Persons experiencing homelessness often have poor access to healthcare and experience significant barriers to basic health management. While this occurs in a wide range of disease processes, this is most obvious is management of basic diseases such as wounds. Small abrasions and injuries are exacerbated by difficult living situations and lack of access to supplies. Patients experiencing homelessness who present to the hospital with significant wounds and/or infections are often discharged with minimal instructions or supplies to ensure maintenance of wound care. 

By providing these patients with a basic backpack with wound care supplies as well as instructions for resources, wound care amongst this population could be significantly improved. Patients would not only have dry supplies to maintain healing but would also have a list of free clinics to visit for further healthcare. By allowing for proper wound healing outside of the hospital, patients would have less frequent admissions for severe infections which would ultimately benefit not only the patients but healthcare systems at large.

To educate the underserved populations in our communities about the various resources that are available to assist the survivors of sexual assault and trauma prior to the onset of harmful coping mechanisms, as well as, eliminate the chains of generational repetition that has a tendency to occur.

The flu is a common disease, affecting all ages, which can lead to serious illness and even death. Many people percieve the flu as something similar to a cold: It's not going to kill me. I'll be fine. I don't need my flu shot. Faces of the Flu allows people to tell their flu stories to show others how bad the disease can really be. Through this project, Faces of the Flu aims to increase the utilization of flu shots to prevent further morbidity and mortality from influenza.

Our goal is to create a society where an individual experiencing a mental health issue can be successful and thrive. We plan to achieve this by providing mental health education to the public creating a more understanding culture and reducing stigma. Working to collaborate and bring attention to the problems facing the mental health community. We hope to connect individuals who are suffering from a mental health problem with appropriate and effective treatment and support. We want to help the person while maintaining their independence, dignity and hope for recovery. 

I believe that an interdisciplinary, multilevel intervention is essential for the transformation of health care from a system that is reactive and medically focused to one that is proactive and holistically based. Each of us fellows will have experience working at different levels of the health care systems, including the interpersonal, organizational, communal, and public policy. Multilevel change can be achieved by working together and building upon the strengths and expertise that my colleagues and I bring to the table.   

Although many aspects of the social work and public health fields inspire me, I am especially passionate about helping the uninsured and underinsured understand how to utilize their health insurance and how to be consumer advocates for health care reform. According to the Pennsylvania Department of Health, Allegheny County has an uninsured rate of 9.9%. Individuals who are uninsured experience worse health outcomes than insured adults do. Studies repeatedly demonstrate that uninsured individuals are less likely to receive care for chronic diseases and health conditions (Kaiser Family Foundation, 2016). Moreover, many individuals are not aware of how to access available health care or what benefits they are due once they have health insurance.  

As an individual who has social capital, I often find the health care system complex and arduous to comprehend. Therefore, I care deeply about empowering those who need health care and who lack the knowledge that will allow them to successfully maneuver through the intricacies of the health care system. While I recognize that existing organizations already address this population and their needs, I hope that the interdisciplinary approach endorsed by the Salk Fellowship will build upon and expand the current work being done. In addition, current policies are looking to undermine and spread misinformation about the United States’ health care system (“The Same Agency That Runs Obamacare Is Using Taxpayer Money to Undermine It,” New York Times, 2017). Therefore, it is imperative that health care activists work together to thwart policies that undermine and confuse health care consumers.

Your voice matters and understanding how the health care system works can help you become a better advocate. 

Research has shown that African American women are one of the most sedentary groups of people. This is problematic because inadequate exercise along with a poor diet can contribute to medical issues, such as hypertension, diabetes, cancer, kidney disease, and others. Our organization seeks to promote activity, a healthy diet, and lifestyle changes among African American women. We hope to improve health outcomes and quality of life.

* To move from "diversity education" to inclusivity training.

* To empower entry-level clinicians in training, by giving them the tools they need to practice more inclusively across the lifespan of their careers: from classroom, to clinic, to educator.

* To empower educators to deliver high-quality inclusivity education and training, despite deficits in knowlede, background or self-efficacy.

We are going to use this platform to be able to communicate effectively, collaborate, and build each other up for this fellowship. Activism satrts here, let us learn and use each other's strengths to the best of our ability. 

We are here to help, and are open to any and all questions that you may possess. If we don't know the answer, we will do our best to find someone who does. Together, we can change the world. 

According the a recent study in the New England Journal of Medicine, 96% of executives, clinical leaders, and clinicians agree that physician burnout is a serious problem in health care. More than 50% of all physicians including residents suffer from burnout. Coupled with a projected shortage of 50,000 physicians by 2020, this degree of burnout will continue to impact quality, access to care and  patient safety. There have been many studies that have linked physician stress to medical errors (3^rd leading cause of death in the U.S.). Decreased quality of care has been cited as the leading reason to address physician burnout.

Despite the recognition that physician burnout is a serious and growing threat to our health care system, there is very little that is being done to mitigate this problem. The answers include both organizational changes that allow physician to function at the top of their licensure as well as personal strategies targeting increased resilience and better stress management.

Mindfulness-based interventions can be a powerful tool for decreasing physician burnout and improving overall health and well-being, with a positive effect on patient safety and quality of care. Mindfulness refers to the ability to pay attention to the present-moment with acceptance and receptivity and mindfulness interventions have been shown in initial studies to reduce stress and burnout.

What is particularly exciting is that we have collaborated with David Cresswell from Carneige Mellon University whose lab is one of the first groups to show that mindfulness interventions can improve brain stress resilience circuits and biomarkers of stress-related disease in multiple patient populations (Creswell et al., 2016). This work has had substantial impact and resulted in well-publicized coverage in fora such as the New York Times, the Los Angeles Times, and the Today Show.

We have formed Pittsburgh based initiative that focuses on physician wellness and patient safety. This initiative includes a unique collaboration between Carnegie-Mellon researchers and UPMC physicians. We will conduct a landmark study investigating the effects of a brief mindfulness based intervention to improve brain stress resilience circuits and biomarkers of inflammation among a high-stress physician population. We hope to publish the results in top journals and more importantly promote our region as a leading innovator in improving physician wellness and patient safety. Given the vast expertise of healthcare, research and medical education in Western PA, our study will have significant local and national impact for both physicians and patients.

When patients are selecting a surgeon to perform a procedure it would be helpful for the patient to know the surgeon's personal history of complications when performing similar surgeries so that the patient could select the "best" surgeon.

Care coordination mistakes are costly... and not just in terms of financial expenses. Some of the most common care coordination mistakes are also major culprits for death and exacerbated patient health problems. U.S. News & World Reportindicates, “Medical errors are [the] third leading cause of death in the U.S. 10 percent of U.S. deaths are due to preventable medical mistakes" such as: Documentation errors  Communication Disconnects Lack of Coordination Neglecting Follow-ups Delays

The CDC recommends everyone between the ages of 13-64 years old be tested for HIV at least once during their lifetime. HIV tests, however, are not always offered to patients by their primary care physicians.  The purpose of this Action Group is to affect provider knowledge about CDC recommendations around HIV testing and push for routine HIV screening in primary care settings and family practices throughout Allegheny County.