Dr. Jacob Pierce
Fall is upon us, and along with the cooler weather and changing leaves, we are expecting to see an increase in respiratory viruses. While it might be too late for ECU football’s conference championship dreams, it’s not too late to increase your chances of staying healthy this respiratory viral season. Respiratory viruses may be an inconvenience for many of us, but they can be devastating for those with certain conditions. Fortunately, vaccines and treatments are available for the major respiratory viruses expected to be circulating this Fall and Winter.
Testing positive for influenza, COVID-19, RSV and other respiratory viruses can be unsettling, but it’s important to remember that we’re equipped with the knowledge and tools to handle it effectively. If you test positive, reach out to your health care provider immediately. For those who are a bit more vulnerable—like older adults, people with underlying health conditions or a weakened immune system—getting early treatment really makes a difference. It can help keep symptoms from getting worse and get you back on your feet faster.
Medications available today for some respiratory viruses like COVID-19 can significantly reduce the severity of symptoms and lower the risk of hospitalization. As an infectious disease physician at ECU Health, I have seen firsthand how devastating these respiratory viruses can be for at-risk individuals. This underscores the importance of acting quickly and taking advantage of these treatments when eligible.
Treatment is just one part of the equation; preventative measures remain as vital as ever. The 2024–25 COVID-19 and influenza vaccines are available this Fall, and staying up to date with vaccinations is one of the most effective ways to protect yourself and those around you. We also now have FDA-approved RSV vaccines for all adults ages 75 years and older. The Centers for Disease Control and Prevention (CDC) also recommends the vaccine for adults ages 60-74 years who are at increased risk of severe RSV.
It is important to recognize that some of the most vulnerable in our community – such as newborns or individuals on chemotherapy don’t have a strong enough immune system for vaccines to work. They rely on the healthy among us to get vaccinated and keep them safe. I know that some of you reading this may have concerns about vaccinations. I encourage you to discuss which vaccines might be right for you with your health care provider. I get my vaccines every year, not to protect myself, but to protect anyone in our community who cannot get them for whatever reason.
Additionally, basic hygiene practices, like frequent handwashing, avoiding close contact with sick individuals and wearing masks in crowded or high-risk areas, continue to be simple yet powerful tools in preventing the spread of respiratory viruses.
By staying informed, acting quickly when needed and embracing preventive measures, we can navigate this season safely and protect the health of our community. It’s not just about avoiding illness; it’s about doing our part to ensure the well-being of those around us. Together, we can make a difference in managing this year’s respiratory viral season and look forward to baseball season.
Dr. Jacob Pierce is the medical director of infection prevention at ECU Health and a clinical assistant professor at the Brody School of Medicine at East Carolina University.
Stacey Greenway, director of cardiovascular disease management services at ECU Health Medical Center, was recently appointed as incoming president of the American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR). Greenway, who recently advocated for rural health care during AACVPR’s Day on the Hill, previously served as a board member for the organization.
“It is an honor to be chosen to lead AACVPR and work alongside my colleagues in cardiovascular care to advance quality and enhance patient outcomes,” said Greenway. “I am eager to provide health care professionals with the best tools and resources to improve patient outcomes and to advocating for policies that recognize the importance of our life-saving work. I also look forward to continued collaboration with health care providers outside of our field of cardiovascular and pulmonary rehab, as we work together to elevate cardiovascular care and provide the highest level of support to our patients.”
Greenway is passionate about advocating for patients and rural health systems in state and national policy and is a leader in cardiovascular disease management. With a background in multidisciplinary rehabilitation practices and public health, Greenway brings experience in clinical leadership and patient advocacy to AACVPR’s mission, which emphasizes advancing the quality of cardiovascular and pulmonary rehabilitation nationwide. AACVPR helps establish standards and advocates for cardiovascular and pulmonary care, addressing the physical, emotional and social needs of patients with chronic diseases. As incoming president, Greenway plans to drive initiatives that support clinical staff and enhance patient access to high-quality, evidence-based rehabilitation programs.
Candace Cahoon, the respiratory care manager for the Pediatric Asthma Program, presented in July at the National Association of Asthma Educators (AAE) annual conference in Charlotte, North Carolina. The AAE is dedicated to providing quality education to a multidisciplinary group of asthma educators, and members include respiratory therapists, nurses, pharmacists, physicians, social workers, nurse practitioners and others. Cahoon’s presentation is one way the Pediatric Asthma Program at Maynard Children’s Hospital strives to share its research, lessons learned and processes for establishing a national model for a pediatric asthma program in the United States.
Cahoon has worked with ECU Health for 10 years, and during that time she has continued her education from a bachelor’s degree in sociology and an associate’s degree in respiratory therapy, to a master’s in health education and several certifications.
The Pediatric Asthma Program, which has grown from serving two counties in 1995 to 29 counties today, aims to reduce emergency department and inpatient admissions for children with asthma, decrease school absenteeism and increase the quality of life for children with asthma in eastern North Carolina. It does this by offering asthma testing, asthma education, tools to manage asthma, access to community resources and medication assistance. Their work with eastern North Carolina public schools has been a particularly effective way to reach children in rural North Carolina communities.
The poster Cahoon presented was the collaborative work of the Pediatric Asthma Program’s entire team, and the goal was to educate others on how to establish and support a pediatric asthma program. “We’re one of the best programs in the nation,” Cahoon said. “We are ahead of the game in terms of what we address for our patients with asthma. I go to conferences and say, ‘we know this; we do this,’ so we are well-known in the state and nationally.” Sue Anne Pilgreen, the manager of the Pediatric Asthma Program, said Cahoon is the “teacher” of their team. “She is a lifelong learner,” she said. “While the content development was a team effort, Candace pulled it all together, submitted the abstract and ultimately showcased our great work.”
Cahoon shared that the Pediatric Asthma Program is now establishing its own professional conference: Pediatric Asthma Management: Providing Holistic Care to Rural Communities. The conference is scheduled for February 28, 2025 and will be held at the Eastern Area Health Education Center, with virtual and in-person capability. Cahoon leads the committee responsible for making the conference a reality. “We want to show how we are touching every single aspect of an asthmatic patient’s life,” Cahoon said. “We have worked to expand and grow our program over the past few years, and we’ve had countless people ask us how we ‘found’ our success, especially in such a rural area,” Pilgreen added. In answer to that, the conference will address key components involved in implementing a comprehensive asthma program, while also discussing the clinical components of how the asthma team treats patients with asthma and helps them transition to home. “We’ll have a case study that goes through the hospital or clinic and has a breakdown of testing, education, home visits and environmental assessments for the patients,” Cahoon shared. The team will also talk about Single Maintenance and Reliever Therapy (SMART) as a new treatment option for patients with asthma that combines in a single inhaler both a corticosteroid and a long-acting beta-agonist so it can be used as a daily maintenance and as-needed relief of asthma symptoms. “The overarching objective for the conference is to help participants to utilize clinical knowledge, skills and expertise to provide holistic pediatric asthma care in the community,” Pilgreen said. “We know this starts in multiple places, including the hospital bedside, schools, and primary care provider offices.”
Ultimately, attending conferences, as well as establishing a conference of their own, highlights and shares the innovative work of the Pediatric Asthma Program at Maynard Children’s Hospital. “It shows that we’re here and we can do this together,” Cahoon said. “We are more than willing to show how over the last 20 years we have put this program in place.” Pilgreen agreed: “The design of our program is unique. Having the opportunity to present our program model and outcomes at a national conference not only elevates our work, but it also gives others the tools to replicate our model in their area. Our goal is to increase the quality of life for children with asthma, regardless of where they live.”
This year, the ECU Health Medical Center’s microbiology laboratory upgraded its technology by adding the BD Kiestra Total Lab Automation (TLA) system. The new equipment improves standardization in laboratory processes, enhances lab efficiency and centralizes microbiology testing. This automated solution to laboratory challenges represents ECU Health’s ongoing pursuit of innovation, efficiency and process improvement.
The Kiestra TLA system is an end-to-end automated lab culture workflow from plate labeling, inoculation, incubation, plate reading, imaging, reading and follow up work, to maximizing staff productivity. “Previously, after incubating cultures, you took the plates out and read each one from the oldest to the newest, but if the culture wasn’t robust enough, the plate had to go back in the incubator,” Caryl Havasy, the system administrator of laboratory service lines, said.
Heather Duncan, the director of ECU Health Medical Center’s laboratory services, further explained the challenge. “Think about incubating plates like baking a cake in the oven,” she said. “The whole time the plate is out of the incubator, it’s not growing the organism, just like a cake stops baking once you take it out of the oven. This can delay an organism’s growth and delay the test results.”
Furthermore, reading plates was subject to human experience and error. The Kiestra, Havasy and Duncan said, takes photos of the plates and uses AI algorithms to see an organism’s growth before the human eye can detect it. “This technology means there’s no variation in how the sample is applied to a plate” Duncan said. That means there’s no delay due to rework, and there’s less room for error.
Acquiring the technology was a four-year process, which included establishing a business case, investing funds, working through construction to get the microbiology lab space ready, installing equipment and training lab technicians. The lab opened officially this past July, and on Oct. 8, the team hosted an open house to celebrate the new technology with a ribbon cutting ceremony and tours for those interested in seeing the new equipment.
It was a great opportunity for Dr. Niti Armistead, the chief quality officer and chief clinical officer at ECU Health, to see the newest technology in action. “The Kiestra is an investment in our people, specifically our laboratory and microbiology team,” she shared. “These are highly trained professionals, and this technology takes away manual, inefficient tasks and allows them to use their skills and education to the fullest extent. This in turn drives improvement in safety with fewer manual errors, efficiency and professional fulfillment. It is another example of how we are advancing our vision to be the national model for rural health as it will be processing specimens from all of our hospitals.”
Jay Briley, the president of ECU Health Medical Center, also attended the event. “It’s exciting to see ECU Health continue to invest in cutting-edge technology like the Kiestra Total Lab Automation system. The system streamlines our processes, reduces manual errors, and allows our highly skilled lab professionals to focus on what matters the most: delivering timely, life-saving results,” he said. “The Kiestra TLA system is a testament to ECU Health’s commitment to innovation and the health and well-being of our patients.”
Andy Zukowski, ECU Health’s chief financial officer, highlighted the value of ECU Health’s investment in this new technology: “The Kiestra Total Lab Automation system represents significant innovation and value for ECU Health. By streamlining our microbiology lab’s processes, it enhances the patient experience and quality of care we provide all while improving throughout and cost savings. The long-term return on investment is clear, as it positions us to continue delivering innovative high-quality care while maintaining fiscal responsibility.”
In celebration of the season, Maynard Children’s Hospital patients, families and team members had a chance to recognize Halloween and bring a sense of normalcy around the day.
Team members from across ECU Health and some community groups came together inside the children’s hospital to dress up and let the children see some of their favorite characters, like Mario, Woody and Buzz from Toy Story, and everyone from Inside Out.
Some tables set up inside Maynard Children’s Hospital even offered interactive games for the kids to play while they were picking up goodies from each team. Those involved said this is one of the most special events of the year, where teams can share a bit of normalcy with the youngest patients at ECU Health Medical Center.
Amanda Jones, a child life specialist at Maynard Children’s Hospital, said she’s grateful to work with a team whose role is to put a smile on children’s faces.
“That’s part of our role here, we try to bring some fun to Maynard Children’s Hospital,” Jones said. “Kids and their families have to be here, so we just try to celebrate holidays, celebrate milestones and bring some of their home to them while they’re in the hospital.”
Jones said while the event takes a lot of planning and organizing, the team member engagement makes it easy to pull together and generate excitement. After four years of hosting a parade outside of Maynard Children’s Hospital, the event moved back indoors this year for a more interactive experience for patients and families.
One of those patients was Aleksandra, who was dressed as Belle from Beauty and the Beast during the event. She said it made her day to see the Minecraft booth set up from one of the teams.
“It was fun to go trick-or-treating and see all the booths. There were so many different booths, it was just really fun,” she said. “Being able to do this with other people, who some of them might have the same condition as me, that was a good memory.”
Her mother, Lydia, said she was grateful for her daughter to have something to look forward to for Halloween while she’s in the hospital. For herself, Lydia said it was nice to see Aleksandra and so many other children light up as they went through the different booths.
“It’s wonderful that they put on an event like this so that all of the children who are missing out on Halloween get this experience,” Lydia said. “I love seeing them have the moment of just being a kid, wearing a costume and forgetting for a day that they’re in the hospital.”
Lydia said she had a great time watching her daughter, other patients and even parents interacting with an Inside Out booth, complete with a replica console from the movie.
Tara Stroud, vice president of Women’s and Children Services, said team members step up in many ways to be there for the patients and families served at Maynard Children’s Hospital and this event is a true example of that commitment.
“There’s something about being able to work in a children’s hospital and really give the child the experience of being a child, whether they’re sick or not,” she said. “It gives a heartwarming feeling to the team to know that we’re going to make a difference – whether it’s caring for them medically or it’s just putting a smile on their face.”
Halloween is a night filled with fun, creativity, and spooky thrills, but it is also an important reminder of easy safety tips, especially for pedestrians. It is essential for parents, guardians and children to take proactive measures to ensure everyone is safe while enjoying the festivities.
“One of the most effective ways to increase visibility and reduce risks is for children and accompanying adults to wear reflective items,” advised Ellen Walston, injury prevention program coordinator at ECU Health.
Selecting costumes that fit properly can help prevent tripping hazards. Parents should ensure that their child’s costume is the appropriate length and consider opting for face paint instead of masks to avoid obstructed vision.
Simple additions, such as a reflective vest or armband for parents, can significantly enhance safety for both children and adults. Additionally, carrying flashlights or glow sticks can alert oncoming traffic to the presence of trick-or-treaters. In neighborhoods without sidewalks, staying as far from traffic as possible and utilizing crosswalks when crossing streets is crucial.
Walston emphasizes the importance of communication between drivers and pedestrians.
“Parents should also encourage children to make eye contact with the driver,” said Walston. “It is important that both the driver and the child are aware of one another.”
Safety in numbers is another critical aspect of Halloween safety. Walston recommends that children trick-or-treat in groups rather than alone. Parents should supervise younger children, while older kids should stay together with their peers.
“Children should travel in groups with smaller children, with their parents available for supervision,” Walston said.
This approach not only improves safety but also builds a sense of community among families, according to Walston. Furthermore, parents should remain vigilant about their surroundings and teach their children to be aware of potential dangers.
Once the trick-or-treating is done, parents should thoroughly inspect all candy before allowing children to indulge. Walston advises disposing of any candy that are missing wrappers or anything that appears to have been tampered with. Walston also suggests avoiding homemade treats unless they come from someone you know.
By taking these precautions and remaining vigilant, families can enjoy a safe and festive Halloween experience. With a little preparation and awareness, you can embrace the Halloween spirit without compromising safety.
Greenville, N.C. – Dr. Ghanshyam Shantha, cardiac electrophysiologist at ECU Health, recently performed the first procedure at ECU Health Medical Center with a new and innovative device that treats atrial fibrillation (AFib), or an irregular heartbeat – the FARAPULSE™ Pulsed Field Ablation (PFA) System. The FARAPULSE™ PFA is a catheter device that uses electrical fields to target specific tissue areas within the heart that causes an irregular heart rhythm that significantly decrease quality of life and carries the risk of embolic stroke.
“I’m incredibly proud of our electrophysiology team at ECU Health for delivering innovative solutions like FARAPULSE that are making a real difference in the lives of patients here in eastern North Carolina, where many struggle with chronic conditions like heart disease, diabetes and hypertension,” said Dr. John Catanzaro, John “Jack” Rose Distinguished Professor and chief of the Division of Cardiology at the Brody School of Medicine at East Carolina University, and director of the East Carolina Heart Institute at ECU Health Medical Center.
“AFib patients face a significantly higher risk of stroke, heart failure and other serious complications. Our team’s dedication to improving the well-being of our community is reflected in the cutting-edge treatments we’re providing to help reduce these risks and offer a better quality of life for our patients.”
More than 454,000 people are hospitalized with AFib each year in the United States, according to the Centers for Disease Control and Prevention. AFib is a common heart condition where the top chambers of the heart beat irregularly due to disorganized electrical signals in the heart. Paroxysmal AFib occurs when the irregular heartbeat does not happen all the time. Traditional treatments often use heat or cold to burn or freeze the malfunctioning heart cells to get the heartbeat back to normal. Thermal ablations pose a small risk of causing damage to other surrounding areas and complications. The newer ablation option, PFA, uses electrical pulses to target these cells more precisely, significantly reducing some of the complications that can come with thermal ablations.
“We’re thrilled to introduce FARAPULSE as a cutting-edge solution for patients with AFib in eastern North Carolina, where AFib rates are particularly high, and access to advanced care is essential,” said Jay Briley, president of ECU Health Medical Center. “Our teams are dedicated to delivering top-tier cardiac care, and their commitment to providing patients with the latest technology is inspiring. This innovative treatment is yet another step toward ensuring the best possible outcomes for our communities, right here at home.”
According to Boston Scientific, FARAPULSE benefits patients by reducing the risk of damage to surrounding anatomy, shorter procedure duration and better patient outcomes. In fact, more than 80 percent of patients with paroxysmal AFib had no returning symptoms within one year, and almost three-quarters of patients discontinued heart rhythm medications within one year.
ECU Health team members that were part of the new procedure include: Ghanshyam Shantha, MD, MPH; John Catanzaro, MD, MBA, Mark Dixon, RN, Dennis Wood, CVT, and Stephanie Clarke, CVT. As the leading academic health system in eastern North Carolina, ECU Health and the Brody School of Medicine perform nearly 450 ablations each year, ensuring patients can access the latest medical treatments close to home. By combining academic expertise with clinical care, ECU Health not only improve patient outcomes but also provides essential training for the next generation of health care professionals. ECU Health’s leadership in advancing cardiovascular treatments reinforces its mission to improve the health and well-being of eastern North Carolina. To learn more about ECU Health’s heart and vascular services, please visit ECUHealth.org/heart.
Access East is a 501(c)(3) that strives to improve health access to, and coordination of, quality care in eastern North Carolina. Access East serves as an important part of the ECU Health system of care, offering support for under- and uninsured individuals and helping navigate the health care system through service lines such as Access East Care Management, HealthAssist, ACA Navigators and Health Opportunities Pilot.
Out in the field
One such facet of their service comes through the Farmworker Program, which works not only to help enroll members of the ENC H-2A (temporary visa) farmworker community in low-cost insurance, but also to direct them to available community health care options, and to provide emergency medical training like wound care or cardiopulmonary resuscitation (CPR). In just under two months, the program has reached more than 2,000 farm workers.
Juan Allen, a community coordinator and Affordable Care Act (ACA) navigator for the program, plays a key role in helping the farmworker community receive the services and care it needs. “I’ve been with Access East for seven or eight years,” Juan said. “I was born and raised in El Salvador on a farm, which is what got me interested in doing this work.” The goal of the program, he said, is to help members of the migrant farming community prevent injuries and illness. “Last year we lost four farm workers to heat stroke, and someone else passed away because no one in the field knew CPR,” he explained.
“So, we go out to the farms and do CPR training, heat exhaustion and heat stroke education, Stop the Bleed training, education about tobacco sickness and anything else they need.” Juan said there is also skin cancer education and screenings, dental cleanings, mental health support and vaccines. “During COVID, we were coordinating vaccines, so that with providers’ help, we got 80-100 people vaccinated per day.”
Juan has also trained as an instructor for the Mental Health First Aid (MHFA) trainings, which is an evidence-based, early-intervention course that, virtually or in-person, uses community-specific scenarios, activities and videos to teach people the skills they need to recognize and respond to mental health and substance use challenges. The ECU Health Foundation awarded funding to Safe Communities Coalition, a non-profit that works alongside the Eastern Carolina Injury Prevention Program (ECIPP) to prevent injuries. “Juan has reached a population (farmworkers) that we have struggled to reach, yet we knew desperately needed the education,” said Sue Anne Pilgreen, the executive director for the Safe Communities Coalition, the manager of the ECIPP and the manager of the Pediatric Asthma Program. “This past fiscal year, we have trained a total of 196 people in MFHA, and 92% felt like they could recognize someone who was suicidal after completing the class.”
“Juan is one of the hardest workers I know,” said Shantell Cheek, the director of Access East. “He has a passion to really help those who are underserved, and he is a true link between Access East, ECU Health and the Farmworker Program.” Wherever there is a need, she said, Access East and the Farmworker Program is there.
The program, which initially was established to help H-2A workers get visas and enroll in the ACA, has grown significantly. “We still do the ACA enrollment,” Cheek said. “But Juan provides care coordination, and different entities like the North Carolina Department of Health and Human Services and the North Carolina Growers Association partner with us. We now help these individuals get medications they need, assist them when they go to the hospital and are being discharged, set up with primary care providers and provide the education like CPR and skin cancer. And it’s not just the migrant workers; it’s their families too. Wherever there is a need, anywhere across the state, they call Juan.”
Partnering with the Brody School of Medicine
She emphasized that Juan tirelessly creates partnerships with regional and community organizations. Shantell also highlighted Access East’s, and Juan’s, ongoing collaboration with East Carolina University’s Brody School of Medicine. “During their first or second year of medical school, students can select a project to work on and Juan’s name often comes up when they mention an interest in the communities we serve.”
Deanna Torres, a second-year medical school student at the Brody School of Medicine, worked with Juan this past summer as a part of a project required of the school’s four Distinction tracks. Deanna opted to apply for the Service-learning track, which is what led her to Access East. The other tracks include Health System Transformation and Leadership, Medical Education and Teaching and Research.
Deanna said she has always had a passion for grassroots community service. “I’m undecided on my specialty right now, but I know I want to help underserved, minority populations.” Deanna grew up participating in a variety of community service activities, including a medical mission to Honduras and a Benedictine Volunteer Corps trip to the Rosebud Indian Reservation in Mission, South Dakota. Once she entered medical school, Deanna continued her journey in service by joining the Service-learning track. “It isn’t required to join a track,” Deanna explained. “But when I was applying to medical schools, the Service-learning track was a major factor in deciding to come here.”
Students in the Service-learning track work extensively with medically-underserved, marginalized and rural populations during their medical school career. They attend a lecture series specific to that track, but they are also required to participate in a service-learning internship during the summer after their first year of medical school. “We select an organization to partner with, and then we create a longitudinal service-learning project aligned with that organization,” Deanna said. While the internship only lasts a summer, the students’ work on their projects continues until they graduate.
Making a difference
With Juan as her mentor, Deanna said she gained an insider’s perspective on a migrant farmworker’s daily life. “I saw how migrant farmworkers are processed after entering the country. I saw how farms are laid out, and I got to see their living conditions, which aren’t always great. I’ve lived in North Carolina my whole life, and I didn’t know how many farmworkers we have in this region or what their needs were.” This exposure led Deanna to her project’s focus, which is “Increasing Mental Health Services to Hispanic Migrant Farmworkers in Pitt County.” The migrant workers, she discovered, often struggle with mental health issues, like depression. “They leave their home country and their families, work in the heat and have no car or independence, and that can be challenging. I want to advocate for the lack of awareness and communication about mental health in the Hispanic community,” Deanna said.
Juan has been instrumental in helping Deanna make the connections and partnerships necessary to work on her project. “He’s a popular man,” she laughed. “Any time I mention Access East, everyone knows him.” Deanna said she appreciated Juan being willing to mentor her, despite his busy schedule. “As a medical student, it can feel daunting to reach out because everyone is busy, but he was always available and offered me resources, took me to the farms and provided logistics. He knows all about these things.”
Dr. Jennifer Crotty, a pediatrician and an associate professor in the Department of Pediatrics at the Brody School of Medicine, as well as the director of the Service-learning distinction track, facilitates connections between students in the Service-learning track and community partners. “The track primarily focuses on local impact and grassroots efforts,” Dr. Crotty said. Of how she came to direct this specific track, she cited her background in pediatrics. “I realized that to have healthy children, we need healthy families and communities,” she said. “That’s why we want to do this advocacy work.” Access East has been a significant partner in this work. “Access East addresses the things we know need to be addressed. When students work with them, they see the time and energy and resources it takes to do medicine in these rural communities.” While she has never met Juan personally, she knows her students get a great experience when they work with him. “He always finds a place for our students, and the students always say their experience was amazing.”
This work is valuable, Deanna said, because it puts a face and name to abstract medical concepts students learn in school. “It puts a story to what you’re learning,” she said. “It shows us that a patient isn’t just one disease, but they are dimensional, and it helps us be better physicians who treat in a holistic manner. This community needs us to advocate for them.” Dr. Crotty agreed, saying that having students participate in these service learning partnerships through ECU Health make them better physicians, no matter what specialty they choose. “They take the knowledge they gained through service learning to wherever they’re going. I love that someone in their surgery residency is thinking about whether their patient has enough food at home. We graduate good doctors because our students are exposed to these types of things, and they know how to handle it.” Juan said that ultimately, this work gives migrant farmworkers a voice. “They’re only here for eight months and they don’t know their rights,” he said. “Access East is vital to reach out to farm workers so we can be a go-between them and the health system.”
Dr. Kristina Simeonsson, a physician with ECU Health Pediatrics, has long heard stories of children missing school because they couldn’t get health assessments or vaccines before the state-required deadline. But now, after months of planning, a shared vision and the desire to support public school children at risk of exclusion due to missed health requirements, Pitt County’s first-ever health assessment and vaccine clinic is helping flip the script for families in-need of care.
“This clinic changes that challenge,” said Dr. Simeonsson. “Instead of being suspended for weeks or months, these kids can stay in school and keep learning.”
For ECU Health, the James and Connie Maynard Children’s Hospital, and the Pitt County Health Department, this initiative is more than just a service—it’s a lifeline for local students. The clinic marks the culmination of a shared dream to improve access to care for children, and its success was clear as about 140 students received essential health services over two days, ensuring they can remain in school without disruption.
According to North Carolina state law, all children entering public schools for the first time or starting kindergarten are required to complete a health assessment and receive certain vaccines. Failure to meet these requirements within 30 days of the first day of school results in exclusion until proper documentation is provided. For many students, especially those new to the area or without a medical home, accessing these services can be a significant barrier.
“Keeping students in school, safe, healthy and ready to learn is a key priority for all school nurses,” said Laurie Reed, nurse manager for the School Health Program, Maynard Children’s Hospital. “One of the biggest challenges faced by school nurses in Pitt County at the beginning of each school year is identifying available resources for their students and families to obtain state required health assessments and immunizations. Significant efforts are made by Pitt County Schools, the Pitt County Health Department and Maynard Children’s Hospital School Health Program to provide widespread communication of state requirements to parents and caregivers throughout the year however we still find that a large number of students are at risk for exclusion on the 30th calendar day of school.”
Dr. Simeonsson and Kayla Manning, public health nursing supervisor for Child Health and Immunization Programs at the Pitt County Health Department, led the clinic, which included the help of pediatric residents, nurses from both organizations, ECU Health school nurse care managers, Brody School of Medicine students, ECU Health child life specialists, and the ECU Health Pediatric Asthma Program. Together, they offered health assessments, vaccines, asthma screenings and referrals for follow-up care.
Dr. Simeonsson emphasized the importance of teamwork in making the clinic a reality.
“We couldn’t have offered this clinic without Kayla, her staff and ECU Health school nurses,” Dr. Simeonsson said. “The collaboration between the health department and our providers has been critical. We’re doing the health assessment part, but Kayla’s team handles the essential screenings and vaccinations, making the process seamless.”
Manning echoed the sentiment, adding, “We’ve long hoped to plan a clinic like this, and working together with ECU Health has allowed us to meet the needs of these children. It’s truly a collaborative effort.”
One of the clinic’s primary goals was to ensure that children not only met their health requirements for school but also received follow-up care for other potential needs. Many of the students had no established primary care provider, meaning they lacked consistent access to health care services. The clinic provided referrals for additional care, such as dental or eye exams, and connected families with available resources.
In addition to helping organize the clinic, Dr. Simeonsson has been supervising the ECU Health pediatric residents and Brody students who are completing the children’s health assessments.
Dr. Abigail Maiorana-Boutilier is one third year resident in the ECU Health Internal Medicine – Pediatrics Residency Program that volunteered at the clinic. She noted that the kids they have seen at the clinic are kids that were not going to be able to go to school after the deadline to receive their vaccines and health assessments that are now able to remain in school. Knowing that makes all the difference for Dr. Maiorana-Boutilier.
“I think it’s one of the most important initiatives that we are able to do as residents because this is very tangible in how we’re helping these kids,” said Dr. Maiorana-Boutilier. “And you see the parents, their relief when they leave here because they know that they their kids can go to school the next day. Being able to get these parents and their kids in, get their vaccines and health assessments and everything done in one day and be able to relieve this huge burden from them is the most rewarding, satisfying feeling ever.”
In addition to the standard health assessments, the Maynard Children’s Hospital Pediatric Asthma Program participated in the clinic to address asthma management. According to Candace Cahoon, respiratory care manager with the program, asthma is the leading cause of missed school days in the United States. Her team performed noninvasive tests to check for lung inflammation and provided asthma action plans, medication administration forms and free inhaler spacers for students.
For both ECU Health and the Pitt County Health Department, this clinic represents the culmination of planning and a shared dream of improving access to care for local children. Dr. Simeonsson described the initiative as “a community response” to a widespread issue.
Medical students like Lauren Nuriddin, a fourth-year student at Brody School of Medicine, played an active role in the clinic. For Nuriddin, who plans to specialize in pediatrics, the experience was a powerful reminder of why she chose this career path.
“I have a very close relationship with Dr. Simeonsson, and we share a lot of the same passions,” said Nuriddin. “I started volunteering for events like these last year, and I’ve been to Duplin County with the Healthier Lives initiative, and I’ve been to different areas around the region. This clinic specifically is really important to me because there’s a lot of research on the effects that happens after kids become suspended, how it affects their confidence and their ability to continue forward in school successfully. It’s a whole downhill domino effect, so it’s important that we make sure we can mitigate this however we can.”
This clinic, the first of its kind in Pitt County, could serve as a model for similar initiatives across the state. The success of the event, which saw more than 130 students in a week, highlights the urgent need for accessible health care services for school-age children. Crystal Kiani, nurse and child health coordinator, Pitt County Health Department, said a lot of the patients they have seen have recently moved to Pitt County from out of state, so they need physicals to get into school.
Valerie Tunnell, nurse and immunization coordinator, Pitt County Health Department, said, “Overall, we are seeing a lot of kids, and we’re meeting the need. We maxed out on appointments today, and we were maxed out on our last clinic day. Because of events like today, we’re able to make sure that the kids are seeing a health care provider and not slipping through the cracks.”
With the clinic’s success, ECU Health, Maynard Children’s Hospital and the Pitt County Health Department are already looking at ways to expand these services and continue improving access to health care for children across the region. Pitt County Schools said the clinic and collaboration made a significant impact on their students.
“I am deeply grateful to the Pitt County Public Health Department, ECU Health team and our Pitt County Schools School Health Managers for their unwavering commitment in working together to plan this event over a six-month period,” said Sara English, Pitt County Schools Interim Executive Director of Student Services. “Their collaboration is breaking down barriers and ensuring that every student has access to the essential health care they need to be able to remain in school and meet state-mandated expectations. It’s a powerful reminder of the strength we find when we come together to support our students and families.”
There were plenty of smiles and handshakes at the Teachers of Quality Academy (TQA) 7.0 Recognition Ceremony on Sept. 30, as 37 graduates from the most recent TQA cohort celebrated successful completion of the program alongside ECU Health and Brody School of Medicine leaders.
TQA is a professional development program for health care leaders designed to fundamentally change care delivery through a curriculum focused on building knowledge and skills in Health Systems Science which comprehensively explores how health care is delivered. Participants engage in advanced learning in quality improvement, patient safety and team leadership, develop improvement projects to apply these skills across the health system, teach others in their environment about these concepts and evaluate the outcomes of improvement interventions. Leading by example, TQA participants promote a culture of quality and safety across the enterprise.
This year’s program graduates came from multiple areas of expertise and locations, including ECU Health Physicians, ECU Health Medical Center, ECU Health North Hospital, ECU Health Chowan Hospital and Contentnea Health. Additionally, the cohort includes participants from ECU Health’s Rural Family Medicine Residency Program, ECU Health’s Administrative Fellowship Program and the MedServ Fellowship Program.
“As an academic health care organization, it’s incredibly gratifying to see educational programming like TQA woven into ECU Health and Brody’s culture of quality improvement,” said Dr. Michael Waldrum, ECU Health CEO and dean of Brody. “You can see and feel the pride that people take in improving quality, and that has real tangible impacts on patients who can experience better health and wellness as a result. This cohort and these graduates are an example of our quality improvement culture which TQA has helped build.”
According to Dr. Jennifer Sutter, TQA physician director, the diverse, multidisciplinary class represented the ultimate goal of the program: to further knowledge and instill principles that help health care professionals across eastern North Carolina improve quality on behalf of the patients they serve.
“It is exciting for us as program leaders recognize and celebrate these dedicated health care professionals for successfully completing TQA,” Sutter said. “Those of us involved in the program have been fortunate to witness incredible growth from our 7.0 cohort. We could not be more proud of what they’ve accomplished and how they will use their knowledge and skills to help further high-quality care in their individual clinical setting through out eastern North Carolina.”
The seventh iteration of the program was comprised of 12 half-day sessions alternating concepts of leadership development and new competencies of Health Systems Science, including patient safety, quality improvement, systems thinking, population health and team-based care. Each learning session also emphasized wellness topics enabling participants to engage in supplemental activities to further enhance the experience of life while at work. The year-long program culminated in each participant completing a comprehensive quality improvement project in their area of focus.
“As part of TQA, I had the honor of partnering with leaders from our community hospitals—North, Chowan, and the Medical Center—all of whom shared a commitment to serving our community,” said ECU Health administrative fellow Madison Stevens, a member of the 7.0 cohort. “The sessions empowered us to explore and refine our leadership philosophies, building a strong foundation rooted in quality improvement, professional growth, and innovation. The program has equipped me with the tools to become an effective and open-minded leader. In our project, my team focused on post-event debriefing in the emergency department, prioritizing the well-being of our team members alongside clinical learning to help teams navigate high-stress situations and improve patient care outcomes. We look forward to sharing our results and broadening our focus on quality improvement to provide exceptional patient care.”
The TQA curriculum is also designed around experiences that span the continuum of care in multiple areas of clinical focus which enables participants to be better prepared to meet real-world challenges. This intentional design, according to ECU Health Chief Quality Officer and Chief Clinical Officer Dr. Niti Armistead, enables TQA graduates to immediately help drive quality improvements in the clinical environment.
“TQA is so important because it creates a community of interdisciplinary professionals committed to improving quality both here at ECU Health and beyond,” Dr. Armistead said. “Quality is a critical component of our quintuple aim and the work being done by TQA program leaders and participants directly ties to our ability to improve the health and well-being of the region. Through TQA, participants learn by doing and acquire collaborative problem resolution skills to drive continuous improvement.”