Friday, November 2, 2012

Building Healthy Relationships: Alliance Aims to Improve Health Care in Maine

Five hundred miles from Boston, nurses at a small hospital on the Canadian border participate via the web in nursing grand rounds at Massachusetts General Hospital.

Reggie Murray, RN, a staff trainer and patient educator at Northern Maine Medical Center in Fort Kent sets up a conference room so nurses can use the opportunity to learn about best practices and unique patient cases. If they miss the live broadcast, they can access the sessions in an online library and also listen to MGH Academy grand rounds that address psychiatry topics.

Grand rounds are a monthly event where a member of the hospital community or expert is asked to speak on a specific topic to educate healthcare providers, such as in the case of nursing grand rounds for the nursing community.

Traveling to Boston to attend monthly grand rounds would be near impossible, Murray says. The hospital has been showing the grand rounds for about a year, she says.

Placing nursing grand rounds online is one of the first efforts of the Lunder-Dineen Health Education Alliance of Maine. So far, at least 11 clinical sites in Maine regularly broadcast the grand rounds.

“What I am hearing is that organizations don’t have the education budgets that they used to and nurses can’t afford to pay out of their own pockets,” says Denise O’Connell, the alliance’s senior program manager. For these reasons, the alliance decided to begin with broadcasting grand rounds and continue working on future educational offerings. Topics discussed during grand rounds have included working with families to obtain “do not resuscitate orders,” which detail end-of-life wishes of patients as well as professional ethics.

The alliance is led by two Maine natives, Jeanette Ives Erickson, RN, DNP, FAAN, Mass General chief nurse and senior vice president of Patient Care Services, and James J. Dineen, MD, longtime Mass General primary care physician. It was formed in 2010, following a generous and visionary gift by The Lunder Foundation and the Peter and Paula Lunder family to the Campaign for the Third Century of MGH Medicine. The alliance’s mission is to provide opportunities for Mass General and Maine healthcare providers to collaborate even more closely.

“The motivation behind the gift is reflected in Dr. Peter Slavin’s recent remarks upon receiving the news that MGH was named the number one hospital in the United States,” says Jack Emory, president of The Lunder Foundation. “We strive together to restore health, prevent disease, preserve families, lower healthcare costs and provide access to the highest quality health care for all. It is the hope of The Lunder Foundation and the Peter and Paula Lunder family that the alliance will unleash the power of MGH to accomplish all of this for the people of Maine. The best results always come when we all work together.”

Mass General is a large urban hospital with many resources that help professional staff remain at the leading edge of their field, says Gino Chisari, RN, DNP, director of the Norman Knight Nursing Center at Mass General. Dr. Chisari explains that Mass General was asked to collaborate with colleagues in Maine to improve the flow of communication and learning, with the goal of continuing to provide outstanding nursing care in both states. Dr. Chisari says there is much to learn from healthcare professionals who work in community and rural settings.

“Everything we learn as clinicians is so we can provide better patient and family care,” Dr. Chisari says.

A needs assessment that gathered information from online focus groups of Maine nurses and physicians provided the alliance with a look beyond publically available health reports on Maine and beyond an informal gathering of information that the alliance is conducting of healthcare leaders in the state. “Our preliminary needs assessment results reveal that time and money are the most significant barriers to nurses and physicians participating in on-going health education,” says Ms. O’Connell.

The unspoken value of the alliance is not to duplicate existing programming, Ms. O’Connell explains. While the current focus area is providing health education for clinicians, the alliance’s website also posts resources about various topics for patients. For instance, veterans returning from war can find a link to the Red Sox Foundation and Massachusetts General Hospital Home Base Program, which provides clinical care and support services to Iraq and Afghanistan service members, veterans and their families throughout New England, who are affected by deployment — or combat–related stress or traumatic brain injury. There are also links to resources on diabetes, keeping children healthy and respiratory and lung health.

The alliance is working with Maine Quality Counts, a nonprofit organization, to help expand the organization’s medical home project. The “medical home” is a movement to better coordinate primary care in order to improve the quality of patient care and reduce the cost.

Challenges to providing health care in Maine include the terrain — the state’s 1.3 million residents are spread throughout the state. And, the population is aging and of lower income than other states, says Lisa Letourneau, MD, MPH, executive director of Maine Quality Counts and program coordinator.

Maine Quality Counts is looking forward to partnering with Mass General to share information and best practices, Dr. Letourneau says. “I would love to build upon the expertise in the Mass General system and to both learn from each other.”

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