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Exploring Physical Therapy Solutions: Expert Insights

Image: A physical therapist working with a patient, providing one-on-one care and guidance during a rehabilitation session. The therapist is assisting the patient in performing exercises to improve mobility and strength.

Written with the contributions of Linda Robinson, MSN, RN, CPXP, and Grace Schore

October marks National Physical Therapy Month, a dedicated time to recognize the pivotal role of physical therapy in patient care. With their expertise in strength training, core exercises, and a range of therapeutic techniques, physical therapists play a vital role in healing the body and enhancing well-being. They empower patients with invaluable tools to consider in their treatment journey, fostering holistic and effective approaches to recovery and preventive health. This month serves as a reminder of the profound impact physical therapy has on the lives of countless individuals seeking to improve their quality of life.

Linda Robinson, MSN, RN, CPXP, Vice President of Clinical Excellence at MDM Healthcare , recently hosted the dynamic physical therapy duo, Andrea Brogden, PT, DPT, and Amy Godfrey, PTA, on our podcast, PX Space.

Brogden and Godfrey, members of the dedicated team based at CORA Physical Therapy in Ponte Vedra Beach, Florida, collaborate to address their patients' physical limitations and concerns.

Brogden underscores the significance of understanding each patient's unique goals during the initial diagnosis.

"These goals can be as straightforward as the ability to comfortably roll out of bed, rise from a chair, or even run a marathon.”

She utilizes these goals as a guiding beacon, fostering a realistic perspective.

“We’re not aiming for a marathon next week; but let’s consider it six months down the road,” she said.

The team employs various metrics, including pain levels and incremental weekly objectives, alongside regular reassessments to monitor the patients’ advancements during their treatment.

"We assess factors such as range of motion, muscle strength, and overall mobility, all aligned with achieving those set objectives," Brogden noted.

One of the topics discussed was treating back pain, which, according to Brogden and Godfrey, is one of the primary concerns shared by those seeking treatment at their clinic.

“It is a very prevalent and common complaint reported by at least 65 million Americans. In fact, about 23% of the world's population suffers from back pain. Back pain can stem from something super mild to incredibly significant, and it can be very traumatic in our lives,” said Brogden.

As the evaluating therapist, Brogden's role is to determine the cause of pain. From there, she creates a treatment plan that Godfrey executes.

“We like to align the body first because when a patient is not in alignment, that can cause shooting pain into the lower or upper extremities. After we get everything aligned, we work on strengthening the core, starting with gentle exercises before progressing,” said Godfrey.

Godfrey discussed how she builds on the progress patients make with each session. As the treatment progresses, patients are gradually challenged to try some Pilates-inspired moves to build core strength.

Both Brogden and Godfrey agree that patients need to feel involved and in control of their treatment.

“I feel like that brings a lot of comfort to a patient, knowing where they are in the process and how we’re going to heal it,” said Brogden.

New tools have recently emerged to help patients in the office. Godfrey is trained in both Augmented Soft Tissue Manipulation (ASTYM) and Graston. These techniques find restrictions in soft tissue and can regenerate them at an accelerated rate. While stimulation was a popular technique in the past, Brogden noted that the team uses a range of techniques in their treatment plan, including dry needling. Dry needling is a technique similar to acupuncture, where small needles are inserted into muscle “trigger points” to relieve pain and irritation. Brogden has recently been certified in dry needling.

Pictured is the team at CORA Physical Therapy, Ponte Vedra Beach Amy Godfrey, PTA (left) and Andrea Brogden, PT, DPT, (center)

Brogden and Godfrey also emphasize patient education, recognizing the importance of keeping clients well-informed about their progress.

Brogden stressed the importance of teaching patients exercises that can be completed in their own homes. This is made easier with an online platform that includes videos on how to exercise correctly and information on the therapy’s benefits.

This is an invaluable tool for patients because good form and proper body mechanics are some of the biggest defenses against back pain. Brogden urged back pain sufferers to consider that daily movements can cause worsening damage if patients are not careful.

According to Godfrey, education is a key part of their patients’ success.

"We educate you from day one on proper body mechanics and proper form, then send you home with a home exercise program," she said.

Utilizing technology, patients have the capability to access their treatment plans from the comfort of their own homes, empowering them to take charge of their own recovery.

Image: A nurse and a patient interacting with patient engagement technology Journey PX, engaged in a collaborative healthcare discussion, sharing information, and utilizing digital tools to enhance the patient's healthcare experience.

Journey PX: Streamlining Recovery

According to Godfrey, technology allows for a personalized approach to patient education. MDM Healthcare's cloud-based patient engagement platform, Journey PX, streamlines communication between patients and clinicians. Products like Journey PX's My Stay offer a helping hand to patients, empowering them with vital health education. With a large library of educational videos, patients are just a tap away from the answers. For more information about how Journey PX can help elevate your patient experience, schedule a free demo with us today.

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Physical therapy plays a vital role in both healing and educating patients, serving as an integral component of a holistic approach to healthcare. By focusing on the body's natural ability to recover and adapt, physical therapists help patients regain mobility, reduce pain, and enhance overall well-being. Through personalized treatment plans, patients are not only guided through exercises and techniques to address specific conditions or injuries but are also empowered with knowledge about their own bodies. This education empowers individuals to take an active role in their healing process, fostering long-term health and preventive measures. In this way, physical therapy addresses not only the immediate physical concerns but also promotes a comprehensive understanding of one's health, ensuring a more holistic and sustainable approach to care. Utilizing technology, patients have the capability to access their treatment plans from the comfort of their own homes, empowering them to take charge of their own recovery.

Exploring Physical Therapy Solutions with Andrea Brogden, PT, DPT, and Amy Godfrey, PTA CORA Physical Therapy

For more insights on this topic, listen to the complete PX Space podcast interview below.

Eradicating Incivility in Nursing: Connie Montalbo on Preventing Toxicity Through Strong Leadership

Image: A joyful hospital care team working collaboratively under the guidance of strong and compassionate leadership.

Written with the contributions of Linda Robinson, MSN, RN, CPXP, and Grace Schore

In a recent article published by the National Institute of Health (NIH), it was revealed that the incidence of incivility directed at nurses had exceeded 46%, with one-third of nurses reporting exposure to physical violence. Despite nursing consistently ranking as the most trusted profession, the issue of incivility remains a persistent challenge.

Nursing leaders are taking proactive measures to address workplace incivility, and in a recent discussion, Linda Robinson, VP of Clinical Excellence at MDM Healthcare, spoke with nurse executive and incivility expert Connie Montalbo, DNP, MBA, RN, NEA-BC.

Montalbo is a distinguished Nurse Executive with decades of experience. With an impressive career spanning multiple healthcare settings, she is a dynamic leader and change agent dedicated to fostering a more respectful and collaborative culture within the nursing profession. She is also an Incivility Expert and founded "End Incivility Today" in February 2019, a platform where she applies her expertise to address the pervasive issue of incivility in nursing. Her mission is to coach leaders in putting an end to passive leadership and disruptive behavior, emphasizing that doing so will not only improve the workplace culture but also positively impact quality of care, staff engagement, and financial outcomes. Prior to her entrepreneurial endeavor, Connie served as the Chief Nursing Officer and Vice President of Clinical Operations at B.E. Smith, overseeing various clinical areas for over five years. Her career also includes significant roles as a Nurse Executive at a variety of hospitals. Her extensive experience in diverse healthcare settings, coupled with her dedication to ending incivility, makes her a valuable asset to the nursing profession.

Image: A stressed nurse in a healthcare setting, reflecting the challenges and pressures of the profession.

Montalbo illustrated the intricate nature of incivility within the nursing profession, emphasizing that nurses grapple with a myriad of stressors, including the demands of patient care. Furthermore, the workforce shortages resulting from the challenges posed by the COVID-19 pandemic have only served to exacerbate this already complex issue.

"I think there are just so many pieces to it. People come into the nursing profession from all walks of life; they bring their own personal stress into the workplace, then they face so much stress in the workplace. In addition to that, they have patients to take care of, the patients' families, the physicians, the leaders, their coworkers; there is just so much going on a nurse's plate all day every day that it is almost like a breeding ground for stress," she said.

Montalbo further explained that incivility comes in many forms, including toxic workplace behavior that ranges from eye-rolling to physical abuse, often stemming from impatience in stressful situations. Incivility disrupts communication, a critical element in the healthcare profession.

Image: A stressed nurse in a hospital setting, symbolizing workplace incivility and its impact on healthcare professionals.

Montalbo explained that the consequences of incivility could be devastating. "There's research out there that documented the impact, which could amount to patient harm and even documented patient death from uncivil behavior. There was high nurse turnover, PTSD, civil litigation for an organization for allowing it to go on. There were also financial costs and emotional costs."

Montalbo stated that the challenge in dealing with the root causes of incivility lay in finding healthy ways of coping with the everyday stresses nurses faced. "The challenge for us in leadership is how do we create the environment and set the expectations that will cope in a more healthy way that's respectful and that doesn't impede on the coworkers," she said.

Montalbo named stress, poor colleague communication, and passive management as the root causes of this issue. She emphasized the need to address this stress and the challenges the healthcare industry faces.

Robinson and Montalbo discussed an alarming cycle where management tends to avoid assigning tasks to toxic nurses, which places an excessive burden on more professional nurses, leading to burnout and impatience. This cycle could even be perpetuated by other colleagues and contributed to the stress faced by nurses.

Another issue highlighted was the phenomenon of nursing's habit of discouraging new graduates with a toxic work environment, referred to as "eating their own young" in nursing culture. Montalbo emphasized the need to support those who were uncomfortable with confrontation.

In her doctoral project, Montalbo worked on improving nursing employees' communication by requiring disputes to be confronted within the employees' comfort zone. She asserted that leaders must set healthy precedents for coping with stress and enforce those expectations.

Montalbo recommended that leaders avoid using phrases like "that's just how she is" or "but he's a really good nurse," which she believed perpetuated incivility. She stressed the need to hold individuals accountable for their behavior, not just implementing new policies.

Leaders have the power to combat the issue of overloading "nice" nurses by ending passive behavior. Often, toxic employees feel out of control and need mentorship to change their behavior positively.

In the pursuit of creating a safer and more nurturing hospital environment, Robinson suggested harnessing technology as a valuable tool. For Robinson, the key was leveraging technology as a resource to optimize nurses' time, streamline clinical workflows, and maintain a personal touch in patient care.

MDM Healthcare is committed to supporting nurses and healthcare teams during these challenging times by providing innovative technology solutions. Journey PX, MDM Healthcare’s patient education and engagement solution, empowers medical teams to streamline clinical workflows by automating and simplifying the patient education process, offering video connections in patient rooms, and handling non-clinical tasks. This ensures that patients receive the necessary information while freeing up valuable time for hospital nurses and healthcare team members.

Journey PX, MDM Healthcare’s patient education and engagement solution, empowers medical teams to streamline clinical workflows by automating and simplifying the patient education process, offering video connections in patient rooms, and handling non-clinical tasks.

Enhancing the work environment for nurses can have a significant impact, particularly by enabling them to optimize their time effectively. Fortunately, healthcare organizations today can harness the potential of technology like Journey PX to support overburdened medical professionals.

The insights offered by Montalbo underscore the multifaceted issue of workplace incivility in nursing and highlight the importance of leadership, technology, and collective efforts in creating a safer, more supportive healthcare environment. Additionally, she emphasizes the significance of addressing nurses' well-being, offering mentorship, and readily available resources to combat nursing burnout and enhance the patient care experience. For a comprehensive exploration of this topic, listen to the complete PX Space podcast interview below.

Dr. Connie Montalbo, a distinguished nursing executive who is on a mission to eradicate incivility in nursing. Dr. Montalbo is an interim nurse executive for BE Smith, and she's also the Founder & CEO of End Incivility Today.

Written with the help of contributing author Linda Robinson, MSN, CPXP, RN, Vice President of Clinical Excellence, MDM Healthcare

Surveys year-after-year report in the United States that blindness ranks in the top 3 of most feared health problems along with cancer and AIDS. Tragically, the Centers for Disease Control and Prevention (CDC) reports that approximately six million Americans have vision loss and one million have blindness. More than 1.6 million Americans who are living with vision loss or blindness are younger than age 40.

MDM Healthcare VP of Clinical Excellence Linda Robinson, MSN, CPXP, RN recently sat down with David G. Miller, MD, President and Medical Director of Cleveland Eye and Laser Surgery Center, to discuss ocular health, chronic eye diseases, and groundbreaking care to slow the progression of vision loss, prevent blindness, and even restore sight.

“Twenty-million people and growing with this disease; really, it's one of those fascinating statistics where the number of people are showing some signs of age-related macular degeneration may be 10% at 70, 25% at 80, and 50% of people hitting their 90s show some signs of age related macular degeneration,” said Dr. Miller. “So, if you're fortunate enough to have a long life, these things are just a much more likely risk.”

According to Dr. Miller, the realm of retinal surgery and diseases has increasingly shifted its focus toward macular degeneration over the past few decades. This heightened emphasis is largely tied to the aging demographic. The formal term for this condition is age-related macular degeneration (AMD), which has a genetic component prevalent in specific families and is notably linked to the aging process. This requires two key factors to align: a familial history of the condition, or the inheritance of specific genes from both parents, coupled with living long enough to encounter the ailment.

Given the rising lifespan of individuals, including the elderly population and the generation of baby boomers, more people reaching their 80s and 90s than ever before, macular degeneration has substantially grown into a prevalent diagnosis. Robinson spoke of her father’s struggles with AMD—most notably the inability to see what was in front of him, decreasing his quality of life. Losing the ability to drive, enjoy sports, and watch TV was extremely difficult for him. This, coupled with hearing loss, limited his ability to interact with the world around him. Robinson could tell that her dad felt very isolated because of his loss of sight.

“A disability acquired late in life, along with the whole aging process; it can bring on a lot of mental changes including possibly depression, which maybe your father was suffering from, whether it's hearing loss or visual loss, or your mobility as an elderly person,” said Dr. Miller. “Losing the freedom you used to have in life can be quite life-altering, and naturally quite depressing.”

These types of symptoms are not uncommon to see with AMD patients.

Dr. Miller describes the visual field of a patient with AMD.

“The macula is the center part of the retina, the retina is the inside lining of your eye. And it's kind of like the film screen in a movie theater. It's where the image is projected so that your brain can see it. And if you can imagine the middle of the movie screen being kind of pockmarked or moth eaten. That's what you're seeing when you're a macular degeneration patient. And as the disease progresses, those, mothy areas kind of coalesce together and form one big blank spot in the middle of vision, these patients can drop to the level of what is called legal blindness.”

He further describes how patients can navigate through a room and can see through their peripheral vision that someone has entered a room but cannot recognize their face. Patients over time become unable to read, write checks, watch TV, drive, etc. They can, however, function in their own home but require assistance.

Dr. Miller went on to explain the two types of macular degeneration.

“There's dry disease, and there's wet disease. And people often confuse the term dry eye with dry macular degeneration. That's completely unrelated, and dry eye is a very common condition.”

He explained, the term dry macular degeneration is used in contrast to wet macular degeneration. Both conditions affect the same part of the retina, known as the macula. In dry macular degeneration, the macula experiences a gradual deterioration, similar to “hair loss or balding.” The cells within the macula progressively decrease in number, leading to what's referred to as atrophy.

On the other hand, he explains, wet macular degeneration often follows a prior phase of dry disease.

“The macula responds to losing those patches of the macula, your eye tries to almost heal itself and grows abnormal blood vessels into that space that then break open leading to bleeding and scarring. So, the breaking open, bleeding, and leaking are the terms that go with wet macular degeneration.”

He continues to add that both types can result in similarly poor vision over time. Wet macular degeneration tends to cause more sudden and acute visual loss, often occurring within months. Conversely, the progression of dry disease is generally slower, taking about a decade to significantly impair vision.

Fortunately, there are treatments available for wet macular degeneration, which can help mitigate the rapid vision loss associated with this form. While treatment options for dry macular degeneration are somewhat limited, there have been breakthroughs in this area as well. It's important to recognize that even though “the majority of patients experience the dry disease, the more severe damage is done by the wet disease itself.”

Robinson brought up how her father who suffered with wet macular began to see things and make up stories around what he saw. She was concerned that it was dementia, but Dr. Miller explained the phenomenon of Charles Bonnet syndrome and how it is a topic at his office weekly. He explained how the brain is kind of fabricating these images.

“You get this very fragmented image on your retina,” said Dr. Miller. “It’s the movie screen, but, you know, literally half the movie screens missing. So, your brain fills in the blanks, and makes a whole image.”

He states that patients and their families are reassured to hear that this is a natural response to macular vision loss and they are not developing a psychiatric illness. Currently there are no medications specifically targeted at addressing Charles Bonnet syndrome. He also added that it is true that losing central vision can lead to disorientation. The combination of age-related mental changes and the loss of clear vision can leave patients less connected to time, space, and their surroundings.

Dr. Miller recommends maintaining good health to prevent macular degeneration. Research indicates that people who exercise regularly, uphold healthy blood pressure levels, refrain from smoking, and maintain a nutritious diet with ample dark green vegetables exhibit a reduced risk of age-related macular degeneration. Certain vitamins also appear to offer protective effects, and there's a potential role for them in prevention. Dr. Miller also recommends monitoring your vision regularly starting in your 40s.

“Macular rarely strikes both eyes at the same time. A simple test you can do is “once a week when you're reading the Sunday paper with a cup of coffee, you close the left eye and you read the headlines and a couple of paragraphs and then your right eye and do the same thing with both eyes can do that you're probably 98% Certain nothing bad is happening. And if something is wrong, or those eyes can't read, go see someone.”

Another area of Dr. Miller’s expertise is diabetic retinopathy.

“Diabetic retinopathy is a leading cause of blindness in American adults under the age of 60 and is the most common eye disease in people with diabetes, he said”

In the United States, 37.3 million people have diabetes, and it is also increasing at an alarming rate 1-in-10 people have diabetes. Miller states that “diabetic retinopathy is the No. 1 cause of vision loss among the working age population.

“The progression of diabetic retinopathy is influenced by blood sugar control and the duration of diabetes,” he said.

Dr. Miller said in the initial five years, retinopathy symptoms are generally minimal, but they become more pronounced after this period. Significant damage occurs around the five-year mark, with signs starting to manifest. Over a decade, more individuals display signs, and by 20 years, around 95% of people with poorly controlled blood sugar experience diabetic bleeding in their eyes, even if they are not yet aware of it.

He said the severity of diabetic retinopathy depends on the duration of diabetes and the level of blood sugar control. Symptoms tend to appear late in the disease progression.

“Typically, by the time they get symptomatic, it's a very late sign of diabetic retinopathy,” Dr. Miller said

Visual symptoms include “blurred vision similar to macular degeneration, or in more advanced cases, bleeding into the vitreous jelly within the eye, resulting in floaters, cobwebs, or even complete vision loss when the eye fills with blood.”

“It’s very important to manage your diabetes every day, and to get annual eye exams,” Dr. Miller said “This is crucial because if it is detected there are treatments that can slow it down or even reverse it.”

He explained that treatment options primarily involve laser procedures conducted in the office using laser beams to safely cauterize bleeding spots at the back of the eye, ensuring no harm to vision. Additionally, a cutting-edge treatment involves injections similar to those used in macular degeneration cases. These injections can effectively halt bleeding or even reverse it through multiple injections over several years. In more advanced cases, such as when bleeding reaches the vitreous gel or retinas detach due to diabetes-related scar tissue, successful outcomes are often achieved through surgery in the operating room.

Most retinal detachments are linked to aging rather than trauma, contrary to belief. Most of these cases are associated with the natural aging of the vitreous gel within the eye. As the vitreous gel in the eye ages, it shrinks and thins within a surrounding sack. Over time, this gel can contract abruptly, tearing the retina and causing symptoms like “flashing lights, some little lightning bolts and floaters.” Timely, medical attention is crucial, as small tears can be treated with laser therapy, preventing detachment. If left untreated, the retina can detach.

“The retina falls off of the back of the eye, almost like wallpaper coming off a wall,” said Dr. Miller. “Retinal detachment requires more complex surgical intervention.”

He discusses how one common treatment to fix a retinal detachment involves removing vitreous fluid and replacing it with a gas bubble to push the retina into position for healing. Maintaining the face-down recovery position is essential for successful healing. This positioning, often for about a week, aids the gas bubble in pressing against the retina for proper healing. Various equipment, including massage tables and specialized chairs, can assist patients in maintaining this position during recovery. Dr. Miller said this is “pretty challenging, but most people pull it off.”

Recently, Dr. Miller was invited to join Akron Children's Hospital Medical Center in Ohio as a retinal surgeon in their pediatric ophthalmology department. His interest was piqued by the “groundbreaking genetic treatments for children born blind.” These treatments involve injecting a virus under the retina to alter DNA, leading to restored vision. This type of genetic treatment is already approved, and there is more new technology on the horizon. This technology is also being adapted for adults, offering a long-term cure with a single injection.

This advancement in genetics is transforming medicine, promising significant improvements in treating genetic defects and enhancing pharmacotherapy.
“It's a very exciting time in medicine,” Dr. Miller said. “Genetic alteration genetics supplementation is going to be really quite remarkable over the next couple of decades in terms of both pharmacotherapy and correcting genetic defects for people.”

He said the potential to restore lifelong sight for pediatric patients is incredibly promising.

“Many brilliant minds are working on these advancements, and I'm confident we'll see significant progress in the next decade.”

For eye health Dr. Miller recommends to do what your mom always told you.

“Eat healthy, exercise, don’t smoke, and be aware of your body. If something isn’t right in your vision you're checking it, you’re getting it checked out. Don't ignore it!”

David G. Miller, MD serves as the President and Medical Director of Cleveland Eye and Laser Surgery Center, the largest retinal surgical facility in the region. He completed a vitreoretinal surgery and diseases fellowship at the Massachusetts Eye and Ear Infirmary, an international center for treatment and research in addition to a teaching hospital of Harvard Medical School. Best Doctors Inc. has recognized Dr. Miller in its list of top retinal disease specialists every year since 2011. He is a charter member of the prestigious Retina Hall of Fame and is a Vitals Patients' Choice Award winner. Dr. Miller’s principal areas of interest are diabetic retinopathy, retinal detachment, and macular degeneration and he has also recently joined Akron Children’s Ophthalmology as a retinal surgeon. Dr. Miller participates in many research studies and speaks locally, nationally, and internationally about vitreoretinal diseases.

To delve deeper into Dr. Miller's insights, you can listen to the full PX Space podcast interview below.

By Ashton Elder and Linda Robinson, MSN, CPXP, RN, Vice President of Clinical Excellence, MDM Healthcare

In the current landscape post-pandemic, US hospitals find themselves grappling with formidable challenges. The pandemic has exacerbated an anticipated shortage of nursing labor and has placed added strain on an already fragile healthcare system. This strain bears the potential to adversely affect patient outcomes and amplify health disparities. At the core of the healthcare system, nurses are experiencing unparalleled stress, burnout, and uncertainties regarding their profession. In this context, it becomes imperative to explore avenues to enhance the healthcare system's functionality for the betterment of all.

Linda Robinson, MSN, RN, CPXP recently engaged in a conversation with Ramona Cheek, the Vice President of Nursing Transformation and Innovation at Bon Secours Mercy Health. Cheek introduces her pioneering research initiative, 'the way we work,' poised to reshape the entire care process, pledging enriched experiences for patients, nurses, and healthcare practitioners alike.

“We know that healthcare and nursing, especially the nursing workforce, have changed. We at Bon Secours Mercy Health have realized that the traditional approaches to staffing and organizing care delivery are not going to work in the future. So, the way we work initiative was born with the intent to reimagine care to provide care for the future,” she said.

This initiative seeks to reimagine the care process, ensuring enhanced experiences for patients, healthcare professionals, and all individuals engaged with hospitals. This innovative drive originates from Cheek's unwavering commitment to heed the voices of nurses who ardently expressed their longing for more quality time dedicated to patients.

“We started the initiative really simply and it was by going out and listening to the voices of nurses, and what we heard from the nurses resoundingly is that they want more time, they want more time to be with patients, to care for patients, to learn about caring for patients,” said Cheek.

The 'the way we work' initiative is fueled by the mission to recapture valuable time for nurses and is built upon four robust pillars, all underpinned by technology and digital solutions.

Cheek explains, “The way we work initiative is built on four pillars and a beam because I think the beam that supports all the other pillars, is, of course, technology and digital solutions. We know that in order for us to do things more efficiently and effectively, we are going to have to employ technology, we know that human resources are at a premium, and we are competing for that ever-shrinking pool of the best and the brightest for human resources. So, technology is going to have to be an enabler that really goes across our other pillars.”

Cheek highlighted the four foundational pillars underpinning this transformative initiative:

Revolutionary Care Delivery Models

The first pillar delves into revolutionary care delivery models.

"We must scrutinize diverse care delivery models and roles, asking ourselves which models will guide us into the future."

Streamlined Workflows and Communication

The second pillar encompasses streamlined workflows and communication.

"We recognize the necessity to reshape workflows and communication. We must shatter the barriers and comprehend our professional responsibilities, scope of care, and practice. This process will facilitate an environment of energy and synergy, allowing us to perform at the pinnacle of our training and education, delivering what our patients anticipate."

Support for New Nurses and Addressing Turnover

The third pillar centers on providing unwavering support for new nurses and addressing the pressing concern of swift nurse turnover.

"We are witnessing an influx of young professionals in the field, while experienced nurses are departing. We must ascertain how to furnish support to these newcomers."

Well-being of Nurses and Flexible Schedules

The fourth pillar concentrates on nurturing nurses' well-being, incorporating flexible work schedules to foster a healthier work-life balance.

"Our well-being holds significance, and achieving work-life integration is crucial. Our work environment must cater to these aspects."

It's vital to underscore that these pillars are all fortified by the beam of technology.

"Artificial intelligence in medicine and nursing will revolutionize our methods." This resonates with the transformative potential of technology in reshaping patient care. One such example is Journey PX, a state-of-the-art, cloud-based patient experience platform, heightening patient engagement throughout the care continuum. Journey PX aligns with all the pillars delineated by Cheek in the 'the way we work' initiative.

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Optimizing Technology to Fit the Needs of Nurses

The conversation extends to the realm of virtual care. Cheek ponders, "Can a virtual nurse serve as an expert resource for new nurses in need of support?" This question reflects the innovative approach of utilizing virtual nursing to address the challenges posed by physical limitations.

Technology such as Journey PX Connect provides hospitals with the ability to bring additional experts to give that added layer of support. Journey PX’s Connect solution enables video calling for patients and families. The solution also provides a secure connection that allows for virtual visits and rounding by providers, nurses, other clinicians, and authorized staff. All of this is done through the patient’s TV in the room.

The interoperability of devices emerges as another significant consideration. Cheek elucidates, "Interoperability and stack ability are pivotal. Devices need to multitask, replacing individual devices addressing specific needs."

Journey PX solutions operate through the patient’s in-room TV. These solutions prepare patients for discharge by ensuring they remain informed about their daily care plans, receive tailored education, and streamline communication among patients, families, and care teams. The platform facilitates bedside shift reports, a cornerstone of quality and safety.

Time-in-Motion Study

Cheek's time-in-motion study reveals that time wastage by nurses predominantly occurs in medication and documentation tasks. Journey PX responds with tailored meds-to-beds programs, integrating with Electronic Medical Records (EMR) and engaging patients at the bedside to enhance medication health literacy. Additionally, Journey PX saves nurses valuable time when it comes to documentation as all of the information is updated in real-time and allows care teams to hardwire bedside shift reports and create LEAN clinical workflows.

Concluding her insights, Cheek offers a final reflection on the journey.

"The biggest realization is that these aren't challenges to solve, but dilemmas to manage."

She underscores the importance of nurses' voices and the trust they place in administrators to foster an environment conducive to patient care.
To delve deeper into Ramona Cheek's perspectives, you can listen to the complete PX Space podcast interview below.

Written with contributing author Linda Robinson, MSN, CPXP, RN, Vice President of Clinical Excellence, MDM Healthcare

Recently, MDM Healthcare VP of Clinical Excellence, Linda Robinson, MSN, RN, CPXP, conducted an exclusive interview with renowned Medical Oncologist and Hematologist, Philip D. Leming, MD. With a remarkable career that includes co-founding the medical oncology department at The Christ Hospital and leading the Christ Hospital Cancer Research Program, Dr. Leming currently serves as the Medical Director of Cincinnati Cancer Advisors, an organization that provides comprehensive and compassionate care to individuals and families affected by cancer. In its quest to enhance cancer care and treatment in the region, Cincinnati Cancer Advisors extends a free second opinion cancer service to members of the Greater Cincinnati community. Additionally, CCA offers consultative oncology services and financial assistance through a partnership with the Patient Advocate Foundation.

In their conversation, Dr. Leming emphasized his philosophy of approaching cancer treatment with a curative mindset.

“Even the worst of all cancers are curable until proven otherwise,” he said.

He also stressed the significance of treating patients with dignity, highlighting the importance of compassionate care and actively listening to patients.

“Oftentimes it’s the simple things that make a difference in patient care such as practicing with compassion or just listening to patients,” he said.

Dr. Leming also shared his practice of getting to know patients beyond their illness, recognizing their individuality and reminding them of the importance of their lives.

“Something that transcends both human and neuroscience is that when someone comes in no matter how old, ill or debilitated, you want to connect with the patient as a human being and give them a reminder of the individual importance of their life,” he said. “It’s important to be able to communicate with patients and get to know them and by doing that you actually get more valuable information to help treat them.”

Drawing on his experience, Dr. Leming highlighted the art of bedside care, emphasizing the value of simplicity in communication and providing patients with a clear understanding of their condition.

“You learn who the person is by listening to them, gauging their anxiety, talking with their family, and trying to put the illness you are being asked to review in perspective,” he said. “The basic part is trying to make things simple for people, care providers should be able to explain most illnesses in an uncomplicated way.”

He advocated for a servant leadership mindset in healthcare, emphasizing the role of healthcare providers in reducing suffering and instilling hope.

“You are there to help, to serve, try to reduce suffering and provide hope. Ideally all the leadership in healthcare should have this mindset,” he said.

Additionally, Dr. Leming discussed the parallels he sees between medicine, music, and martial arts, emphasizing the importance of mastering the fundamentals and approaching each discipline with precision and accuracy.

“Medicine is like music and martial arts; you can never master it, and it has been around for centuries,” he said. “The master, or the sensei in martial arts, does the basics correctly every single time. It’s interesting we think the master must be extraordinarily complex, but a concert pianist will sit down and practice the scales and a martial artist will practice the Kata slowly. Anyone who has done either martial arts or music will tell you that it is much harder to do things slowly and accurately than it is to speed through things, and the same philosophy applies to the application of the art of medicine.”

To delve deeper into Dr. Leming's insights, you can listen to the full PX Space podcast interview on major podcast platforms or by clicking the icon included in this feature article.

Written with contributing author Linda Robinson, MSN, CPXP, RN, Vice President of Clinical Excellence, MDM Healthcare

Dr. David Fryburg is driven by a profound mission to champion kindness, viewing it as a force more potent than any pharmaceutical drug he has encountered in his extensive years in the healthcare industry. In a recent podcast episode of PX Space, host Linda Robinson, MSN, RN CPXP, engaged in an enlightening conversation with Dr. Fryburg, who serves as the co-founder of Envision Kindness. This non-profit organization is devoted to harnessing the influential power of kindness through the art of photography and storytelling.

With a wealth of experience as a physician and scientist, Dr. Fryburg's journey has been shaped by his tenure as a faculty member at the esteemed University of Virginia Medical School and his work in the biomedical industry with reputable organizations like Pfizer and the Foundation for the National Institutes of Health. Leading teams of scientists in groundbreaking studies on new medicines and improved diagnostic methods, Dr. Fryburg's invaluable contributions to the medical field have earned him numerous grants and awards.

Envision Kindness was born out of Dr. Fryburg's firm belief in the need to shift focus towards the positive aspects of life. Recognizing the unique ability of positive pictures and stories to inspire, connect, and heal, the organization strives to bring these uplifting moments directly to people's lives. Through their endeavors, they aim to create a world where kindness takes center stage, cultivating an environment of empathy, compassion, and joy.

“Our mission is to promote kindness, connection, and joy for people on a population scale, particularly in high-stress settings like healthcare, and we do it through media which works really well and really fast,” he said.
Dr. Fryburg explained his mindset when he decided to start Envision Kindness. “As an endocrinologist, while leading these teams of scientists, I found myself getting saddened, stressed, and anxious in proportion to how much news I was consuming. Research showed that consuming news this way can quickly make people feel sad and stressed, affecting their own lives. So, that made me think that’s really not fair… people deserve a higher quality of life,” he said.

To generate their healing images, Envision Kindness took a creative approach.
“We had to build our content from scratch. The way we ended up building it was through creating an international kindness photography contest. We’ve done four iterations of it, and we are actually about to launch the fifth. We get over 2,000 submissions from around the world each year,” he said.
Envision’s 2022 Our World is Kind contest received over 2,500 wonderful and inspiring images of kindness, compassion, joy, and love.

“Our kindness images have a main theme, which is the positive interaction between living beings. People are uplifted and inspired by these images, and that improves mood through media,” he said. Dr. Fryburg further explained some of the science behind kindness.
“Since I’m a scientist, I decided to do more than produce the images; I also studied their impact. We were very fortunate to have a team of psychologists help conduct our first study using still images of kindness. In that study, what blew everyone away was that kindness images had twice the effect of pretty images, such as nature images, on people’s mood when it came to producing feelings of gratitude, sympathy, compassion, and love,” he said.

The results were so powerful that the statistician who examined them had never seen data like this before.
“The results were so overwhelming that they screamed 'pay attention, there’s something important here,'” he said.
Dr. Fryburg's deep dive into the psychology and biology of altruism revealed that kindness is an innate quality observed across every species on Earth. Several scientists have studied how kindness affects our choices in life, well-being, and more in a positive way. In fact, Dr. Fryburg mentioned that in his many years in the pharmaceutical industry, he has yet to see a drug that has the effect of kindness.

Envision Kindness stands as a compelling example of the media's potential to enhance the healthcare experience. Pioneering a cutting-edge, cloud-based patient experience platform, Journey PX is dedicated to elevating human experiences in healthcare through innovative technology solutions. Journey PX patient engagement solutions span the continuum of care, delivering scalable and cost-effective technology solutions that are adaptable to facilities of all sizes, streamlining care team operations.
With a firm commitment to humanizing care, Journey PX, like Envision Kindness, understands that media can be leveraged artfully within hospitals. Our digital signage solution, Navigate, offers versatile applications, including alleviating patient stress. Embracing the latest technological advancements, healthcare organizations can now transform the hospital environment with digital display technology, providing patients, families, and care teams a modern and immersive experience.

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MDM Healthcare offers a diverse range of Pro AV solutions that elevate various areas both within and outside hospitals. Their offerings include curved indoor DVLED displays, UHD Multi-Touch digital displays, and outdoor DVLED displays, each designed to make a significant impact. These solutions find versatile applications, such as showcasing digital donor walls and informative screens in waiting rooms, facilitating communication in reception areas, and streamlining check-ins through medical kiosks.

Pro AV solutions provide hospitals with enhanced communication techniques, enabling them to share vital health and safety information, broadcast educational videos in treatment wings, and display captivating digital artwork. Embracing Pro AV technology, hospitals can harness interactive experiences, improve wayfinding throughout hospital facilities, enable real-time information absorption, introduce modern digital art, employ robot guides, and much more. For a deeper understanding of the capabilities that Pro AV solutions can bring to your hospital organization, don't hesitate to contact us.

In a world where headlines often highlight the darker aspects of humanity, it becomes easy to overlook the profound impact that kindness and compassion can have on individuals and communities. Nevertheless, amidst the chaos, organizations like Envision Kindness strive to remind us of the beauty of human connection and the transformative power of acts of goodwill. This blog article delves into the heartwarming mission of Envision Kindness, exploring their vision, initiatives, and the positive influence they are making on a global scale.

You can hear more from Dr. David Fryburg by listening to his PX Space podcast interview. Also, learn more about Envision Kindness on their website

Written with contributing author Linda Robinson, MSN, CPXP, RN, Vice President of Clinical Excellence, MDM Healthcare

As June unfolds, we acknowledge the significance of Alzheimer's and Brain Awareness Month—a time dedicated to raising awareness about Alzheimer's disease and other forms of dementia that impact millions of individuals across the United States.

In this article, we delve into the topic of dementia care, highlighting insights from our recent PX Space podcast interview with renowned Dementia Care Specialist, Teepa Snow, MS, OTR/L, FAOTA. With her unique positive approach to dementia care, Snow offers valuable insights and strategies that can transform the caregiving experience and enrich the lives of both caregivers and those living with dementia. Snow is also the Owner and Founder of Positive Approach to Care®, an organization dedicated to enhancing the life and relationships of those living with brain change by fostering an inclusive global community. Snow’s personal mission is to better the lives of people with dementia—as well as the lives of their caregivers—by sharing what she has learned. An occupational therapist by training, today Snow stands out as a prominent global champion and educator, advocating for individuals affected by dementia or other cognitive impairments.

Snow explained why she decided to devote herself to dementia care.

“I had family members who developed dementia and I had friends who were figuring out how to support people living with dementia. I was working in a variety of settings where people living with dementia and their families were not getting what I considered good support, care information, or preparation and that’s not OK. So that got me on the road to thinking there are better ways to do this and it’s not fair that people and families don’t know that,” she said.

Snow has become a guiding light for caregivers and healthcare professionals seeking innovative ways to provide compassionate and effective dementia care. Her Positive Approach to Care™ (PAC) philosophy emphasizes the significance of connection, empathy, and person-centered care in supporting individuals with dementia. Through this approach, Snow focuses on recognizing and embracing the remaining abilities of individuals with dementia, rather than focusing solely on their limitations.

Snow firmly believes that education is the key to empowering caregivers. The diagnosis not only affects patients, but families as well. Snow pointed out that four out of five families fall apart due to dealing with the effects of this condition long term.

“This condition is devastating for families,” Snow explained. “Families often walk into the situation really unprepared to deal with more than the memory loss. However, dementia is an umbrella, it’s always more than memory. It’s judgement, problem solving, and changes in initiation,” she said.

In the interview, she discusses the importance of gaining an accurate understanding of dementia, its impact on brain function, and how to effectively communicate and connect with individuals living with dementia. By equipping caregivers with knowledge and practical skills, Snow enables them to navigate the challenges of caregiving with confidence and empathy, fostering a positive caregiving environment.

A cornerstone of Snow's approach is the concept of person-centered care. She emphasizes the need to recognize each person's unique abilities, preferences, and life experiences, allowing for personalized care that respects their individuality. Snow explains that caregivers can create an environment that promotes dignity, independence, and a sense of purpose for those living with dementia.

Communication can be a significant challenge when caring for someone with dementia. Snow shares valuable insights and techniques to enhance communication and meaningful engagement. Snow explained that the ideal skillset needed to communicate with memory care patients is often not properly taught. She gave the example of a patient being unable to recall the word restaurant: the patient says “the place where we go out to eat,” and the caregiver responds, “the place where we go out to eat, do you mean a restaurant or something else?”

Snow explains, “Instead of just giving them the word, you give them options to choose and that’s actually keeping their brain active, and it’s keeping people connected instead of flustered and confused. It’s better for the patient, but it’s also better for the caregiver as it turns out,” she said.

By adopting effective communication techniques, caregivers can reduce frustration, enhance relationships, and foster a sense of well-being for both the caregiver and the person with dementia.

Snow also encourages caregivers to focus on creating positive moments and joyful interactions throughout their caregiving journey. These moments can arise from engaging in meaningful activities and giving patients positive affirmations. Snow explained how impactful positivity is for dementia patients.

“The affirmation of ability is huge. You have to count the little wins. Finding those places and spaces to lift someone up, it actually makes their brain work better,” she said.

Snow expressed the healing power of celebrating these moments and fostering a positive atmosphere, caregivers can create a more fulfilling and enriching experience for themselves and their loved ones.

By emphasizing education, person-centered care, effective communication, and the creation of positive moments, Snow empowers caregivers to make a profound difference in the lives of those they care for. Empowering patients in their care journey is a philosophy embraced by innovative, cloud-based patient engagement platform Journey PX. Journey PX solutions empower patients by keeping them informed of their daily plan of care, providing individualized education, and streamlining communications between patients, families, and care teams. Journey PX’s digital whiteboard, My Day, Today, provides vital information to hospital care teams, patients, and their families. My Stay provides patients with the education they need via access to an extensive education library. This allows patients to become more empowered through health literacy and enhances their readiness for discharge. It also helps support patients after discharge by providing education that can be texted to them, giving an added layer of assurance that they will not be readmitted. Journey PX’s virtual care solution, Connect, is another piece of technology that supports the overall health and well-being of the patient, by allowing patients access to family members and care experts virtually at the bedside.

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You can hear more from Teepa Snow by listening to the PX Space podcast interview. Also, learn more about her organization Positive Approach to Care® by visiting their website, contacting them at info@teepasnow.com, or calling 877-877-1671 for a consultation if you are a caregiver or family member of a memory care patient.

Written with contributing author Linda Robinson, MSN, CPXP, RN, Vice President of Clinical Excellence, MDM Healthcare

The healthcare industry has continued to evolve rapidly in the wake of the COVID-19 pandemic, and in response to challenges such as workforce shortages, more complex patient cases, and the rise of telehealth.

Some industry professionals have turned to innovative ideas about care delivery models to adapt to these challenges.

One department at the University of Louisville Health has recently adopted a new interdisciplinary care team model that places pharmacists at the bedside with a patient assignment in an unconventional role, adding another expert to the bedside care team. The University of Louisville Health execs came up with the supplemental care delivery model program in response to the nursing shortage.

A recent study published by McKinsey and Company suggests that if there are no changes in current care delivery models, there will be a gap of 200,000 to 450,000 nurses nationwide by 2025. Conversely, for every 1 percent expansion of capacity—created through changes in care delivery models, technology-enabled productivity tools, or alternative sites of care settings for patients—the number of nurses needed would decrease by about 25,000. Recently Linda Robinson, MSN, RN, CPXP, Vice President of Clinical Excellence, MDM Healthcare, spoke with two members of the University of Louisville Health team—Tara Neuner DNP, RN, CCRN Mixed Acuity Professional Development Practitioner, and Amy Braden PharmD, BCPS Manager of Inpatient Pharmacy Operations about the topic.

Braden explained that the University of Louisville Health executive leadership team considered various ideas, and ultimately decided to bring in pharmacists, who are medication experts, onto a unit to become more directly involved with patient care, providing patients with not only medication education but the administration of medications as well.

Braden said the conditions that gave birth to the innovation of the model adopted by the University of Louisville Health team. Questions such as: “‘What can we do to combat this nursing shortage?’ ‘We are seeing some pharmacies close in the area, with the disruption in retail pharmacies, is there an opportunity to bring pharmacists into the patient care model?’ We asked ourselves what we can do with our care model to change some of the ways that we are taking care of our patients and have a better interdisciplinary approach,” she said.

The University of Louisville team decided to integrate pharmacists directly into the care model so they could collaborate with nurses and become a part of the care team at the bedside. Thus, the pharmaco-management pharmacist program was born.

Braden elaborated on why bringing pharmacists on to the bedside care team has been so beneficial.

“[These pharmacists] are a bit of a hybrid. They are bringing in a lot of their retail experience and their ability to connect and talk with patients. They are also administering medications on the unit, which is something very new. These pharmacists took on a whole wealth of knowledge as far as medication administration, different routes of administration,” she said.

Neuner explained that she developed an educational program that started with the fundamentals of nursing and simulations with mannequins. Much focus was placed on medication administration routes and techniques as well as hospital protocols, policies, and procedures. Many of the skills were new and not part of the skill set of a retail pharmacist. Three months after training was completed, real-life patient scenario competency sessions were held that required the pharmaco-management pharmacists to perform their duties in a simulated environment. Neuner also provides continuing education sessions when new situations arise. She makes sure that they are comfortable, prepared, and have all the resources that they need.

Nuener described how the pharmaco-management pharmacists have brought a new level of patient and nursing support onto the trauma stroke unit. Neuner said the pharmacists on the unit have given her great feedback. "They love it, they have built relationships with the nurses with the unit secretary, when we brought them back down to their follow up class, their competency class, we found that they also have formed relationships with the patients and they were just happy and ecstatic, "she said.

The extra education, personalization, and support the new model has provided patients is extremely beneficial. Nurses on the unit have also had additional burdens lifted from their shoulders, as Braden explained.

“I know one of the big things that one of the charge nurses on the unit said was that sometimes they don’t have the time to get to the meds because they are so focused on other tasks.” She further explained that putting pharmacists on the unit gives patients the chance to ask questions from different expert members of the care team, which is an optimal care model.

Transitions of care was another area the University of Louisville Health team was hoping to expand with the new program. “The way that we have our pharmacists set up right now, they try to participate in transitions of care as much as possible. We have our internal medicine pharmacists who are helping facilitate discharge by getting meds to beds from our outpatient pharmacy that is on site. Also, by making sure that patients know the importance of their medications before they leave to ensure that they get their prescriptions,” said Braden.

She also explained that the new model has helped support patient’s readiness for discharge.

“We are trying to decrease readmissions and increase continuity of care as much as possible. But by having these extra pharmacists on the unit, we are really making sure that every single patient has this opportunity. We are really trying to tee them up for success in advance,” she said.

Healthcare organizations can also transform their care delivery plan by investing in the right patient engagement technology. Journey PX supports care delivery by leaning down clinical workflows, closing gaps in communication, and allowing healthcare professionals to meet with patients virtually at the bedside via a secure connection through the patient’s in-room TV.

Robinson shed some light on how Journey PX can accomplish this.

“Having been a nurse for 35 years, I find the model adopted by the University of Louisville transformational. Seeing how care delivery models are evolving is exciting. Another thing I have seen is organizations bringing healthcare experts into the patient room virtually. If you cannot create a supplemental model with real bodies, virtual is a wonderful way to accomplish that,” she said.

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Journey PX solutions also prepare patients for discharge by keeping them informed of their daily plan of care, providing individualized education, and streamlining communications between patients, families, and care teams. Journey PX facilitates hospital organizations in hard-wiring bedside shift reports, one of the biggest drivers of quality and safety.

Journey PX can also create a meds-to-beds program that is customized to the unique needs and designs of hospitals. Journey PX can integrate with the EMR and engage the patient at the bedside via prompts, medication education, and pharmacy information to drive medication health literacy. Read more about the topic in a recent feature article on the subject.

To hear more from Tara Neuner and Amy Braden about the topic, listen to the full PX Space podcast interview below.

Written with contributing author Linda Robinson, MSN, CPXP, RN, Vice President of Clinical Excellence, MDM Healthcare

Rick Rolfsen, DNP, RN, has had an unconventional pathway to his successful nursing career. In a recent PX Space podcast interview, host Linda Robinson MSN, CPXP, RN, spoke with Rolfsen, who is a friend and former colleague. In the interview, Rolfsen shared his insights on the nursing profession, his teaching experiences, and how his career as a nurse has allowed him to pursue his passions, including a fun opportunity with the Cincinnati Bengals.

“My path to nursing was a little less traditional than most. Growing up I didn’t think much about nursing as a career as I played a lot of sports and initially was studying to be an athletic trainer in college,” he said.

He explained his career goals started to change as his studies continued and he was given a suggestion to consider studying to become a nurse.

“It was the mid-eighties, and there weren’t a whole lot of men getting into nursing. It was a time when it was just starting to evolve with more men getting into the field,” he said.

Rolfsen has found unique ways to incorporate his passion for sports into his profession. He volunteers as the medical staff for the Covington Catholic High School Football Team and volunteers on the medical team that does semi-annual check-ups for his favorite NFL team, the Cincinnati Bengals. These opportunities allow him to combine his love for sports with his nursing expertise.

Rolfsen explained that once he began his career as an RN, not only did he love his job, but several opportunities for career growth and additional education emerged for him. These opportunities led him to earn both Master's and Doctorate degrees in nursing, as well as his current positions as a professor and full-time ER nurse. Currently, Rolfsen inspires the next generation of nurses as a nursing professor at Thomas More University in Crestview Hills, KY. He also works as a charge nurse at St. Elizabeth Emergency Department in Covington, KY, and -as a staff nurse at Cincinnati Children’s Medical Center Orthopedics.

Rolfsen's career demonstrates that nursing is a diverse profession that allows individuals to help people and incorporate their interests into their work. His experiences also highlight the importance of mentorship and passing on knowledge to the next generation of nurses. He explained that the COVID-19 pandemic has mainly had a positive impact on his new classes of incoming students. He stated that although a few nursing students did drop out of fear initially, mainly the numbers at his university stayed the same. He also expressed that these students saw the important role healthcare workers played during the pandemic and were drawn into the profession because they wanted to help.

“Kids were telling us that they saw what was going on and they wanted to help. During the pandemic, people were praising nurses for the hard work they were doing. Nurses were showing up and working on the front lines and that drew more kids into nursing,” he said.

The team at Journey PX is passionate about partnering with nursing teams to transform care delivery models. Guided by recommendations from a seasoned team of experts, the cutting-edge, cloud-based patient engagement platform offers solutions that save clinicians steps and time, allowing them to lean down clinical workflows and offload non-clinical tasks. Journey PX offers patient engagement solutions that are uniquely designed to allow nurses more dedicated time at the bedside with their patients. The Journey PX solution My Stay, offers patients access to an extensive library of patient education videos, giving patients access to the health education they need to become more informed about their condition and proactive about their care. Nurses can support the patient by auto-assigning them an individualized education plan that is particular to their health needs. The Journey PX Connect solution also offers nurses the capability of securely connecting via video in the patient’s room, which allows them more access to patients, saves them valuable time, and helps keep them safe, reducing exposure.

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In a time when nurses face more challenges than ever, with burnout from the COVID-19 pandemic and a workforce shortage, Rolfsen's story offers new perspectives and hope to future nurses. His unconventional path to a successful nursing career breaks down common stereotypes and illustrates the variety of enriching benefits the career offers. As a nurse, educator, and sports enthusiast, Rolfsen's experiences show how the nursing profession can be a pathway to success in many different areas of life.

You can hear more insights from Rolfsen in his PX Space podcast interview with host Linda Robinson.

Written with contributing author Linda Robinson, MSN, CPXP, RN, Vice President of Clinical Excellence, MDM Healthcare

February is National Heart Health Month. According to the Centers for Disease Control and Prevention (CDC), heart disease is the leading cause of death in the United States, and strokes are number 5. The CDC also states that approximately one person dies every 34 seconds in the United States from cardiovascular disease.

MDM Healthcare Vice President of Clinical Excellence Linda Robinson, MSN, CPXP, RN, recently sat down and discussed heart health with Dr. Creighton B. Wright, an acclaimed cardiac and thoracic surgeon. Dr. Wright, who retired from clinical practice last May, has earned an extensive list of prestigious awards and medals for military service throughout his career. These include being honored by The American Heart Association with several awards: The Kaplan Visionary Physician Award, The Award of Excellence, the Distinguished Achievement Award, and most recently with the inaugural Creighton B. Wright Leadership Impact Award, which he accepted at the Greater Cincinnati Heart Ball on February 3rd.

Dr. Wright used the metaphor of a house to explain the way the heart functions. “Basically, when we talk about the heart, we talk about our rooms, our doors, our electricity, and our plumbing. We have the atria and the ventricles, which are the rooms, we have the electrical system, which relates to pacemakers, and other electrical aspects, the ablations and the treatment for atrial fibrillation and the arrhythmia, like we saw with the cardiac arrest recently that took place on the Bengals field, and then the plumbing, which for many people are the coronary bypasses. So we have the inflow through the coronary arteries and the outflow through the veins. The disease processes are blockages in the arteries, from hypercholesterolemia, diabetes, and other elements that cause obstruction of the blood vessels, and Angina pectoris, or coronary events which cause myocardial infarction, the heart attack that most people are so frightened of,” he said.

He further explained how the treatment has continued to evolve over the years. He explained that when he was first trained as a cardiovascular surgeon, in 1971 coronary bypass surgery was just beginning to become a common procedure. He also explained how technology used for treatment has evolved over time, noting that the modern-day pacemaker was optimized using technology from NASA scientists. “During my career, we have developed better procedures to open those blood vessels, or in the circumstances where it is a long segment, we bypass it. So much of the coronary bypass work has evolved to arterial grafts. So, the internal thoracic artery or the radial artery as well as saphenous, veins from the legs are used as the detours the bypasses around a given blockage like you would have on a street you take, take a detour, take an alternate pathway around that blockage,” he said.

Dr. Wright shared some insights into heart disease prevention noting that in addition to monitoring cholesterol, lifestyle factors such as obesity, exercise, stress levels, and smoking all play a part in heart health. He also mentioned genetics as another primary indicator for a heart disease diagnosis. “You can’t pick your grandparents; the gene pool is the gene pool. You can, however, modify your behavior, and certainly obesity and smoking are two major health impacts I have had to deal with as a physician,” he said. A healthy diet, regular exercise, and giving up unhealthy behaviors are some ways patients can combat heart disease.

Dr. Wright noted the importance of patients receiving health education from the right sources, so that information is as up-to-date and accurate as possible. “That's why we work with the American Heart Association, we try to do evidence-based education. There are lots of scientific programs locally and nationally where much of the current science is presented on an annual basis. People are working from the cellular level to the total human level to try to enhance heart knowledge and heart care,” he said.

The importance of accurate health information from the right sources is a concept that is also embraced by Journey PX. Journey PX’s patient engagement solutions drive communication and crucial health education, even when clinicians are not in the room. The extensive library of patient education videos offered through the My Stay solution keeps heart and stroke patients informed and educated about their care throughout their hospital stay. The education library can be embedded in the EMR and can be automated or manually deployed based on stroke and or heart health risk factors, treatments, or diagnoses. Once the education is completed, it can auto-document the completion and comprehension back into the EMR. In addition, Journey PX’s Connect solution allows for secure virtual rounding and provider visits. The combination of these features saves clinicians valuable time and steps and provides patients with a richer patient experience. My Stay also allows vital health education to be delivered via email and text upon discharge for both patients and their caregivers.

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Dr. Wright “We need to make sure that we are communicating on a level that is understandable to the patient, whether it is language, culture, or education level. We have medical languages, which are different. So, we can use terms such as osteodystrophy and myocardial infarction, but the key is to be sure that we are explaining these medical concepts in terms that everybody can understand and to make sure patients can comprehend this knowledge,” he said.

This is another concept Wright mentioned that is echoed by the team at Journey PX, which is designed to make sure that anything that goes on the Digital Whiteboard, My Day Today, is in a language patients can understand. “We never want patients to become frustrated or afraid to ask questions in the hospital,” said Robinson. She continued to explain that this philosophy extends to the videos Journey PX houses in the health education library, My Stay. Patients are best served by technology that is intuitive and easy to use. If patients can use a TV remote, they can use the cloud-based patient engagement solution Journey PX. It integrates with the hospital’s electronic medical records (EMR), so it displays accurate real-time information. Displaying information in this way is something that drives positive outcomes.

Finally, Dr. Wright, who served as an Army Colonel in both the Vietnam and Gulf wars, mentioned that the US Military has had a problem recruiting medical personnel and doctors, and encouraged students to consider turning to the US military service as it had significant benefits including scholarships. “We need patriots," said Dr. Wright.

You can hear more from Dr. Wright about heart health by listening to the PX Space podcast interview. To view more information on heart disease and stroke, and to support the cause, head to the American Heart Association website.

Exploring Physical Therapy Solutions: Expert Insights

Eradicating Incivility in Nursing: Connie Montalbo on Preventing Toxicity Through Strong Leadership

By Ashton Elder and Linda Robinson, MSN, CPXP, RN, Vice President of Clinical Excellence, MDM Healthcare

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