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Clinical Intern in Advance Care Management: Roland Scaife ’17 at Fidelity Health Care

For my fourth and final cooperative education experience, I was given the opportunity to work with Fidelity Health Care, a home health care service located in the Dayton area. Once again, I was able to work with Dr. Abi Katz, a palliative physician and the medical director of the Advanced Illness Management (AIM) program.

The AIM program is built around a model of care focusing on the palliative care of patients with chronic illnesses who are referred to the service through the Premier Health Care hospitals. Palliative care focuses on treating the symptoms that patients with advanced and chronic illnesses face with the goal of improving a patient and their family’s qualities of life. Through the work of nurses, social workers, a visiting physician, and health coaches, the AIM program provides home services and support in an attempt to address patient concerns, promote patient involvement in treatment, provide some relief for patients from their conditions, and help identify and reduce the potential barriers and stresses that the patient and their family may face. This is done through the six pillars of care, which are identifying symptom red flags, using medication reconciliation to avoid adverse events, providing advance care directives to make the patient’s voice heard at the end of life, performing follow-ups with physicians, providing a personal health record so that patients are well aware of their current condition and can communicate their story in an emergency, and addressing a patient’s spirituality. Each person is unique and their progression through the pillars will never be the same.

My role in the AIM program has me working within the office and in patients’ homes. I have been focused on data collection, entry, and analysis, as well as contributing to and constructing spreadsheets. Also, I have worked on a literature review for research surrounding palliative and advanced care. One specific project was to construct a table of recommended physician follow-up times for patients leaving the hospital. The goal was to determine if certain timelines lead to a reduction in readmission rates to the hospital within thirty days of discharge. Additionally, I have been producing metrics for Dr. Katz’s patient log and working on the admission/discharge measures for the AIM program.

Outside of the administrative work, I have become an active member of the team providing care for patients, acting as their care guide. A care guide is someone who meets with patients and helps to identify the barriers to their health and promote the establishment of goals. This a unique opportunity for me as it allows me to talk one-on-one with patients and help them with psycho-social issues that may be affecting the patient’s quality of life beyond just their medical needs. This was particularly nerve-racking as I was uncertain of my ability to develop this type of rapport with patients but as I meet with them more it is becoming more comfortable. With my co-op being almost half over I look forward to meeting more patients and learning their stories.

In addition to my work at Fidelity, I am also working as an on-call simulated patient for the Boonshoft School of Medicine. For this work, I actually act as the patient and help in the training of medical students as they try to build a rapport with me and figure out what ailment I may have. This has given me a new perspective on healthcare as I am now the patient and I can learn the skills that are needed to be an effective physician. I never thought I would have 53 doctors-to-be meeting with me and performing physical exams on me over the span of 22 hours in only 2 days, but I hope I have the opportunity to work more with these students in the future so that we can build their skills before they go on as real doctors.

Photo credit: https://www.premierhealth.com

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<p><strong>Roland</strong> is a biomedical science major at Antioch College. A member of the class of 2017, his main themes for Co-op positions have been scientific research and medicine. His current interest is to continue into the medical field following undergraduate, and pursue his goal of becoming an oncologist. </p> <p>In the process of completing his fourth Co-op, Roland's first Co-op was in the spring of 2014 was as a quality control intern for Chroma Technology Inc. in Bellows Falls, VT. While there, worked in a team dynamic and was able to gain experience using spectrophotometric equipment in the inspection of optical filters. Working independently and in teams, he was able to learn various qualitative and quantitative data collection techniques, as well as assist in research and development projects to improve efficiency of process. In the winter of 2015, Roland worked for Dr. Abi Katz, an Antioch alum and palliative physician, in the Post-Acute Care Continuum of the Kettering Health Network. This was his first experience working in a hospital, although most of the work was spent in the administrative aspect of healthcare. He was able to learn about the establishment of advance illness management procedures and palliative medicine.  His main contribution was in a project centered around reducing the number of medication related errors within the Kettering Medical Center. Ultimately this took the form of a medication review process flow that outlined various steps to reduce the possibility of error. In addition, he was able to create a series of learning materials for those just learning to use the medication input and review system. Much of this work involved research and review of literature and obtaining the feedback of physicians, pharmacists, and nurses during interviews. For his third Co-op, Roland traveled to the Sheba Medical Center in Ramat Gan, Israel. Working as a volunteer research assistant, he and two other Antioch students were able to learn from Dr. Jeffrey Goldstein, a radiation oncologist and Antioch Alum. The three students were able to gather data on the location and size of internal mammary chain lymph nodes in breast cancer patients, as well as complete a scientific paper that is currently under review. Each student was able to communicate effectively and bring their own skill sets to produce the final paper. </p> <p>Currently, Roland has returned to work for Dr. Katz as a clinical intern for Fidelity Health Care, working within an advance illness management program. He has aided in literature review for transitional care methods for reducing patient readmissions to the hospital, and is also working to establish a care guide copilot that will allow him to work one-on-one with patients and help to identify barriers in their treatment and establish goals to help empower them. </p> <p>Additionally, he has also serve as a tutor for various science courses at Antioch, aiding in the learning of other students and supporting their growth in the subjects. Through tutoring, he has also been able to develop skills in instructing course materials and developing interpersonal skills that promote positive information exchange. He has tutored:</p> <p>CHEM105/160: General Chemistry I&II</p> <p>BIO105/160: General Biology I&II</p> <p>Math160: Calculus II</p> <p>BIO215: Cellular & Molecular Biology</p>

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