Dr. Julie Silver has been an integral part of developing the new Spaulding Research Institute from conception to launch. Her research and clinical work have focused on improving gaps in the delivery of healthcare services, particularly cancer rehabilitation. She has published many scientific reports and is well-known for her ground-breaking work on “impairment-driven cancer rehabilitation.” She is the co-founder and co-director of the Cancer Rehabilitation Group for the American Congress of Rehabilitation Medicine, a research-focused interdisciplinary professional society. As a healthcare leader, Dr. Silver also is committed to supporting the healthcare workforce, and she is a researcher and nationally recognized expert on inclusion, diversity and equity. She has published multiple reports on bibliometrics—educating researchers about both conventional and alternative metrics—aimed at supporting both research dissemination and faculty promotion. Her work has been featured in several major print and broadcast media throughout the United States.
In Part 1 of this presentation, Dr. Silver addresses the topic of “How to Lead High Impact Strategic Initiatives in Health Care” from the perspective of the traditional three hats worn in academic medicine: medical education, clinician, and researcher. When dealing with patients who had polio, she came to the realization that someone had to record their stories regarding what happened to them, which led to her creating an oral history project. When it comes to innovation, it is not enough to have a great idea, but to have a strategy around it, which means the necessity of developing an innovation engine that takes a great idea to enable others to understand it.Tipping points really matter and are the hardest part by being able to define what really makes a difference. Another key essential is to leverage your network. When you want to have divergent change, it helps to have a bridging network and to be able to leverage different groups to bring about big change.
Kathryn Schmitz is a Professor of Public Health Sciences at the Pennsylvania State University’s College of Medicine. She has led many exercise trials and her work has been translated into clinical practice. Dr. Schmitz has published more than 230 peer-reviewed scientific papers and has had $25 million dollars in funding for her research since 2001. She was the lead author of the first American College of Sports Medicine Roundtable on Exercise for Cancer Survivors, which published guidance for exercise testing and prescription for cancer survivors in July 2010. In June 2017, she became president-elect of that organization, assumed its presidency in June 2018, and became Immediate Past President in June 2019. While serving as chairperson in March 2018 of an International Multidisciplinary ACSM Roundtable on Exercise and Cancer Prevention and Control, participants agreed it is time for exercise oncology to go prime time. The question is how. Her professional mission is to answer that question. Her doctorate is from the University of Minnesota-Twin Cities.
She began Part Two of her presentation by indicating that as a result of the intervention described in Part 1, arm swelling among lymphedema patients was reduced by 70% among women with five or more nodes removed. A big question that arose was who was going to do all the things necessary that were part of a research study? Problems with sustainability and dissemination occurred. There also were safety concerns and costs that could not be met. She then described another initiative that was undertaken. Following a referral by an oncologist, physical therapy evaluation and education in a group setting occurred. Participation could occur in a YMCA setting or at home, but a challenge was to figure out how to pay for equipment in the home after the program ended. Subsequently, the program was renamed Strength After Breast Cancer, which is paid for by insurance. She described a series of lessons learned involving transportation, competing demands affecting patients with jobs, location, keeping up with training requirements, and cost. A need also exists for provider education on matters, such as progression of the weights used by patients. She concluded by noting that her mission and the Rusk mission are a shared mission.
Dr. Kathryn Schmitz is a Professor of Public Health Sciences at the Pennsylvania State University’s College of Medicine. She has led many exercise trials and her work has been translated into clinical practice. Dr. Schmitz has published more than 230 peer-reviewed scientific papers and has had $25 million dollars in funding for her research since 2001. She was the lead author of the first American College of Sports Medicine Roundtable on Exercise for Cancer Survivors, which published guidance for exercise testing and prescription for cancer survivors in July 2010. In June 2017, she became president-elect of that organization, assumed its presidency in June 2018, and became Immediate Past President in June 2019. While serving as chairperson in March 2018 of an International Multidisciplinary ACSM Roundtable on Exercise and Cancer Prevention and Control, participants agreed it is time for exercise oncology to go prime time. The question is how. Her professional mission is to answer that question. Her doctorate is from the University of Minnesota-Twin Cities.
She began Part One of her presentation by indicating that only a miniscule proportion of patients who begin cardiac rehabilitation complete the entire number of sessions, even though it is clear that such rehabilitation works effectively. Patients are not being referred, they are not coming and they are not staying once referred. The first thing to do to fix the problem is to ask if there is evidence and the answer is yes. From there it is necessary to look at the referral base to see if there are clinicians who will make the referrals, whether 3rd party coverage is available for your program, and if there are acceptable co-pays. Flexibility is necessary regarding when patients can obtain services and a lot of training is required, not only for the clinicians, but also for the rehab providers. Research should be conducted on what is necessary to fix problems and the results disseminated so that more than just a single rehab facility is implementing correct procedures. Based on her research, she described an example involving breast cancer care. She discussed the risks of lymphedema for women undergoing treatment. Unfortunately, the advice patients receive places them at even greater risk of a condition they want to avoid. She described a weight training intervention.