May 12th is International Nurses Day!

National Nurses Week runs May 6th through May 12th. The celebratory week culminates on Florence Nightingale’s birthday. May 12th is recognized as International Nurses Day by the International Council of Nurses. This year marks the 30th year of celebrating National Nurses Week.

I have been a nurse for 24 years this June. I still remember the day I took my NCLEX exam. I also remember my first job as a nurse tech, as a new graduate registered nurse, as a travel nurse, and every other nursing role that has led me to where I am today.

I believe that the education, training, preparation and experience of becoming and being a nurse prepares you with the ability to not only assess someone but also something. Your nursing knowledge, skills, and abilities are necessary not just in your day to day work but in your life as well.

Additionally, being a nurse holds so many opportunities for you. Whether you opt to change direct care areas of focus, choose to travel, choose to pursue an advanced practice role, choose leadership, education, informatics, or any other role, there is that possibility for you to explore.

Nursing as a profession has a long history of evolving and advancing through the determination, intelligence, and forward thinking nature of other nurses.

Today in 2024, we continue to extend the boundaries of where nurses can and do have an impact on the delivery of quality care to others.

You may be inspired by Florence Nightingale, Mary Seacole, Clara Barton, Anita Dorr, Mary Mahoney, or any other nurse in the world who has advocated for better.

Now consider that someone may be inspired by you and your nursing abilities, your role, your education, your accomplishments and/or any other characteristic or attribute that differentiates you from the nurse next to you.

Happy International Nurses Day to you! May you have a year that provides you with continued inspiration and meaningful moments as a nurse.

~ Dr. Kelley

Know My Nurse Life 2.0

Nightingale Apps is re-releasing Know My Nurse Life, our iMessage digital sticker app with 21 nurse and medical themed emoji-like images to enhance your SMS messages. Soon to be available in Apple’s App store for a nominal purchase.

Below is Nightingale Apps’ Privacy Policy

Privacy Policy

Your privacy is important to us. It is Nightingale Apps’ policy to respect your privacy regarding any information we may collect from you across our application, Know My Nurse Life, and other sites we own and operate.

Nightingale Apps does not ask for any personal information in Know My Nurse Life. Nightingale Apps does not share any personally identifiable information publicly or with any third parties, except when required by law.

Know My Nurse Life is a sticker app and is intended for enhancing your communications through SMS messages. Please be aware that we have no control over the content sent or received through SMS messages that use Know My Nurse Life stickers. Nightingale Apps cannot accept responsibility or liability for their respective privacy policies.

Your continued use of Know My Nurse Life will be acknowledged as acceptance of our privacy practices and policies. For any questions, please reach out to us.

Effective September 21st 2023

 

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Patient-Centeredness & the Persistent Fax Machine

Patient-centered care is one of the six factors of quality in healthcare. Yet, there are many opportunities for improved patient-centered care.

To anyone that has had to fill out a form or receive a form from a healthcare provider or practice, there is a great likelihood of being told to ‘fax it back’.

Yet, how many have access to a fax machine at home?

Next, you are working to find a way to get the information back to or from the healthcare facility or organization that is not through a fax machine.

Knowing most do not have a fax machine, and encountering this issue, this is one example of an opportunity to improve patient-centered care.

In the bigger picture, healthcare has opportunities to explore the healthcare experience through the eyes of patients and unveil the blind spots to truly address patient-centeredness.

This is just one example but there are many others.

The article here provides several factors that contribute to the persistent challenge however, at some point, we will not be using fax machines….

In the meantime, one area of impact is on quality through that patient experience.

 

~ Dr. Kelley

The Administrative Burden of Being a Patient

Last week I had two once-a-year visits back to back. One was with my Primary Care Provider (PCP) and the second was with a new dermatologist. Both visits were booked out 9 months or longer in advance which initially surprised me.

As someone who is a healthcare professional of over 20 years and actively working in the space of innovation, I cannot help but notice some of the challenges of being a patient. My reflections are not intended to critique any particular provider, practice, clinic, facility or other healthcare organization. Instead, I see the challenges reflective of unmet needs faced by patients that could largely go unnoticed by healthcare professionals.

Patient-centered care is one of the 6 quality outcome metrics. However, I often wonder how we are defining patient-centered care. Is it defined by the perspective of healthcare professionals as to what we think patient-centered care means OR are patients involved in the process of defining what patient-centered means to them?

I had a couple of snafus trying to get to both appointments. The address for both offices was incorrect from the reality. Luckily, I was able speak to someone in the buildings, completely unrelated to my provider’s practice, who shared with me the correct locations. In both instances, I heard, “You are not the only one.”

Imagine if I was running late or my mobility was compromised so additional walking would be potentially burdensome to make it to the correct location. I would miss that appointment due to an administrative error. That appointment scheduled 9 months in advance and requiring my day to be arranged around it. The healthcare practice may see it as a no-show when that was not at all the intention.

The second administrative burden that I ran into was obtaining a detailed receipt for the charge paid upon leaving the dermatology visit. I used my Health Savings Account (HSA) card for the payment and the next day received an email requesting a detailed receipt for the payment. The receipt I received from the office only provided the location, date and amount. The reason for the payment was not included in the receipt.

When I called a few days later, I was surprised to hear how difficult it would be to obtain the detailed information. I asked if it is possible to receive a receipt with information as to details on the charge for the payment. The response was, “I don’t know.” She worked to investigate on her end and then said that someone would call me back. I did receive a call back and need to call another department to get the requested information. My question to her was why is it not on the receipt that I received the day I paid? The answer I received was HIPAA in the event I lost the receipt.

The phone calls, time, and effort to get the detailed receipt is an expense of its own as a patient that extends far beyond the 20 minute appointment. I often wonder how many patients go through the efforts to address the details requested for proof of purchase and/or reimbursement of rendered services.

Being a patient, even for a visit once a year, presents challenges that I am not sure are often recognized or considered as healthcare professionals. Without integrating patients into the process, these burdens will continue and lead to the same challenges over and over again.

Users are at the greatest advantage of identifying opportunities for change. In healthcare, change tends to require an ability to demonstrate quality outcomes. In this category, I envision patient-centeredness as the primary focal area.  To fully reach the utopia of patient-centeredness, we need to understand the areas where being a patient presents challenges beyond the healthcare visit itself. To a patient, the entire process is seen as one experience.

Have a lovely evening,

 

Dr. Tiffany Kelley PhD MBA RN-BC

 

Telehealth Care: An Innovation in Waiting

I often ask my informatics and innovation students to take a guess as to when telehealth was first conceptualized for use. They are often surprised to hear me say that the concept emerged in the 1960’s (60 years ago). Now while we did not have the capabilities for such operationalization of telehealth care at that time, we did have that capability long before March 2020.

The tipping point to integrate telehealth technology services into care delivery was the Covid-19 pandemic and the need to be able to provide care to patients in a safe way that would not put people at risk for contracting Covid (to the extent possible – not all appointments could be televisits).

Prior to March 6th. 2020, telehealth services were not a service that was reimbursable for most visits. The Centers for Medicare and Medicaid Services (CMS), the largest payer of healthcare services in the United States, granted the ability for providers to be reimbursed for telehealth services (temporarily) across the US. This provision opened the opportunity to leverage the technology available, develop new processes and support people with their healthcare needs.

“Prior to this announcement, Medicare was only allowed to pay clinicians for telehealth services such as routine visits in certain circumstances. For example, the beneficiary receiving the services must live in a rural area and travel to a local medical facility to get telehealth services from a doctor in a remote location. In addition, the beneficiary would generally not be allowed to receive telehealth services in their home.” (CMS.gov)

I’ve long advocated for the opportunity of telehealth to address visit types that may lead to missed appointments or access to care issues. Just this week I had a telehealth follow up visit. I scheduled it at the end of the day and was able to log off of my meeting to log on to my appointment without any need for travel, parking, rearranging my schedule and more. The visit did not require any labs, tests, auscultation or vitals. Therefore, this was an optimal use of telehealth.

Other use cases I often think about

  • individuals who perhaps do not have an effective and/or efficient transportation means for follow up or consult visits,
  • individuals who do not have the funds for parking, or cannot take an afternoon off for such a visit,
  • individuals seeking mental health services who may be too depressed to leave their home and make an in person appointment.
  • individuals in areas where the specialist is in network but not local to the patient

These are just a few use cases where telehealth has likely eased some pressures of patients seeking to access care where being in person was not a necessity. Access to care is essential for optimal outcomes. As we navigate forward toward a post-pandemic healthcare environment, the initial unmet need faced in March 2020 will have changed but this does not mean that there will not be a need to continue to offer such services.

Providing quality care requires patient-centered approaches. Why not continue to make it accessible to receive care?