April 2018 Newsletter

Renewal of HRSA Funding Will Help Address Health Workforce Needs of Rural and Underserved Areas in Nebraska

Awarded funding will support Nebraska AHEC Program through year 2022
(pictured: Dr. Michael Sitorius, Program Director)

Dr. Michael Sitorius

The Health Resources and Services Administration (HRSA), part of the U.S. Department of Health and Human Services, awarded the University of Nebraska Medical Center (UNMC) $2.7 million in continued funding for the Nebraska Area Health Education Center (AHEC) Program in late 2017.

Administered by UNMC and the Department of Family Medicine, Nebraska AHEC has worked to improve Nebraskans’ access to health care since 2001.  The Nebraska AHEC Program is comprised of five centers that promote healthy communities and health care delivery in the state’s regional service areas by increasing the number of health care workers of all disciplines, with a focus on primary care, particularly in rural and underserved areas.

“The AHEC program contributes to the education of health professionals at UNMC and other institutions across Nebraska.  Having an adequate number of well-trained health professionals is vital to increasing access to quality health care, reducing health disparities and improving the health of Nebraskans,“ said Michael Sitorius, MD, chairman of the UNMC Department of Family Medicine and director of the Nebraska AHEC Program.  “This renewed funding is promise that the programs will continue to support the state’s growth, recruitment, and retention of health professionals.”

Funding Changes

HRSA recently implemented changes to improve the outcomes of several programs, including AHEC.  Across the country, AHEC will accomplish our work by focusing on the following three priorities: improving workforce distribution, increasing the number of diverse and culturally competent primary care providers, and supporting health care practice transformation.

The Nebraska AHEC Program will continue to provide a link between health training programs and Nebraska’s rural and urban underserved areas by exposing students to health career options, enhancing community-based and clinical training opportunities for students, and addressing issues related to health care access and quality through continuing education for primary care providers.  In this five-year-funded project, the Nebraska AHEC program will have a greater focus on students enrolled in health profession training programs and providing them enhanced community-based and clinical training opportunities in the state’s rural and urban underserved communities.  The Nebraska AHEC Network will support health career education to students and continuing education for providers through enhanced partnership with existing efforts.

New Programs & Initiatives

One significant new initiative required in this project period is the development of the Nebraska AHEC Scholars Program.  In Nebraska, the program will instruct 75 health professions students from a variety of disciplines in interprofessional education, behavioral health integration, social determinants of health, cultural competency and practice transformation.  The longitudinal program will provide and support enhanced opportunities for students interested in serving rural and underserved areas of Nebraska. The NE AHEC Program office, AHEC centers, and various community stakeholders are currently planning what the Scholars program will encompass with plans to implement the program in fall of 2018. Stay tuned for more information and application details.

Related to continuing education, Nebraska has partnered with Missouri and South Dakota to develop the Midwest Learning Collaborative.  The Collaborative will allow the three states to leverage the resources and talents available in each state to deliver high quality, easily accessible webinars on a multitude of topics for clinical partners and health professions students interested in providing health care to rural and underserved populations.  The first webinar is slated to be offered in June of 2018, additional information and registration details will be released soon. The study was commissioned and funded by the Nebraska Area Health Education Center Program (AHEC) and used the most recent data from the UNMC Health Professions Tracking Service and the state of Nebraska.

You can learn more about the Nebraska AHEC Program on our website by clicking here.  

New Report Provides a Snapshot of Nebraska’s Rural Health Workforce

Media release from UNMC highlights findings of AHEC-funded health care workforce report

Workforce ReportA 2018 rural health care workforce report issued by the University of Nebraska Medical Center reveals that while there has been an 11 percent increase in the number of physicians in the state over the last 10 years, there are 13 counties that still do not have a primary care physician.

This and other key findings of the study appear in the 64-page report, “The Status of the Healthcare Workforce in the State of Nebraska.”

“The health care workforce is an essential component in making Nebraska the healthiest state in the union and timely and accurate data such as this report will help inform initiatives and policies to help address those challenges,” said Jeffrey P. Gold, MD, UNMC Chancellor.

The study was funded by the Nebraska Area Health Education Center Program (AHEC) and used the most recent data from the UNMC Health Professions Tracking Service and the state of Nebraska.

“This report helps to measure the progress we have made in the state in dealing with some of the workforce issues in rural Nebraska and in planning for the future,” said Mike Sitorius, MD, professor and chair of family medicine in the UNMC College of Medicine.

“Some programs have helped increase the number of rural health professionals, but there still exist substantial recruiting challenges to bolstering the health workforce and access to health care in rural and underserved areas,” said Fernando Wilson, PhD, acting director of the UNMC Center for Health Policy and lead author of the report.

Among those challenges, include:

“In partnership with stakeholders from Scottsbluff to Omaha, we’ve made progress over the years. But the landscape of health care is rapidly changing, and we must remain diligent to sustain the progress we’ve made and close the gaps,” Dr. Wilson said.

Dr. Wilson led a nine-person research team representing several professions from UNMC and with input from Thomas Rauner, director of the primary care office in the Office of Rural Health for the state of Nebraska.

The report examined 21 health care professions ranging from physicians and physician assistants to nursing, dental and allied health professionals.

It also looked at the sex, age, race and ethnicity of each health care professional, as well as measured the number and rate of health care professionals per 100,000 people by county.

Other key findings of the report include:

Based on the findings the following recommendations were made:

The last study of this kind was done in 2009 when UNMC released, “A Critical Match: Nebraska’s Health Workforce Planning Project.” At that time, the report was the most comprehensive review of the status of the health professions in the state that provided the groundwork for workforce planning efforts, Dr. Wilson said.

The full report can be downloaded from the Nebraska AHEC Program’s website by clicking here.

From the Northern Nebraska AHEC Center: Previous Career Day Participant Gives Back as Medical Student

(pictured: Alex Hansen presenting at Career Symposium)

Alex HansenGiving back to his community is a priority for Alex Hansen. Hansen, a West Point native and West Point-Beemer High School graduate, recently presented at the Northeast Nebraska Career Symposium in October at Wayne State College.

Hansen is pursuing his doctoral degree at the University of Nebraska Medical Center (UNMC) and out on his Family Medicine rotation. Knowing how important it is to engage medical students on rural rotation, Northern Nebraska AHEC (NNAHEC) Executive Director Gretchen Forsell, asked Hansen to be a speaker at the Symposium. “With the shortage of practitioners in rural Nebraska, connecting the medical students with the community they are working in during their clinical rotations just makes sense,” Forsell said. “There’s a direct impact on recruiting students to practice in rural Nebraska settings once they graduate.”

This year’s symposium hosted by the UNL Extension in the northeast area extended career choice learning to 1,100 high school sophomore students from 43 schools. For the past 14 years, NNAHEC has managed the healthcare sessions, educating 350 students a year on medical careers. In 2008, Hansen attended the symposium as a sophomore. As a presenter this year, Hansen focused on the role of a physician, medical specialties, and doctorate degree requirements. “It is a long, long road both in getting there and in your career afterward. As you progress through college, there’s an immense amount of pressure to meet all the standard criteria medical schools expect in an applicant,” Hansen said. He credits his love of biology and science, as well as his parents’ support for his decision to pursue a medical degree. Health career events like the symposium also provided a spark, he said.

Hansen will graduate from UNMC in the Spring of 2019 and plans to specialize in ophthalmology. His interest in giving back to the community is still present. “It would give me the opportunity to pass on the torch through teaching and training other aspiring physicians,” he said.

From the Southeast Nebraska AHEC Center: Advancing Better Health in Southeast Nebraska

(pictured: Carmen Chinchilla, New SE NE AHEC Program Director)

A note from the Executive Director, Kim Buser, of Public Health Solutions District Health Department (PHS) and the Program Director, Carmen Chinchilla, of the Southeast Nebraska AHEC (SE NE AHEC) provides insight into the services they offer.

Carmen Chinchilla

As the new host site for the Southeast Nebraska AHEC, PHS is excited to begin helping shape the future healthcare workforce and to meet the health needs of their 17-county region better. Public Health Solutions has long-standing ties to the five counties it currently serves. With SE NE AHEC, PHS will be able to expand its impact to twelve more counties in the southeastern region of the state for this program. A crucial part of the initial work will be enhancing current partnerships and cultivating new connections within the new service area and beyond. Developing strategies and programs that focus on connecting students to health careers, enhancing the education of pre-health and health profession students and connecting practicing health professionals to communities not only supports the mission of AHEC but improves the health of the southeast region.

SE NE AHEC’s role in preparing the next generation of health practitioners will focus on improving the health care workforce distribution into rural and underserved areas; increasing the number of diverse and culturally competent primary care providers; and supporting innovative models of care that integrate health care services and disciplines. Moving forward, SE NE AHEC will help students enrolled in health profession training programs access enhanced community-based and clinical training opportunities in the region’s rural and urban underserved communities.

As the new director for the Southeast Nebraska AHEC, I look forward to working with community partners as the program increases the shadowing and rotation opportunities for students, and providing resources and opportunities for current practitioners interested in developing their skills and expanding their knowledge.

From the Nebraska Panhandle AHEC Center: UNMC Nursing Simulation Provides Real World Experiences

(pictured: Medical student, Ethan Monhollon, and nursing students participate in real life simulation)

SimulationOn March 14, 2018, UNMC nursing students with the assistance of a third-year medical student experienced an interprofessional critical access hospital simulation in Scottsbluff at the UNMC CON-WND campus.

The third-year medical student, Ethan Monhollon, visiting from Chadron during his rural Family Medicine rotation helped to provide interprofessional education during the simulation. Nebraska Panhandle AHEC helped to connect Monhollon to the simulation opportunity. UNMC nursing students assumed the roles of licensed practical nurses, registered nurses, and certified nurse assistants while working with the medical student to practice valuable skills necessary in their future roles. Nursing students participate in real-world situations with both live and simulated persons twice a year.

During the simulation in March, students walked into situations involving: a woman giving birth, a child with RSV, an elderly woman with dementia that had fallen out of bed with a head contusion, and an unescorted criminal with breathing difficulties. Communication is a critical component of successful team-based health care, during the simulation students practiced communicating about the situation, background, assessment, and recommendation (SBAR) of each case to facilitate their patients’ care. Following each one-hour scenario, students took time with seasoned UNMC nursing faculty to debrief and receive feedback.

"Clinical simulations are critical in the training of healthcare providers across all certifications. These activities push students to think critically about the patient in front of them. In doing so, students practice the communication and clinical knowledge necessary to deliver healthcare effectively as well as prevent harmful outcomes that are otherwise avoidable. The UNMC nursing training simulations show that patient care is a team sport; the more healthcare providers practice, the better we will all be in caring for each of our patients,” Monhollon said. Experiences such as this provide a snapshot into the powerful work AHEC can have with connecting students to interprofessional education.

From the Central Nebraska AHEC Center: The University of Nebraska Kearney now the host site for the Central Nebraska AHEC Center

Leveraging relationships and resources already yielding opportunities and success

(pictured: New Program Coordinator, Brandon Drozd)

Brandon DrozdSince September, the University of Nebraska Kearney (UNK) has served as the host site for the Central Nebraska AHEC (CN AHEC). The Program Coordinator, Brandon Drozd, is working hard to utilize and leverage existing resources and partnerships to meet the health workforce needs of the central region.

One critical role that AHEC plays is providing a link between students in pre-health and health profession training programs and connecting them with the rural or underserved areas they will be serving through opportunities for enhanced community-based and clinical training. With the new host site located on an undergraduate campus, there are numerous avenues to maximize on this partnership and build relationships with students interested in health professions within the 35-county CN AHEC region. A key example includes collaboration around existing Kearney Health Opportunities Program (KHOP). This program brings in top-tier students from across the state interested in becoming a health professional and practicing in a rural area. The KHOP program provides scholarships and programming to students during their undergraduate education and students that complete their undergraduate commitments transition into the health profession training program UNMC. Currently, there are 78 students enrolled in the program.

Recently, CN AHEC organized and facilitated the regional science meet on March 15, 2018. More than 55 8th grade students from five different schools within the region attended. The science meet was supported in part by AHEC, UNMC, and the Nebraska Coalition for Life Saving Cures. Projects this year ranged from ‘Flytrap Frenzy’ to ‘Do Males or Females Have a Larger Lung Capacity.’ During the meet, students rotated between being judged on their projects to attending several breakout sessions facilitated by the UNK staff and ESU 10. The breakout sessions involved students racing to solve coding problems, learning about the constellations in a mobile star lab, and practicing CPR where students had hands-on training learning how to do chest compressions.

The day ran smoothly thanks to the help of the UNK Health Science students, KHOP students, and UNMC third-year medical students on their rural rotation helping as part of their community project.

Students with the top scores will be invited to attend the State Science Experience at the UNMC Omaha campus from June 7-9 where students will have the opportunity to learn more about science and health careers.