stimulation Clinical Trials

 

Dr. Knikou (top-center) and her DPT students work collaboratively towards a better understanding of human movement in health and disease.

Dr. Maria Knikou was recently awarded a $400,000 grant by the Craig H. Neilsen Foundation to develop strategies in treating people who suffer from serious spinal cord injuries, and bringing sensation and mobility back into their lives.

“People with spinal cord injuries have motor dysfunction that results in substantial social, personal, and economic costs,” said Dr. Knikou, a neurophysiologist and Professor of the Clinical Doctorate in Physical Therapy (DPT) program with the School of Health Sciences, explaining the impetus for her research. “This uncontrolled muscle spasticity and motor dysfunction can result in disabilities that significantly reduce quality of life.”

This grant will enable Dr. Knikou and her researchers to develop a stimulation protocol in order to, Dr. Knikou explains, “induce functional recovery” in people who are attempting to recover from moderate to serious spinal injury.

Research in action: non invasive transcranial magnetic stimulation assesses connections between the brain and leg muscles.

Dr. Knikou’s research on spinal cord injuries focuses on utilizing non-invasive trans-spinal stimulation of the spinal cord with constant or direct electrical current to strengthen the connections between the brain and spinal cord, thereby improving movement.

The two-year grant was awarded for Dr. Knikou’s project, titled, “Trans-spinal Stimulation to Increase Neuroplasticity and Recovery after SCI,” which seeks to test a new intervention to treat motor dysfunction of people suffering from spinal cord injuries.

Her lab uses Trans-Spinal Constant or Direct-Current Stimulation to alter the signals between the nerves and muscles in people suffering from spasticity due to injuries. According to Dr. Knikou, this spasticity causes stiffness of the muscles affected by the nerve damage caused by spinal injuries. This stiffness can cause patients suffering from these injuries to have difficulty moving and going about their daily lives. Dr. Knikou’s project aims to not only treat subjects who are undergoing the clinical trials but also to research more effective strategies in order to provide long-term treatment.

The treatments are non-invasive and require the subjects to receive 40-minute non-invasive Trans-Spinal Stimulations daily for three weeks. One of the machines used is called Trans-Cranial Magnetic Stimulation (TMS), which both acts as treatment for the subjects during the clinical trials as well as helps the researchers study the action potential of the stimulation being provided.

Dr. Knikou celebrates victory on understanding the function of the human nervous system via non-invasive electrophysiological methods.

Dr. Knikou elaborated on the methodology that her lab uses, saying “People with motor incomplete spinal cord injury will be randomized to receive trans-spinal stimulation with direct or constant current.” The researchers, many of whom are post-graduates working on their DPT degrees as well as CSI postdoctoral research fellows, also use an EEG machine to map the areas of the brain that are being stimulated in order to better understand which placement and intensity of the electrodes works best with each subject. “Results from the proposed project will provide for the first time evidence on a novel neuromodulation method that has the advantages of being noninvasive, cost-effective, and can be used in different clinical settings to improve motor function and decrease spasticity after spinal cord injury in humans,” Dr. Knikou concluded.

While the overall goal of these clinical trials is to provide relief to people currently suffering, it will also build novel and effective rehabilitation strategies.

Dr. Knikou remains passionate about training the next wave of physical therapy researchers, and she demonstrates this by tasking her lab’s doctoral and undergraduate students with assisting with the clinical trials in a very hands-on manner.

Speaking of her philosophy behind her delegation of her student’s responsibilities, Dr. Knikou says.  “I want them to not only be consumers but also creators of research.”

For more information about the Trans-Spinal Stimulation clinical trials, visit www.csi.cuny.edu/schoolofhealthsciences.

CUNY Service Corps Club – First Meeting, Tuesday Nov. 10

The CUNY Service Corps Club will hold its first meeting on Tuesday, Nov 10 in Building 3S, Room 107 from 2:30pm to 4:30pm.

The CUNY Service Corps is in the process of forming a student group at CSI, open to all students interested in short-term service opportunities to improve the quality of life of fellow New Yorkers. The club will be meeting to introduce students to the mission and purpose of the club, hold elections for officers, and discuss future goals and projects.

Register online for this event.

Innovative Care, Patient Outcomes, Professional Successes, are the pulse of the Nursing Doctorate program

The College of Staten Island School of Health Sciences offers the Doctorate of Nursing Practice to prepare practitioners of nursing to provide innovative care at the highest level by translating credible research findings into clinical practice in diverse healthcare settings such as hospitals, homes, and throughout the community.

The program is open to all Bachelor of Science Nursing graduates with a minimum of one year clinical experience. The CSI DNP also accepts advanced-standing students who already have a Master’s degree in Nursing and are currently certified or licensed as Clinical Nurse Specialists or Nurse Practitioners. Registration closes December 1, 2015 for Fall 2016 classes.

Because of changes in the healthcare structure due to the Affordable Care Act, advanced practice nurses have an expanded role in regards to the health promotion and health maintenance of patients in both primary care and acute care settings. The ACA has opened up access to health care to those who did not have insurance which has subsequently opened up various opportunities in both independent and collaborative practices for Nurse Practitioners and Clinical Nurse Specialists who are able to meet the health care needs of this expanded population.

The College of Staten Island is keeping its students one step ahead of the curve by providing the DNP since that degree will very soon be the gateway to these certificate programs in New York City.

The restructuring of healthcare organizations and insurance companies has also created many new roles for advanced practice nurses. Many positions within large healthcare organization look upon clinical doctorates “very favorably,” notes Chairperson of Nursing Dr. Mary O’Donnell. 

“This is a very large bump in status for Advanced Practice Nursing,” stated Dr. O’Donnell.  “Advanced Practice Nurses are more in demand now than they have ever been.”

Elaborating on the importance of the DNP degree, Dr. June M. Como, Graduate and Clinical Doctorate in Nursing Practice Program Coordinator at CSI, said, “Having a Clinical Doctorate provides you with more evidence-based practice tools and a deeper clinical understanding—the main focus of which is to translate research evidence into practice to enhance patient outcomes and to be able to use it in a more timely fashion.”

“Our DNP program is designed to meet healthcare workforce needs and to provide opportunities for the preparation of advanced-practice nurses at the doctoral level to provide the highest level of nursing practice in the clinical setting,” said Dr. Maureen Becker, Interim Founding Dean of the School of Health Sciences. “The curriculum emphasizes the use of research findings in advanced clinical care, strategies for health education of the public, advocacy for vulnerable and culturally diverse populations, analysis of outcomes of care, mitigating environmental and genetic influences on health, advanced-treatment modalities, healthcare informatics use, and identification of evidence gaps with formulation of systems-level interventions.”

“CSI DNP graduates will receive better pay in their fields, more respect from the healthcare industry as a whole, and, also very importantly, CSI is the most economical game in town,” added Dr. Como, who also co-wrote the proposal for the program.

A recipient of a CSI DNP degree will perform one of two roles in the field of advanced-practice nursing: that of a Clinical Nurse Specialist (CNS) or a Primary Care Practitioner (NP).

Students in the two degree programs take many of the same courses but focus their course assignments, competency development, and clinical hours on the role of choice—as clinical nurse specialists who work with the adult and gerontological populations within the spheres of direct care, nursing personnel, and organizations/networks, or as primary care nurse practitioners who also work with the adult and gerontological populations. Both advanced-practice nurse roles focus on promoting health, preventing disease, and managing the care of individuals, their families, and communities.

The CSI DNP is currently offering scholarships. For additional details and to apply online visit www.csi.cuny.edu/career.

 

No Heavy Lift: Four Major Grants Strengthen Spinal Cord Injury Research

Dr. Zaghloul Ahmed

The past academic year has been exceptionally rewarding for Dr. Zaghloul Ahmed, who has earned four major grants for his work in treating mobility complications due to serious spinal cord injuries.

The grants, two awarded by the New York State Department of Health, one by PSC CUNY, and one by the National Institutes of Health (NIH) total nearly $850,000 toward Dr. Ahmed and his collaborator’s spinal cord injury research.

Dr. Ahmed’s research on spinal cord injuries focuses on using Trans-Spinal Direct Current Stimulation to alter the muscle tone in mice suffering from spasticity due to these injuries. According to Dr. Ahmed, the spasticity causes stiffness of the muscles affected by the nerve damage caused by spinal injuries. This stiffness can cause patients suffering from these injuries to have difficulty moving and going about their daily lives.

Dr. Ahmed’s project aims to discover what types of treatment can lead to long term relief in people who have suffered from spinal cord injuries or even from strokes.

The experiment tasks the researchers to run a very weak direct current through a mouse’s spinal cord suffering from spasticity in order to stimulate the corresponding nerve. What they have found is that depending on several factors such as current duration, intensity, direction and location, there is a significant decrease in muscle tone abnormality which results in an increase in motor movement.

Dr. Ahmed, an Associate Professor with the Department of Physical Therapy (DPT) with the School of Health Sciences at the College of Staten Island, commented “I am very happy and grateful that the government has given us this grant. We can now expand our work and get ready for the next application.”

The next step in the research, Dr. Ahmed hopes, will move the work from mice to clinical trials in humans though there are still a few factors that need to be clarified.

“We still need to investigate how long the treatment will be effective, what dosage, and how much current, exactly we need to pass through,” said Dr. Ahmed on the work that his lab is conducting.

“We always have one or two groups working on different levels of this project,” commented Dr. Ahmed on the fluidity of the program, adding that the physical therapy department currently has a system where each of the faculty gets a small group of students to work on their clinical research. There is currently one group of students working on mice and another group working on the human element of the project studying reflexes which will one day apply to Dr. Ahmed’s project once it enters clinical trials in people.

“Our physical therapy students [at CSI] are working very hard,” noted Dr. Ahmed, adding he has also engaged a group of high school students to work on the behavioral aspects of the project.

These grants awarded for Dr. Ahmed’s project, along with his research team’s dedication and hard work, will one day benefit those who have suffered spinal cord injuries and help them once again lead normal lives.

Dr. Zaghloul Ahmed was awarded the 2011 NYC BioAccelerate Prize For a Neural Stimulation System.