This may be a running post…a list of “new” ideas that are transforming healthcare AND that nurses (and let’s not forget social workers!) have known for decade and which are finally getting the attention they deserve. Someday I will have to do a post on a paper I did for my PhD on “Rubbish Theory”. (Hint..one way things or ideas move from being perceived as rubbish to being valued as important is when they move from being associated with females [nursing? social work?] to males [medicine?]; and don’t even consider trying to convince me this isn’t still true!) BUT despite my frustration with why nurses couldn’t get these ideas out in front, we need to be glad for our patients that someone is finally noticing and start supporting these initiatives. So here is my current list of “things nurses have always known that are finally being valued in the mainstream”.
Culture of Health – the Robert Wood Johnson Foundation is putting their significant voice and money behind health as complete “physical, mental and social well-being”.
Social Determinants of health – I am certainly glad that the mainstream has finally discovered that there are things like income, education, race, and zipcode that have a negative (or positive) impact on one’s health…but did NPR really have to run a series of stories on Marketplace talking about innovative physicians who are starting to work with these issues! Honestly! I want to hear stories on NPR about nursing centers! Or lets talk about Lillian Wald and the Henry Street Settlement for goodness sake! The editors at NPR should go to Bonnie Pilon’s blog https://my.vanderbilt.edu/healthcareintheshadows. Bonnie is traveling the country collecting stories about nursing centers. Sad but true that the blog is named “healthcare in the shadows”. Marginalized patients being cared for by marginalized health care providers!
Upstream Risks – those bright medical students (see HealthBegins.org website) have discovered the concept of upstream interventions and are running with it! My personal favorite is their “Upstream Risks Screening Tool and Guide” (https://healthbegins.wufoo.com/forms/upstream-risk-screening-tool-2015/). Does anyone besides me notice that this is similar to my work on vulnerability assessment published in 2010 ….but who is complaining? It is my own fault that I thought a tool had to be valid and reliable to be published! (Another blog topic..nursing’s risk aversion and obsession with “rules”). But whether it is psychometrically sound or not, the Risk Screening Tool is a great idea (I can say that since I had the same idea :)) and we should incorporate some version of it in our practice.
Complex Care Management – you should all take the time to read the Commonwealth Fund Issue Brief from August 2014, “Caring for High-Need, High-Cost Patients: What Makes for a Successful Care Management Program? http://www.commonwealthfund.org/publications/issue-briefs/2014/aug/high-need-high-cost-patients” . This is strong information you can bring to administration to support the ROI on complex case management interventions. A great business opportunity for nursing!