“Being involved in VACEP, you discover what’s going to happen before it happens”

Learning each day.

It’s why Joran Sequeira loves emergency medicine, a specialty that requires knowing about and constantly discovering more about all the other ones. And lifelong learning is also why she stays engaged in VACEP.

Joran was one of the first students in our inaugural 2016 Leadership & Advocacy Fellowship, designed to promote leadership beyond the emergency department. Since then, she’s been at the table for every VACEP board meeting and remained an active participant in the policy issues impacting the emergency medicine specialty in Virginia.

Outside clinical rounds, her passion project has been to help patients in need of mental and behavioral healthcare. Over more than two years, she and other VACEP board members worked with the Virginia Hospital and Healthcare Administration (VHHA) and the Department of Behavioral Health and Developmental Services (DBHDS) to create safe, cost-effective and feasible guidelines for patients and emergency departments. These collaborative guidelines help streamline the medical assessment and reduce costs and time needed to take care of patients presenting with psychiatric emergencies.

The guidelines went live statewide on Nov. 5, 2018 — but the work isn’t over. “Our efforts continue as we review cases and revise the guidelines as needed,” Joran says. “Moreover, our effort has opened doors to other discussions surrounding current psychiatric legislation such as TDOs to state hospitals.”

Getting involved early

Joran (as she says, rhymes with “Duran Duran”) is a physician with Alteon Health and was recently promoted to Director of Clinical Operations at the Bon Secours Memorial Regional Medical Center emergency department, located in Hanover County.

Joran got involved in ACEP during her residency at the University of Virginia. With an interest in operations and health policy, she serves on the front lines of the political and lobbying effort in emergency medicine at both the state and federal level.

“It is eye-opening to be involved in VACEP. You discover what’s going to happen before it happens. You learn quickly that if you aren’t present to educate lawmakers on why a bill could be dangerous for the healthcare system or patient safety, life-threatening laws could go into effect,” she says. “It has been a worthwhile experience meeting my district representatives and senators or their legislative aides in Richmond and D.C.”

Coordinating care

As part of her role in VACEP, Joran has been highly involved in the Virginia Emergency Department Care Coordination (EDCC) system as a representative of Bon Secours.

Working with the Virginia Department of Health and in partnership with VACEP, Utah-based Collective Medical implemented the Emergency Department Information Exchange (EDie) across emergency departments in health systems statewide in summer 2018. EDie plugs directly into existing EMRs and alerts emergency physicians to high-utilizer patients, prescription “shoppers,” and those with complex needs. Physicians regularly share stories of reduced costs, bypassed tests, and saved lives thanks to a system that Gov. Ralph Northam, himself an M.D., calls a “game changer.”

Joran sits on a workgroup with representatives from other health systems, care management, Collective Medical team members, and health plans. “We discuss how to maximize utilization of the EDie platform in order to provide resources to patients and minimize frequent and necessary ED use,” she says.

You also gotta take a break from it all

Outside of shifts and advocacy efforts, Joran loves traveling and experiencing different cultures and food. She’s visited more than a dozen countries, including Argentina, Switzerland, the Galapagos Islands, and more. Across her journeys, she’s built an outhouse from scratch in the Australian outback, made dumplings in Xi’an, China with a sweet Chinese grandmother, and whipped up tortillas and fried yucca balls in Costa Rica.

In Richmond, she enjoys the James River with Perry, her Welsh Terrier, attending local festivals, and enjoying one of the nation’s most lauded brewery scenes.

She’s also engaged to a sports reporter from the Richmond Times-Dispatch, Eric Kolenich — an ideal matchup, as emergency physicians and reporters carry similar wild hours.

And when she returns to her shiftwork from advocating across Virginia, she shares news of VACEP’s efforts with her colleagues. “It is important that we remain transparent and inform our fellow EPs so that they know the incredible work ACEP and VACEP do,” she says.