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The Continuum Project

The Continuum Project is a Massachusetts General Hospital (MGH) culture change initiative that grew out of a 2015 taskforce convened by MGH president, Dr. Peter Slavin, and charged with developing a comprehensive strategy to care for patients and families facing serious illness.

Our team works to implement the Serious Illness Care Program at MGH, to engage patients and families in living well now and preparing for the future, and to develop educational material for clinicians, patients, and families.

Within each medical specialty, the project is led by scholars—clinicians who develop additional expertise in palliative care through a two-week palliative care course. These scholars partner with the Continuum Project to optimize workflow, promote local culture change, and publish implementation science scholarship.

Our Vision

We envision a health system in which all people across the continuum of age and illness receive care that focuses on what matters most to them, enhances well-being, and fosters respect and belonging.

Our Mission

Our mission is to elevate patient voices by improving communication and care planning between clinical teams, patients, and caregivers. We accomplish this through team-based education, patient and caregiver engagement, clinical champion development, data-driven improvement, and access to tools and resources.

Our Specialties

The Continuum Project collaborates with the following MGH specialties:
Cardiology

Cardiology

Emergency Medicine

Emergency Medicine

Geriatrics

Geriatrics

Medical ICU

Medical ICU

Neurology

Neurology

Oncology

Oncology

Pediatric ICU

Pediatric ICU

Pediatrics

Pediatrics

Primary Care

Primary Care

Surgery

Surgery

...and More

...and More

What We Do

How the Continuum Project is Transforming Serious Illness Care
Serious Illness Care Program icon

Serious Illness Care Program

Implements a systems-based approach to high-quality advance care planning that gives clinicians knowledge, skills and infrastructure.

Engagement icon

Engagement

Engages patients, families, clinicians and staff in the process of preparing for serious illness decision-making and empowers them to have their needs met.

Education icon

Education

Develops models of palliative care education that improve palliative care skills across all disciplines.

Who We Are

The Continuum Project is comprised of dozens of individuals that help to drive our mission to care for seriously ill patients. At the forefront of the project is our core team who work hand-in-hand with passionate scholars in each of our clinical areas across the hospital. We also have a wonderful support system of advisory boards who help guide the Continuum Project.

Core Team

Elizabeth Lindenberger, MD

Medical Director View Bio
Elizabeth Lindenberger, MD
Medical Director

Dr. Lindenberger is a Geriatrician, Palliative Medicine Physician, and Director of the MGH Continuum Project.  She serves as Core Faculty and Associate Director of Education in the MGH Division of Geriatrics and Palliative Medicine.  Throughout her career, Dr. Lindenberger has worked to improve the care of older adults and those with serious illness through educational innovation, fellowship training, and program development.  Dr. Lindenberger has led communication-training programs for clinicians from all disciplines, and she serves as Senior Faculty for the national Vitaltalk program.  Additionally, Dr. Lindenberger has dedicated herself to promoting palliative care within the field of neurology, with special focus on the care of patients with ALS, dementia, and other neurodegenerative diseases, and their caregivers.

Jeff Greenwald, MD

Associate Director for Implementation View Bio
Jeff Greenwald, MD
Associate Director for Implementation

Dr. Greenwald is a hospital medicine clinician and member of the Core Educator Faculty in the MGH Department of Medicine.  He serves as Associate Director for Implementation within the  Continuum Project.  He works closely with the programs in Hospital Medicine, Neurology, Nephrology, and Pediatrics. Dr. Greenwald’s research examines triggers for palliative care involvement and how patients, families and clinicians are affected by systems that support serious illness conversations.

Joanna Paladino, MD

Associate Director for Research View Bio
Joanna Paladino, MD
Associate Director for Research

Joanna (Jo) Paladino, MD is a palliative care physician researcher at the Mongan Institute Center for Aging and Serious Illness and the Associate Director of Research for the Continuum Project at Massachusetts General Hospital. Dr. Paladino has focused her career on designing, studying, and spreading a system-level serious illness communication intervention (Serious Illness Care Program, SICP) that includes structured communication tools, clinician skills training, and systems-innovations, including EHR integration. She has partnered with health systems and national organizations to adapt, implement, and study serious illness communication and care delivery innovations across specialties, clinical settings, and diverse patient populations. Dr. Paladino supports the research and evaluation efforts for the Continuum Project and has experience with intervention design, clinical research, mixed-methods, program evaluation, and implementation science. She teaches courses at Harvard Medical School in communication skills, train-the-trainer, and implementation. Dr. Paladino lives with her husband and son in Boston, Massachusetts.

Alexis Drutchas, MD

Curriculum Design & Education Co-Lead View Bio
Alexis Drutchas, MD
Curriculum Design & Education Co-Lead

Dr. Alexis Drutchas is a palliative care physician at Massachusetts General Hospital and an Instructor of Medicine at Harvard Medical School. She completed her residency in Family Medicine at Brown University, and following residency was a primary care physician for four years at Fenway Health in Boston. She then went on to complete the Harvard Interdisciplinary Palliative Care Fellowship, and stayed on as part of the MGH inpatient palliative care team. Her work in the Continuum Project includes curriculum design and serious illness communication training for interdisciplinary clinicians and learners across MGH.

Susan Edgman-Levitan, PA

Engagement Lead View Bio
Susan Edgman-Levitan, PA
Engagement Lead

Susan Edgman-Levitan is the Director of the Stoeckle Center for Primary Care at MGH and a national expert on patient engagement with more than 25 years of patient engagement experience.

Tamra Keeney, DPT, PhD

Rehabilitation Lead View Bio
Tamra Keeney, DPT, PhD
Rehabilitation Lead

Dr. Tamra Keeney is a clinician scientist and physical therapist in the Division of Palliative Care & Geriatric Medicine and Mongan Institute Center for Aging and Serious Illness.  Dr. Keeney completed her Doctor in Physical Therapy (DPT) in 2011 at Saint Louis University, a PhD in Rehabilitation Science from the MGH Institute of Health Professions in 2018, and an AHRQ T32 Postdoctoral Research Fellowship at the Center for Gerontology and Health Care Research at Brown University.  Her work in the Continuum Projects includes program evaluation and increasing engagement of rehabilitation clinicians in serious illness communication training across MGH.

Angela Miller, MA

Program Evaluation Analytical Lead View Bio
Angela Miller, MA
Program Evaluation Analytical Lead

Angela Miller is the Senior Data Analyst at the Center for Aging and Serious Illness, where she serves as Analytical Co-Lead of the CASI Data Core. In her role she provides programming, analytical, and statistical support for projects.  Angela completed her bachelors in economics from the University of Michigan and a masters in health economics from Eastern Michigan University. Prior to joining CASI and the Continuum Project, her previous work focused on evaluating Population Health Management programs for insurers and health systems. Her work with the Continuum Project focuses on program evaluation including database creation, metric development, and analytical reporting.

Michaela Rowland, NP

Nursing Education & Training Lead View Bio
Michaela Rowland, NP
Nursing Education & Training Lead

Michaela Rowland is a palliative care nurse practitioner with experience and training in oncology. In her role as the Nursing Education and Training Lead for the Continuum Project, she has a special interest in the integration of palliative care principles to nursing care for patients and families facing oncology diagnoses and serious illness.

Matt Russell, MD

Primary Care Lead View Bio
Matt Russell, MD
Primary Care Lead

Dr. Russell is a Geriatrics and Palliative Care Clinician with expertise and training in relationship centered communication (RCC) through the Academy on Communication in Healthcare, of which he is a faculty member. In addition to leading the implementation of the Serious Illness Care Program in Primary Care, he also serves as the Clinical Director of Geriatrics and the Medical Director of Ambulatory Geriatrics at MGH.

Jaclyn Shameklis, MD

Curriculum Design & Education Co-Lead View Bio
Jaclyn Shameklis, MD
Curriculum Design & Education Co-Lead

Jaclyn Shameklis, MD received her undergraduate degree from Dartmouth College and her medical degree from the Geisel School of Medicine at Dartmouth in Hanover, NH. She completed her internal medicine residency at Brown University in Providence, RI and stayed on for an additional year to work and teach as a Chief Resident. Following this, Dr. Shameklis began the Harvard Palliative Care Fellowship program and upon completion joined the MGB Palliative Care and Geriatric Medicine department as a palliative care attending in September 2020. Dr. Shameklis joined the Continuum Project in 2021 and is now working as a co-educational lead for the Serious Illness Conversation trainings.

Tingjia Shi, MS

Data Analyst View Bio
Tingjia Shi, MS
Data Analyst

Tingjia Shi is a Data Analyst at the Center for Aging and Serious Illness. She earned her Bachelor’s degree in Biological Science from University of Pittsburgh and a Master’s degree in Biostatistics from New York University. Her work in the Continuum Projects focuses on program evaluation including database creation, metric development, and analytical reporting.

Kelly Spinelli, BS

Project Manager View Bio
Kelly Spinelli, BS
Project Manager

Kelly has many years of healthcare experience in project management, process improvement/quality improvement, workflow integration as well as implementing and supporting hospital information systems. She assists with the development, organization, facilitation and implementation of the Continuum Project.

Keri Sullivan, MPH

Project Manager View Bio
Keri Sullivan, MPH
Project Manager

Keri assists with the advancement of Continuum Project initiatives specifically related to program evaluation & data as well as patient engagement. She has experience working in multiple areas of healthcare, including patient services, clinical research, and administration. Keri has an interest in health equity and community health, which is a lens she brings to this project.

Scholars

2022-2023

Katelyn Beans, RN
Neurology
Amanda Drapcho, LCSW
Emergency Medicine
Elizabeth Grznarik, RN
Medical ICU
Hera Kamdar, MD
Neurology ICU
Jacqui Mullen, LICSW
Neurology ICU
Abigail Scherrer, PA
Hepatology
Victoria Sinyak, PA
Hospital Medicine

2021-2022

Katy Black, MD
Pulmonary & Critical Care
Susan (Pui) Cheung, MD
Nephrology
Kate Davidoff, MD
Pediatrics
Caitlyn Dowd, RN
Pediatrics
Shelly Karparis, RN
Nephrology
Lauren Lapointe, LICSW
Emergency Department Social Work
Deborah Lee, MD
Geriatric Medicine
Carolyn McDonald, RN
Neurology
Beth McIntyre, NP
Nephrology
Danielle Saly, MD
Nephrology
Nina Tolkoff-Rubin, MD
Nephrology
Nneka N. Ufere, MD
Hepatology

2019-2020

Annah Abrams, MD
Pediatric Psychiatry
Lauren Boal, MD
Pediatric Hematology-Oncology
Christy Cauley, MD
Surgery
David D’Alessandro, MD
Cardiac Surgery
David Dudzinski, MD
Cardiac ICU
Jean Fahey, RN
Neurology
Michelle Gorski, RN
Cardiac ICU
Masaya Higuchi, MD
Geriatrics
Daniel Hoch, MD
Neurology
Dalena Matthews, RN
Cardiac ICU
Danielle Salgueiro, RN
Neurology ICU
Sara Stevens, NP
Oncology

2018-2019

Katlyn Breton, NP
Primary Care
Erin Coglianese, MD
Cardiology
Michael Flaherty, DO
Pediatric ICU
Sara Joyce, NP
Oncology
Natasha Lever, NP
Cardiology
Janet Murphy, MD
Oncology
Rhaea Photopoulos, NP
Oncology
Lydecke Sweet, MD
Primary Care
Kerstin Zanger, MD
Pediatrics

2017-2018

Lillian Ananian, PhD, MSN, RN
Medical ICU
Brooke Duggan, LICSW
Geriatrics
Areej El-Jawahri, MD
Oncology
Kellyann Jeffries, NP
Oncology
Brittany Kelly, NP
Pediatrics
Christine McCarthy, RN
Medical ICU
Sharda Mukunda, MD
Geriatrics
Kerry Reynolds, MD
Oncology
Emily Rubin, MD
Medical ICU
Darlene Sawicki, NP
Neurology
Shannon Scott-Vernaglia, MD
Pediatrics
Jeanne Vaughn, NP
Oncology

2016-2017

Emily Aaronson, MD
Emergency Medicine
Joyce Barkin, NP
Primary Care
Kim Cheevers, RN
Pediatric ICU
Brad Dickerson, MD
Neurology
Diane Fingold, MD
Primary Care
Denisa Gace, DO
Hospital Medicine
Jeff Greenwald, MD
Hospital Medicine
Tara Jennings, NP
Oncology
Cindy LaSala, CNS
Hospital Medicine
Annie Lee, MD
Primary Care
Alison McDonough, MD
Primary Care
Michele McHugh, NP
Primary Care
Michael Nathan, MD
Primary Care
Elahna Paul, MD
Pediatric ICU
Maria Rice, RN
Emergency Medicine
Justine Romano, LICSW
Pediatric ICU
Kate Treadway, MD
Primary Care
Phoebe Yager, MD
Pediatric ICU

Advisory Board

Engagement Advisory Committee

Dianne Austin
Director of Diversity, Inclusion & Engagement, Human Resources
Colleen Delaney
Director, Internal Communications, Publications and Operations, Public Affairs
John B. Herman, MD
Associate Chief, Psychiatry
Michelle M. L’Heureux, MD
Physician, Internal Medicine
Virginia Manzella
Senior Administrative Director, Primary Care
Carol Michael
Patient/Family Representative
Ellen Robinson, RN, PhD
Nursing, Institute for Patient Care; Clinical Nurse Specialist
Carrie Stamos
Patient/Family Representative

Slavin Taskforce

Peter Slavin, MD
MGH President
Katrina Armstrong, MD
Chief of Service, Physician-in-Chief, Medicine
Shea Asfaw
Chief of Staff, MGH
Ed Bajwa, MD, MPH
Physician, Pulmonary and Critical Care Unit
Debjani Banerji, MHA
Administrative Director, Division of Palliative Care & Geriatric Medicine
David Brown, MD
Chief, Department of Emergency Medicine
Debra Burke, RN, DNP, MBA, NEA-BC
Senior Vice President, Patient Care; Chief Nurse
Susan Edgman-Levitan, PA
Executive Director, Stoeckle Center for Primary Care Innovation
Jeanette Ives Erickson, RN, DNP
Chief Nurse Emerita, Nursing
Tim Ferris, MD
Chief Executive Office, MGH
Theresa Gallivan, RN
Associate Chief Nurse, Nursing
Marie Elena Gioiella
Director, Social Service Department
Peter Greenspan, MD
Vice Chair; Medical Director, MassGeneral Hospital for Children
Vicki Jackson, MD
Chief, Palliative Care Division
Keith Lillemoe, MD
Surgeon-in-Chief and Chief, Department of Surgery
Jesse MacKinnon, RN
Nurse, Patient Care Units
Josh Metlay, MD, PhD
Chief, Division of General Internal Medicine
Carol Michael
Patient/Family Representative
Cathy Minehan
MGH Board of Trustees
Britain Nicholson, MD
Senior Vice President, Development
Pat O’Malley, MD
Director, Pediatric Palliative Care
Rev. John Polk
Chaplaincy
Kimberly Parks, MD
Cardiologist, Cardiology Division
Ann Prestipino, MPH
Senior Vice President; Surgery, Anesthesia, Emergency Medicine and Clinical Business Development
David Ryan, MD
Chief, Hematology/Oncology Unit
Ellen Robinson, RN, PhD
Nursing, Institute for Patient Care; Clinical Nurse Specialist
Joan Sapir, EdM, MBA
Senior Vice President, Administration
Lee Schwamm, MD
Executive Vice Chair; Chief, Stroke Service
Peggy Slasman
Senior Vice President, Public Affairs
Jennifer Temel, MD
Clinical Director, Thoracic Oncology
Katharine Treadway, MD
Physician, Internal Medicine
Tony Weiner, MD
Physician, Psychiatry

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