By Jennifer Larson, contributor
April 29, 2011 - The Agency for Healthcare Research and Quality (AHRQ) recently released a special video series highlighting the innovative approaches of six organizations to solving health problems in their communities, including two initiatives headed by nurses.
The AHRQ Health Care Quality: Frontline Innovators on Changing Care, Improving Health Series features the work of six very different organizations that found creative ways to address patient-care needs.
“It’s representative of innovation that’s happening in health service delivery,” said Judi Consalvo, program analyst in AHRQ’s Center for Outcomes and Evidence. “It’s a learning tool.”
The videos, which were released in March and are available on YouTube, cover a wide variety of programs that target diverse populations and diseases. They highlight people who truly understood their communities and their unique needs and looked for strategic ways to meet those needs. And they’re told in compelling ways, Consalvo said.
Two of the leaders of the featured programs are nurses: Georgia Oliver, RN, directs a program in Memphis, Tenn., that trains members of churches to help educate their congregations about important health issues, and Linda Wick, NP, oversees a clinic in Duluth, Minn., for congestive heart failure patients that provides telemonitoring services to improve care and reduce hospital readmissions.
Entering through the church doors
Memphis is home to more than 2,000 churches. So when leaders with Christ Community Health Services’ outreach program decided to find ways to reach the medically underserved population in the African American community in 1998, it was only natural that they chose to reach out to those people through their churches. And the Memphis Healthy Churches initiative was born.
Originally, the program was designed (and funded) to focus on increasing access among African Americans to cancer information, screening and treatment for a one-year period. Ten churches were included, and volunteers were recruited to serve as educators to their fellow churchgoers. Ten more churches signed on by the end of the first year.
However, the program was so successful that church members began asking for health information about other important issues. The program was expanded to target five key health disparities: diabetes, cancer, HIV/AIDS, obesity and cardiovascular disease.
Today, 100 churches participate in Memphis Healthy Churches. Their representatives are trained and committed to determine the health education needs of their congregations and find ways to meet those needs. The program also provides recognition for the volunteers.
Oliver noted that many of the churches have even established health ministries and allocated funding for them out of their church budgets.
“That’s an outcome that I’m really proud of,” she said.
“Another reason it’s successful is that the education we provide is evidence-based,” she said, noting that the program provides ongoing mandatory education for the congregational health educators, who submit regular reports on the five health disparities.
Keeping watch over patients at home
Launched in 1999, the Heart Failure Program at St. Mary’s Duluth Clinic Heart Center is a multidisciplinary program that incorporates chronic care and disease management principles and home telemonitoring for high-risk patients.
Linda Wick, NP, is one of two nurses featured in the AHRQ's video series which features health care innovators making a difference in their communities.
The goal of the program is to provide better disease management and thus reduce complications and reduce or prevent hospital readmissions. And it depends on nurses for its day-to-day success.
Patients are carefully monitored on an outpatient basis according to protocols set up to insure they receive the appropriate management. And higher-risk patients also receive telemonitoring services between clinic visits. Thanks to the remote monitoring system, days don’t slide by when the patient’s health worsens and no one knows about it.
Each morning, 200 of these higher-risk patients step on a scale in their homes. Their weight is electronically transmitted to a nurse’s computer in the St. Mary’s clinic, where that information is tracked. These patients have been determined to need closer monitoring.
If a patient’s weight shoots up overnight, a nurse is alerted that something may be wrong, and she calls the patient to find out what happened. When necessary, she helps the patient figure out if he needs to take an extra 20 mg of Lasix or boost his potassium supplement.
Not only has the clinic been able to demonstrate a reduced admission rate and a reduced length-of-stay rate for its patients, but the patients say that they like the coaching provided by the program nurses, said Wick.
“We are patient advocates first and foremost, and I think patients recognize that,” she said.
Modeling success for others
The AHRQ video series won three Bronze 2011 Telly Awards in an international competition. It also won a 2010 Aegis Award for Training/Education.
“We’re very proud of this,” Consalvo said.
Consalvo noted that the featured programs can be replicated in many other communities, too.
“You may have to tweak it a bit to work in your setting,” she added.
The videos can serve as examples of how people can find ways to address health disparities or other issues in their communities, and that alone can be inspiring for many others.
As a nurse for more than 40 years, Oliver said she would encourage other nurses who are interested in finding innovative solutions to “think outside the box.”
“You have to be creative and think about the knowledge we have of the whole person…to reach those people who are most at need,” she said.
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