Jennie Chin Hansen, chief executive officer of AGS, delivers the Norman and Alicia Volk Lecture in Geriatric Nursing.Delivering the 5th Annual Norman and Alicia Volk Lecture in Geriatric Nursing, Jennie Chin Hansen, RN, MS, the chief executive officer of the American Geriatrics Society (AGS), eloquently challenged her audience to renew their efforts to ensure that older adults receive better care in hospitals, in their communities, and at home.
A crowd of more than 300 nursing students, faculty, and guests attended the recent lecture at New York University’s College of Nursing. The topic was “Health Care Today and Tomorrow: How Can We Make a Difference?”
Jennie argued that nurses hold critical leadership positions across the country and are essential to achieving the Triple Aim goals of:
1. improving the patient experience of health care;
2. improving the health of populations; and
3. reducing the per capita cost of care.
The John A. Hartford Foundation, she commented, has been at the forefront of this effort in both its model development efforts and in academic geriatrics workforce education.
One of the most important nursing innovations to help achieve the Triple Aim, funded by the Hartford Foundation and developed and disseminated by NYU’s College of Nursing, is Nurses Improving Care for Healthsystem Elders (NICHE). NICHE is the leading nurse-driven program designed to help hospitals improve the care of older adults. Its mission is to provide the principles and tools to change the culture and practice in hospitals to ensure that all older people have patient-centered care. To date, 450 hospitals in 45 states and four Canadian provinces have earned the NICHE designation.
Nurses, Jennie reported, also play a critical role in the development and dissemination of many other innovative efforts aimed at providing better care to older adults, including Hospital at Home (Bruce Leff, Johns Hopkins), Acute Care for Elders (ACE), and programs addressing transitional care issues, such as Project RED and Project BOOST, and the care transitions models being actively disseminated by Eric Coleman and Mary Naylor.
Passage of the Affordable Care Act, Jennie argued, which emphasizes innovation, payment reform, and greater cost-effectiveness, provides a unique opportunity for all health professionals, hospitals, insurers, employers, patients, and their advocates to come together to provide better and less costly care for all.
As an example, she described the Centers for Medicare and Medicaid Services’ (CMS) Partnership for Patients initiative, a public-private partnership working to improve the quality, safety, and affordability of health care for all Americans. The Partnership and its more than 3,700 participating hospitals are focused on two primary goals: making health care safer and improving care transitions.
This initiative aims to decrease hospital-acquired conditions by 40 percent and hospital readmissions by 20 percent by the end of 2013 compared to 2010. The program has identified 10 core patient safety areas to address—many of particular concern to older adults—such as adverse drug events, catheter associated urinary tract infections, injuries from falls and immobility, and pressure ulcers.
Looking ahead, Jennie identified the use and further development of technology as a game changer. For example, mathematicians using voice technology are beginning to help diagnose Parkinson’s. And GeriJoy, a “talking dog,” is being “taught” to provide virtual companion services to seniors. An MIT startup, GeriJoy is being programmed to incorporate more supervisory and emergency alert functionalities into its service in response to a recent incident in which the company’s virtual talking dogs saved a home-bound older adult from an abusive paid caregiver.
Norman and Alicia Volk funded the lecture series, now in its 5th year.Jennie noted there are also important movements under way to refocus how we think about health professionals and sites of care, which often act as single entities when they need to work collaboratively. The health care system is also moving from caring for an individual “dependent patient” to a focus on patients, families, and caregivers who are informed and involved in decisions regarding their health and quality of life.
In the future, we must also continue to break down the silos in which different health professionals and health care organizations are educated, trained, and operate.
Jennie concluded her remarks by challenging her audience to be leaders with “tenacity that can swim through ambiguity, to do things right and to do the right things.” Nurses and other health professionals must ask patients “what matters to them” instead of “what’s the matter with them” and ensure that patients are treated in the most appropriate health care settings in a cost-effective and person-centered manner.
Norman (our Board Chair) and Alicia Volk, who funded this lecture series, were thanked for their support, which has enabled the NYU College of Nursing to invite nursing leaders from across the country to serve both as role models for students and challenge students to embark on careers that will provide quality care at an affordable price to all of our citizens.