Yale New Haven Hospital's Jeannette Bronsord, Executive Director Surgical Services, and Ena Williams, Senior Vice President and Chief Nursing Officer

The challenge: Charge nurses spend a lot of time creating patient assignments each shift, that meets each nurses’ skills and level of experience while balancing the workload across the team. Yet, they don’t always have the patient data they need to get a full picture of each nurses’ workload, and frontline nurses often report feeling overwhelmed.

The solution: The Electronic Patient Assignment Generator (ePAG) is a data-driven software tool that uses AI to auto-generate smarter patient assignment recommendations at the beginning of each shift to create a more sustainable, well-balanced patient load for nurses. While charge nurses typically have access to data like number of patients and patient acuity from the electronic medical record, they often don’t have details like complicated medication regiments, or high-need family members – details that affect the amount of hands-on time required to care for the patient. Without this information, nurses can easily become overwhelmed with the number of patients under their care.

The ePAG interprets workflows, workload and hospital geography to create fair, efficient patient assignments not only at the start of each shift change, but dynamically throughout shifts, so charge nurses can track if and where nurses are beginning to fall behind. Unlike existing solutions, new assignments can be made with the full picture of the work happening during a shift, improving nurse satisfaction in real time.

“This frees up thousands of nursing care hours that can be reinvested in patient care activities that really matter,” said Jeanette Bronsord, MAOL, DNP.

What’s next: The Yale New Haven Healthcare team is currently finishing their pilot and prototype. They plan to scale the tool to inpatient units over the next 1 to 3 years, and to other areas of care within 3 to 5 years.

James J. Peters Department of Veterans Affairs Medical Cente's Salvacion Francisco, Deputy Chief Nursing Executive, and Noreen B. Brennan, Chief Nurse Executive

The challenge: Workplace violence is a growing problem in healthcare, and one in four nurses report experiencing physical violence in the emergency department. While most hospitals have interventions in place for severe episodes, nurses at the James J. Peters Department of Veterans Affairs Medical Center were looking for interventions they could implement earlier.

Patients often escalate as a response to unmet needs. These can be simple – socks, a blanket – or from heightened agitation due to medication, substance use, or general stress. There are several simple tools that can be used to divert an escalating patient. Simple interventions from snacks to ear plugs to aromatherapy and beyond can help prevent easier to meet needs from escalating into a serious situation. However, there wasn’t a “one-stop-shop” for nurses to access these de-escalation tools quickly.

The solution: The team developed a ‘de-escalation cart’ filled with resources, which they describe as the ‘Maslow’s cart for de-escalation,’ a play on the chart developed by psychologist Abraham Maslow outlining the hierarchy of physical and emotional needs.

“The biggest component is wraparound service,” said Noreen Brennan, PhD, RN-BC, NEA-BC. “It’s not putting up guardrails or a security person to prevent violence, it’s putting the control of what’s going on in the hands of the provider.”

What’s next: In year 1, the team is working to secure funding to implement the carts and technology throughout its facility – “Workplace violence isn’t contained to the ED,” said Brennan. With more than 5,000 emergency departments across the US, the team sees an opportunity to disseminate their solution broadly over the next five years.

North Carolina Department of Health and Human Services' Dr. Susan Haynes Little, Chief Public Health Nursing Officer, and Lindsay Novacek, Director of Nursing Continuing Education

The challenge: The NC Department of Health and Human Services is funded to facilitate efforts that support a competent and confident workforce, and many different disciplines conduct regular training sessions for the state’s public health nurses. Yet, these nurses were not able to receive continuing education credits, as there was not a standardized approach to verifying and documenting these trainings, despite the credits being necessary for the nurses’ licensure renewals.

The solution: NurseCE is an innovative continuing education platform that creates a standard mechanism for tracking and collecting CE data for nurses receiving trainings from public health staff including legal experts, physicians, dentists, social workers, epidemiologists, and others. As a result, public health nurses in North Carolina are better equipped to address and care for their communities, while saving time through streamlined documentation.

“This puts the Department of Health and Human Services in the driver’s seat to provide the training public health nurses need to do their jobs while providing the contact hours they need for their renewals,” said Susan Haynes Little, DNP, RN, PHNA-BC, CPH, CPM, FAAN.

What’s next: The NC DDHS team is currently training staff on the platform and are planning for future iterations that increase engagement, like developing a leaderboard and gamification components.

Olympic Medical Center's Aaron Possin, Emergency Department Director, and Vickie Swanson, Chief Nursing Officer

The challenge: Director of the emergency department Aaron Possin, MSN, MBA, was concerned that biases were impacting nurses’ ability to listen and really hear what was going on with patients. In tackling the problem through design thinking methodologies, he and Vickie Swanson, MSN, discovered that often, the culprit was burnout. Nurses experiencing burnout were quicker to make conclusions about patients, and to solve the bias, you had to solve the burnout.

The solution: Meet Dave. Olympic Medical Center hired a caregiver advocate – Dave Hasenpflug – to work 20 shifts in-unit for one month. With an education background and trauma-informed training from a compassion fatigue educator, Dave rounded with staff, was present at shift huddles, performed individual rounding, conducted active listening, and provided actionable feedback and personalized care to staff. Self-reported burnout plummeted from 88 percent of ED RNs reporting burnout to less than 20 percent.

“He was boots on the ground, and the staff found it incredible to have him there,” said Possin.

What’s next: There’s only one Dave, but the goal is to expand the program, eventually having a full-time position for all nurses, all hours, all shifts, in all departments and at all campuses.

Corewell Health South's Dr. Natalie Baggio, Senior Vice President of Clinical Operations and Chief Nursing Executive, South Region, and Dr. Sandi Plank, Senior Director Clinical Education, Talent Development & Resiliency

The challenge: An average day in the life of a nurse manager might look like this – quality huddles, rounding on patients, rounding on nurses, administrative tasks, budgeting, supply orders, certification and compliance work, and much more. There often aren’t enough hours in a shift to complete all the responsibilities nurse managers are tasked with.

The solution: Nurse Bridge is an AI solution to automate and bridge gaps in administrative communication between nurses and their managers. It supports bidirectional communication, scheduling and policy management and provides nurse managers with the ability to automate when and where they receive actionable information.

“Nurse managers are critical to the success of healthcare systems, but they experience burnout and high turnover rates,” said Natalie Baggio, MBA, BSN, RN. “Supporting our nursing workforce is crucial to our vision.”

What’s next: The team is working on expanding the solution into other nursing specialties as well as advance technology integrations with existing health system tools.

Hawai'i Pacific Health's Tracy Methered, Director of Clinical Informatics, and Amy Thomas, System Chief Nurse Executive

The challenge: The nursing workforce shortage is critical everywhere, but the geographically isolated islands of Hawai’i are particularly affected. Hawai'i Pacific Health has a shortage of 1,000 nurses, which is substantial when there are only 16,000 registered nurses in the state. While it is particularly difficult to recruit, because it is difficult to relocate to the region, these dynamics aren’t wholly unique to Hawaii. Rural communities across the country face similar workforce gaps, and health systems are seeking innovative approaches to maintain quality patient care.

The solution: The Virtually Integrated Extended Workforce (VIEW) featuring KUMU is a two-part solution. KUMU, which means wise one in Hawaiian, is a voice-activated, hands-free solution that nurses can use to connect to the VIEW, a virtual care team supporting admissions, medication reconciliation, discharge and patient education, dual medication verification and more. The combination of the two solutions means nurses can easily pull in support even when actively providing hands-on care to a patient.

What’s next: In phase 1, the team is rolling out to a 38-bed medical/surgical unit. Eventually, the team hopes to expand to other units and across the system, while building out additional features including interpretation services and ambient listening for documentation.

“We know that virtual observation and care decreases the work burden for nurses and allows them more time in the day for their patients, which creates more satisfaction in their role,” said Tracy Methered, MBA-HCM, BSN, RN.

Jefferson Health System's Charlene Eltman, Associate Chief Nursing Informatics Officer, and Colleen Mallozzi, Senior Vice President, Chief Nursing Informatics Officer

The challenge: To put it simply, being a new nurse can be hard. “You have this goal of taking your hands and putting them on someone and healing them, or guiding them through some of their darkest days,” said Colleen Mallozzi, MBA, RN. “But health systems are struggling after COVID, and it’s falling on the backs of our nurses.” There are different resources available to nurses, from employee assistance programs to mentorship tools, but the ecosystem of support is fragmented.

The solution: Nurse Beacon is an app that instantly connects nurses to resources. Integrated with the system’s information system, nurses can leverage wellbeing tracking tools, provide shift feedback before, during and after their shifts, and access educational policies and support tools. Managers are also able to intervene and provide direct support more quickly where needed.

“It’s immediate assistance to connect you to your peers, to our policies, fully integrated with your hospital system,” said Charlene Eltman, MSN, RN, RN-BC.

What’s next: The team is currently working to secure investment and is planning to kick off app design in the first quarter of 2025, develop and iterate throughout 2025, and go to market in early 2026.

Blythedale Children's Hospital's Jill M. Wegener, Senior Vice President, Chief Nursing Officer, and Patient Care Service, and Kara Dyer-Dombroski, Nursing Director of the Pediatric, Adolescent & Traumatic Brain Injury Unit

The challenge: Nurses are often responsible for discharging patients, and medically fragile children are often discharged home with their families, where parents and home care nurses take over from pediatric clinicians. Unfortunately, the clinical competency and skill level needed to effectively care for those children isn’t always available, with a substantial impact on patient outcomes.

The solution: Successful Transitions is an app with two components. The ‘All About Me’ section collects and stores the relevant medical and educational information, including bespoke care videos demonstrating how to care for the patient correctly and safely. The second section is a chat feature that families and caregivers can use to connect with Blythedale educators. While not meant for emergencies, nurse educators can triage calls and provide the support and information families need.

What’s next: The Blythedale team is currently working to train more educators for the app, as well as build out future iterations that would include expanded pharmacy support and other functions. They are also working to advocate for state legislators to establish consistent rules around who can safely care for medically fragile children.

Trinity Health's Dawn Vollers, Regional Director for the Center of Professional Practice & Development, and Peggy Norton-Rosko, Regional Chief Nursing Officer

The challenge: Incivility and bullying behaviors are a common challenge in health systems. This experience can occur between peers, managers, even among nurses and other clinicians, like physicians or other specialists. In high stress environments, frustration can easily bubble over, and there have not historically been impactful interventions when those situations occur. Often, it leads to increased turnover, especially among new or early career nurses, which impacts workforce shortages.

The solution: Buddy the Bully Bot app is an interactive AI chatbot developed on research-informed algorithms. There are multiple pathways within the app, for targets of bullying, perpetrators of bullying, bullying bystanders, and managers. It provides immediate, in-the-moment resources to de-escalate the situation and pursue outcomes that align with a healthy work environment.

“We believe Buddy the Bully Bot can change the landscape of nursing,” said Dawn Vollers, MSN, RN, NEA-BC. “It’s a solution to address this universal problem.”

What’s next: The Trinity team is developing a subscription-based model for health system and hospital implementation, as well as pursuing future functionalities including data analytics, leadership dashboards, and to nursing students as well as other fields.

West Virginia University Health System's Dr. Lya Stroupe, Director of Nursing Professional Practice and Education, and Melanie M. Heuston, Inaugural Chief Nurse Executive

The challenge: Nursing has a reputation problem. With shortages, burnout and bullying often described as challenges too complex to solve, part of the story is missing. “Currently, there are few avenues for high school students or young adults to see the professional, positive attributes of this caring profession,” said Melanie Heuston, DNP, RN, NEA-BC. “We want to use innovation to showcase the profession and the amazing opportunities that exist.

The solution: Free for students to use, Nurse Quest is an app where users can explore a day in the life of a nurse, chat with a current nurse or a retired nurse, talk with patients, and explore nursing schools and pathways to the profession.

“It’s a reality-based experience for the end user, and it really gets at the caring work of bedside nurses, and what’s wonderful about being a med/surg nurse,” said Heuston said.

What’s next: In phase 1, the team is building a static site and app content. In phase 2, the team plans to make the site more dynamic and add additional components like scholarship opportunities and gamification badges.

So, what happens when you train a group of nurse leaders to think differently? The answer: they’re empowered to dive deep into challenges and bring all voices to the table to develop actionable solutions. Additionally, they are able to bring powerful innovation methodologies back to their systems, further accelerating change for the benefit of nurses and patients alike.

Apply by August 2, 2024, for the NurseHack4Health Pitch-A-Thon, an opportunity for nurse-led health system teams to pitch their workplace and workforce solutions for the opportunity to receive up to $150,000 in grant funding!

To learn more about the Johnson & Johnson Nurse Innovation Fellowship, click here.