
Caroline R. Piselli
Yale School of Nursing Alumnus, United States
Abstract Title:An adaptable patient-clinician customized-integrative- experiential-evidence-based outcomes approach
Biography:
Caroline’s lifelong passion to innovate and provide sustainable better global health for all is a priority throughout her lifelong career and volunteerism. Initially, at Yale New Haven Hospital, she was a critical care clinician/manager, clinical cardiology and health promotion practice/NIH research and corporate strategy leader; at 3M, she served as healthcare/ global-strategy executive, corporate commercialization/patent lead and at PwC/Guidehouse, she co-founded/led a value-based population health consulting practice. She is President/CEO of PGC, an author, national speaker of > 200 presentations, associated publications and guest lector/new course co-development at Yale School of Nursing, Management and George-Washington University.
Research Interest:
Background: The original purpose of this patient-clinician’s (PC) self-designed and implemented prospective-descriptive, experiential-evidence-based research (EEBR) of a customized integrative-holistic-medicine whole-person-care-model (IWPC) incorporating evidence-based-practice (EBP) guidelines, holistic interventions-lifestyle changes (HILC), practical symptom management adjustments and hybrid continual quality improvement (CQI)/ Design for Six Sigma (DFSS) type approaches was to enable accurate communication about symptom and functionality trends to a myriad of clinical specialists treating the PC’s co-morbid neurological autoimmune diseases (NAD), sequelae to an unexpected, unprovoked life-threatening acute event. The purpose immediately transitioned to a practical EEBR prototype evaluation reference for clinicians evaluating treatments and the PC’s proactively HILC prevention, as 6-years of demonstrated improved outcomes; the PC’s clinicians strongly recommend conference presentations and publications to enhance clinical practice.
Methods: The EEBR qualitative and quantitative metrics are tracked, analyzed and graphically summarized, incorporating customized variables, e.g.symptoms, a function of disease status progression or improvement, in relation to interventions. The PC, customized DFSS to enable framework flexibility to diseases, root cause, cause and effect and failure modes, patient change-management ability to weighted overall life goals; clinical, mental and physical fortitude and other requirements to achieve ultimate outcomes.
Results: The EEBR prototype identified detailed symptom attributes of the initial <5 acute symptoms (e.g. paralysis, extreme pain, etc.), and progression to 33 co-morbid symptoms (e.g. unpredictable pain, spasms, weakness, sleep impairment, brain fog,etc) related to interventions. Historical key learnings are applied proactively as preventive and treatment approaches within DFSS and CQI practice.
Conclusions: The significance of the beyond expected outcomes and application beyond the scoped NAD IWPC practice is a customizable model, applicable to many diseases, long-term COVID, gerontology and extends to human, personal, social and financial burdens. The PC hopes to publish, automate this approach via a customized app to enable clinician-patient-partnerships to improve experiential outcomes.