Harrington Fund supports community partnerships and scholarship to address social determinants of health

In the spirit of paying it forward, Christiana Care Health System has designated a $13 million bequest from the estate of a legendary champion of the health system and its community to advance scholarship and support innovative projects that help reduce health care disparities for underserved and disadvantaged populations throughout our area.

The gift establishes the Charles J. Harrington Fund, named for its benefactor, the late director emeritus of the Christiana Care Board of Directors and former Christiana Care trustee who was a strong proponent of service and of the importance of philanthropy.

“The Harrington Fund enables us to advance scholarship and community partnerships that will benefit the health of our neighbors and our region,” said Janice E. Nevin, M.D., MPH, president and chief executive officer of Christiana Care. “It is our honor to recognize Mr. Harrington’s legacy by using his gift to advance clinical knowledge and promote the transformative power of partnership by joining forces with groups already making a difference to even more effectively serve our community together.”

With the delivery of health care transitioning rapidly toward a population health approach — where the focus shifts to effective and meaningful ways of keeping groups of individuals healthy through primary care and prevention before they need to seek emergency care — addressing economic, environmental, employment and other social factors that impact health become paramount. Programs that address social determinants of health, such as those selected for support from the Harrington Fund, delve into grassroots issues facing our community and promise greater value in health care by removing obstacles that keep people from achieving optimal health.

Supporting our community’s health

One component of the fund, known as the Harrington Value Institute Community Partnership Fund, supports new or existing innovative community programs that target one or more social determinants of health and include both a community focus and a clinical outcome.

Understanding that medical conditions can be aggravated by legal or social problems, the partnership integrates attorneys into the health care team to help with issues such as proper mold remediation in an asthmatic resident’s rental home or preventing a utility company from cutting off electricity to the home of someone who requires supplemental oxygen to reduce the need for repeated emergency treatment at the hospital.

“Providers often don’t think about legal issues when treating patients, and the patients themselves are often not aware that a legal remedy exists for their problem, or they cannot afford legal representation,” said Susan Howard-Smola, J.D., MBA, senior clinical researcher with the Christiana Care Value Institute. “Linking these typically disparate resources provides patients with more comprehensive care that benefits the patient and the health system.”

Three additional projects — one that helps guide end-of-life preference conversations between patients and their health care providers; a second that works in low-income and low-performing schools to improve reading due to language-based learning disabilities; and a third that dedicates the services of both a full- and part-time bi-cultural and bi-lingual promotoras in the Hispanic community for culturally appropriate health outreach and education — were announced as 2016 funding recipients at the Value Institute’s spring symposium on June 10.

“With this generous funding, we are able to partner on opportunities that target social determinants of health — factors that affect daily life and health, such as neighborhood, education and economic stability — and include both a community focus and a clinical outcome,” said Edmondo Robinson, M.D., MBA, FACP, Christiana Care’s chief transformation officer, who chairs the advisory group for the fund. “Foremost in our minds when selecting recipients is advancing our commitment to the health of our neighbors,” he said.

Recipients of the Harrington Value Institute Community Partnership Fund for 2016 are: DMOST Implementation, Education and Research; Reading Intervention Reading Corps Program; Healthy Latina Families: Improving Access and Care.

DMOST Implementation, Education and Research

Led by John Goodill, M.D., Christiana Care’s director of palliative care education and outreach, in partnership with the Delaware Academy of Medicine and Delaware Public Health Association.

The Delaware Medical Orders for Scope of Treatment (DMOST) form facilitates end-of-life conversations, documents decisions and translates into more person-centered care reflective of what individuals want — or don’t want — and what is likely to be beneficial in the final phase of their life. Said Dr. Goodill: “It empowers people to get the medical care they need, at the place and in the way that they want.”

As Harrington Fund recipients, Dr. Goodill and project partners, the Delaware Academy of Medicine and Delaware Public Health Association, have achieved a five-year goal to bring this important clinical tool to our community. Initially it will launch a paper form shared between patients and their health care providers, and plans are to create a statewide electronic registry for the information collected. Most states already have similar tools in place to help guide end-of-life treatment, and research indicates increasing evidence that a medical order health care providers are obligated to follow is more effective than an advance directive in ensuring that people get the type of medical care they want at the end of their lives.

“Our ultimate goal is helping people live as well as they can for as long as they can,” said Dr. Goodill. “With Harrington Fund support, Delaware now has the ability to do that.”

Reading Intervention Reading Corps Program

Led by Vicki Innes, executive director, Reading Assist Institute, Wilmington, Delaware

For someone who cannot read, knowing how to properly take prescribed medications, following care instructions after surgery or even truly understanding their own medical conditions can be challenging, if not impossible. With more than 7,500 early elementary students in Delaware reading below grade level, the consequential impact on their future health could be staggering. About 20 percent of these students have some level of developmental reading disorder, like dyslexia, making it difficult to learn how to read in the same way as their classmates.

In a unique school and community partnership, the Wilmington-based Reading Assist Institute (RAI) tutors students individually and works with teachers and their classes, bringing evidence-based, multisensory, structured language instruction for struggling readers. Support from the Harrington Fund will allow the RAI Reading Corps to provide early intervention for more students in grades 1 to 3 in low-income and low-performing public elementary schools who suffer from language-based learning disabilities and who are reading at or below the 25th percentile. The hope is that by opening their world to reading, doors will also open to better health.

Healthy Latina Families: Improving Access and Care

Nora Katurakes, MSN, RN, OCN, manager, Community Health Outreach & Education, Christiana Care Helen F. Graham Cancer Center & Research Institute, in partnership with the Latin American Community Center.

Through the Healthy Family Program and strategy of using promotoras access to care, health literacy and language barriers are addressed. Launched in 2012, the Promotoras for Healthy Family Program strategically embeds specially trained Hispanic, Spanish-speaking health advocates and resources known as promotoras throughout Latina communities to provide health outreach and education, eliminate barriers to care and link members of the Hispanic community with medical homes.

Support from the Harrington Fund allows continuation of the program including both a full-time program manager and part-time staff promotoras, as well as recruitment and education for a team of up to 20 trained volunteer promotoras reaching throughout the Hispanic community. The goals are to enroll 100 new Hispanic families from identified neighborhoods; continue to serve enrolled families; and reach an additional 400 individuals with information about health and access to care.

Advancing Scholarship

In October, the Harrington Fund also made it possible for Elizabeth J. Brown, M.D., MSPH, a highly regarded specialist in family medicine, to join Christiana Care’s Family & Community Medicine faculty as the Harrington Clinical Investigator and a Value Institute scholar. Previously a fellow in the renowned Leonard Davis Institute of Health Economics at the University of Pennsylvania and a Robert Wood Johnson Foundation Clinical Scholar at Penn’s Perelman School of Medicine, Dr. Brown’s research includes access to care, education and organization of health care delivery, with areas of focus in child and adolescent health, geriatrics and long-term care and health policy.

“Dr. Brown’s research portfolio and clinical skills have already become a valuable asset to the Value Institute’s commitment to research that meets the Triple Aim of improving the quality of the health care experience, improving the health of populations and reducing health care costs,” said Timothy J. Gardner, M.D., medical director of the Center for Heart & Vascular Health and executive director of the Value Institute. “Support from the Harrington Fund enables us to further build our research base for the benefit of the neighbors we serve.”

The Harrington Fund is also helping to build the health care research pipeline in Delaware through the Value Institute Harrington Fund Student Research Scholarship. Now in its second year, the 10-week summer internship program allows two rising university juniors or seniors to gain hands-on experience in research projects aimed at improving the delivery of health care in the community. This summer’s scholarship winners are a pre-medicine-focused Delaware State University student who plans to pursue a career in cardiothoracic surgery, and a nursing student at Delaware Technical & Community College focused on research in women and children’s health.

As Delaware’s leading health care provider, Christiana Care is committed to partnering with community-based services to address social needs that impact wellness and access to care. Innovative partnerships and scholarship supported by the Harrington Fund promise tremendous benefit to the community by addressing social determinants of health and making health care truly accessible — and of greater value — to all.

Charles J. Harrington, Ph.D.

Wilmington Trust, which managed the estate of philanthropist Charles J. Harrington, Ph.D., presented a portrait of Dr. Harrington to Christiana Care Health System. The portrait had its home at Wilmington Trust, where Dr. Harrington sat on the board of directors.

Presenting the portrait were Wilmington Trust representatives Mark Graham, leader of wealth advisory services; Clark Robertson, vice president and senior relationship manager of wealth advisory services; Nicole St. Amand, assistant vice president; and Bill Bechstein, chief operating officer and vice president.

At Christiana Care, Dr. Harrington has come to represent service to others. In 1996, the Board presented Dr. Harrington with the first “Trustees Lifetime Achievement Award,” later renamed as “The Charles J. Harrington Trustee Award” and presented to an outstanding trustee during the annual Trustees meeting.

“Dr. Harrington’s long-time affiliation with Christiana Care truly reflected his interest in the organization and its future,” said Penny Saridakis, vice chair of Trustees at Christiana Care. “We thank our friends at Wilmington Trust for giving us a wonderful remembrance of Dr. Harrington.”