This is the first story in a series highlighting faculty who are shining examples of quality and compassionate patient care and patient safety. Every day, these health care providers put their patients first. In the process, they create successful models of advanced care focused on empathy, safety, technology and evidenced-based medicine, models that carry through everything they do – into their practice, their teaching, their research, their community outreach, and into the USF Physicians Group.

It’s in Dr. Lucy Guerra’s genes to be completely drawn in to the team-based patient care offered at USF Health. Her own Latino heritage includes a close-knit family that is involved in nearly every aspect of life, including each other’s health.

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Knowing she is living true to who she is, she practices team-based medicine every day, putting her patients first, reinforcing the concept to medical students and residents she teaches, and watching the students, in turn, practice it as they provide free care to the local underserved community at the BRIDGE Clinic.

Dr. Lucy Guerra in the midst of teaching medical students and residents at the Morsani Center for Advanced Healthcare.

Dr. Guerra wears multiple hats in her career as a physician. She is associate professor, director of the Division of General Internal Medicine in the USF Health Morsani College of Medicine, co-faculty mentor for the BRIDGE Clinic, and associate director of the Internal Medicine Residency Program.

She doesn’t see them as multiple roles, but as one job, she said, a testament to her preference for working at an academic medical center.

“We all need to change our concept of what medical care is and to think of it as having evolved to a very patient-centric model,” Dr. Guerra said. “It’s more about working as a team to provide the best care and realizing the patient is part of that team. It’s a trend we call value-based care. When patients come to a place like USF Health, they’re going to always meet with the physician and other health care providers – a nurse practitioner, social worker, pharmacist or physician assistant – and it’s always going to include medical students and residents because we are an academic teaching institution.”

But an academic medical center is more than patient care and Dr. Guerra is emphatic in her efforts to incorporate USF Health’s other missions into her world.

“Our other missions – research and teaching—are equally important to patient care because you really can’t do one well without the other,” she said. “If we don’t have the research component then we can’t find better drug therapies and better behavioral therapies to treat patients. And sometimes I think this needs to be emphasized more because patients don’t necessarily realize that. The research part is very ethereal – you just don’t see it in action. Patients think of research as being done in the lab. But when you’re coming here, to an academic institution, you have the opportunity to participate in research studies and get involved. If patients realize they can participate in some kind of research study that will make a difference for the next generation of patients that come after them then wow, what a contribution they’ve made to medicine, as well to the future of their own grandchildren.”

For the teaching mission, Dr. Guerra said that, beyond the science of medicine, she tries to remind her students and residents why they chose medicine as a career.

“People who are learning and in a learning environment sometimes get caught up, just like I did, in studying or trying to get good grades or trying to pass, and you have to keep reminding them why they chose this profession,” she said. “For a physician, a nurse or anyone working in health care, it really needs to be a commitment. You’re making a commitment to somebody else – the patient. If you can ground a student in that, then they’re going to be the better health care provider for it.”

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She conveys that same philosophy to her colleagues, urging them to always remember why they went into medicine, to do their best to block out the added duties, patient charts, and demanding schedules and return to their core reasons for choosing medicine as a career.

Sometimes, she said, it’s as simple as looking at the young and eager medical students and residents to reignite the passions that carried them through medical school.

“Participating in things like BRIDGE, or teaching students and residents, can remind them why they went into health care to begin with,” Dr. Guerra said. “They’re seeing what they were a few years before or a decade before. And that’s the difference we find working at an academic medical center, where you have a lot of younger people around all the time from different disciplines.”

What keeps her motivated, staying on track with a demanding career? Among many things, she looks to her own father, who was a physician in Cuba and Spain before coming to America.

“I admire my father because he was always studying, learning English and trying to pass the medical boards here,” she said. “And he was older when he did that, in his late 30s, and worked three jobs during that same time. I just thought if someone could care so much about something, that’s what I’d like to do.”

Photos and multimedia story by Sandra C. Roa, USF Health Office of Communications. 

USF Health has been at the forefront for training healthcare professionals to work in teams – from its ground-breaking coursework that combines students from medical, nursing and physical therapy programs to the newly opened Center for Advanced Medical Learning and Simulation that is training professionals from around the world.

A new program at USF Health is honing those skills further by providing case-based sessions across time, an approach that offers a more realistic view of how healthcare teams care for patients requiring multiple visits and whose care needs to be reassessed as their conditions change.

“We have worked as a collaborative Interprofessional team to develop a really robust small group case-based session,” said Dawn M. Schocken, director of the Center for Advanced Clinical Learning for the USF Health Morsani College of Medicine, which hosted the program.

“The small-group facilitation makes this a successful and terrific learning activity and a wonderful experience for our learners to learn to work as a team, before they enter the workforce.”

The IPE Educational program, which features small group sessions focused on a patient scenario, is training students from multiple educational tracts –USF Health Morsani College of Medicine, College of Nursing, College of Pharmacy, and the School of Physical Therapy and Rehabilitation Sciences – to work together. Student learners included fifth-semester nursing students (from the Leadership Course); doctoral students (year 2) from the School of Physical Therapy and Rehabilitation Sciences; second-year medical students; and doctoral student (year 2) pharmacy students. In addition, 16 faculty members from across USF Health volunteered to participate, including five faculty from College of Nursing, four faculty from College of Pharmacy, two faculty from School of Physical Therapy, and five faculty from Morsani College of Medicine.

Sessions for the program started last week and included 260 student learners. Spanning two days, students met with faculty members who facilitated discussions surrounding the care of a 65-year-old female patient recovering from a stroke and currently in a skilled nursing facility. Each student had already learned about the patient’s care from admission to the hospital with a condition called diabetic ketoacidosis through a stroke in the intensive care unit and discharge from the hospital to a skilled nursing facility.

The goal of this program was to have the students work together to develop a plan of care for the patient as she recovers from her illness, and address any concerns either she or her family have regarding her care. During the small group sessions, a standardized patient, representing the real patient’s family member, met with the student teams to discuss their concerns for their family member’s care.

The scenario will continue for the student/faculty teams in February when they will meet again to learn a new portion of the case, and then carry on their discussion to assess new needs for our ‘patient’.

Response to the team-building experience is positive, said Gail H. Schinka RN MS, clinical instructor of nursing and coordinator for the VA Nursing Academy, a partnership of the USF College of Nursing and the James A. Haley Veterans’ Hospital to expand education for nursing students and health care for veteran.

“This exercise gave all of the students some good insight into the roles of other disciplines and allowed them to explore how best to communicate with each other to drive positive patient outcomes,” Schinka said.

Student learners gain a decided advantage by training in teams, said Chiara Stetson, a fifth-semester student from the College of Nursing.

“Fostering an interdisciplinary team approach early on in healthcare education will hopefully transition to a multidisciplinary approach in treatment across the health care field,” Stetson said. “Utilizing the knowledge, skill, and expertise from multiple disciplines, with the common goal of patient-centered care, has been shown to improve patient outcomes.  Hopefully this approach can be integrated into the healthcare system in the years to come leading to increased satisfaction of both the patients and their providers. (The IPE session) was a great learning experience one that I would love to see being continued in the future.”