THE 2023 INNOVATOR AWARDS PROGRAM
is proprietary. She notes, “Nicklaus Children’s decided even before the pan- demic that we were going to build versus buy and continue to improve and invest in it. One of the challenges, for example in our old platform, the patient had to create a username and had to create an account and add more data input to be able to access a platform. Now in this new workflow the patient will be receiving a link.” Terrell adds that families receive
reminders in the form of SMS text mes- sages and the platform can be accessed through desktop, phones, and tablets. One of the key features, she adds, is language. “One of our new workflows that we are implementing involves virtual interpret- ers. We’ve always had interpreter services, it’s a requirement by law, but now we’re improving the process so that a language interpreter can join the virtual room and be live along with the providers and the clinicians,” Terrell states.
Tackling technology challenges Regarding the challenges to implementing the Baby Steps program, Altares Sarik says that, “One of the challenges that we antici- pated when we were writing the grant, and we planned for, was that a parent or a caregiver would need to have a smart device or a tablet in order to access the services. We knew that we had disparities in access in our service area. We actually wrote money into the grant for a number of tablets so that we could give those to the families if they didn’t have access.” “Surprisingly,” Altares Sarik notes,
“We have never in the history of our program had anyone actually request a tablet. Generally, families have access to a smartphone of their own or another fam- ily member’s smartphone. It underscored how ubiquitous this technology is now.” Altares Sarik explains that one of the
key things the team decided to do at the beginning of their project, as they were onboarding and credentialing their team to be able to use telehealth services, was putting together a concise workflow. Nicklaus had their telehealth partners conduct training in person for the NICU nurses, even if that particular nurse was not part of the core program. The team wanted to ensure their staff was trained in case there were technical issues or scheduling issues. “This gave our clinical nursing staff understanding and expertise in telehealth, a new skill set that they didn’t have before,” she says. “One of the reasons we looked at this grant
Melody Hernandez, Ph.D., M.D., B.S.N.
makes it unique. Clinical nurses are well- trained to give education and anticipatory guidance to patients and also to guide them to their transition through to the community. A lot of what I end up doing is building a therapeutic relationship with the families, on the app, and on the outside. And once they’re outside, I try to make sure that they know I’m their ‘any- thing and everything type of question’ girl. I want them to know that they can ask me anything they would have asked in the NICU and anything they would ask in the pediatrician’s office. And if I don’t
be able to say, ‘OK, this program does make a difference.’ Ultimately, we would like to expand and have a bigger grant.” Altares Sarik concludes by saying that
“We have been approached by multiple other hospitals and health systems who have started to learn about the program through our external dissemination and they are very interested in learning about the program, our workflow, and how to implement it. As an organization we are now focusing on how to share what we’ve learned, and opportunities to formalize this program.” HI
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and pursed this grant was to create the capacity for telehealth among nursing; it was an additional benefit of the program.” Flor Tena, R.N., C.C.R.N.-K [Acute/
Critical Care Knowledge Professional] manager of professional nursing prac- tice and navigation program, Nicklaus Children’s Hospital, comments, “For a long time, we’ve sought to enhance the transition of care from the NICU to the community and to the home.” Tena adds that in her previous experi-
ence launching a telehealth program there wasn’t a designated person taking telehealth calls, it was only if individuals had time in their schedule. She adds that another bar- rier was that the program wasn’t free, and although she tried purchasing gift cards to help families enroll, it was a very complex and cumbersome process.
A unique telehealth program As for the uniqueness of this program, Hernandez comments that “This is a nurse-led telehealth program, which
have the answer, I will make sure to get the answer to them. And if I have to make sure to transition them to a higher-level care, then I will make sure that they do that in the adequate form, keeping them out of the ER.” Hernandez reiterates, “I
think it’s
important that we have the future nurses of America understand and learn that there are more opportunities for them other than traditional bedside nursing. There are so many different facets of nursing, and this is one of them.” The team says that through the end of
2022, there were 643 infants and families enrolled in the Baby Steps program and they have completed 655 visits. As for what’s next for the program, Matsuda says that “This was the first partnership between Nicklaus and the University of Miami on this type of program. Being able to show that we were able to successfully launch and continue the program is great. We have great preliminary data. But we want to rigorously evaluate the program using more research methods and
Photo by Edgar Estrada
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