Erin Athey CEO, Founder of C3: Community Concierge Care and Christina Calamaro leader of the Emory University School of Nursing team were selected from a global pool of applicants to receive up to $100,000 in grant funding and access to mentoring from experts across the Johnson & Johnson Family of Companies to help bring their innovative ideas to life.1
As part of our broader pledge to support frontline health workers and help provide equitable health solutions for communities of color, Johnson & Johnson partnered with the American Association of Nurse Practitioners (AANP) and the Association of Public Health Nurses (APHN) to launch the Johnson & Johnson Nurses Innovate QuickFire Challenge, focused on Improving Access to Care. This is the seventh challenge in the QuickFire Challenge series that aims to empower nurse-led innovation in healthcare.
The COVID-19 pandemic has made challenges in accessing equitable care even more acute for millions of people around the world. Limited access to healthcare can increase the risk of poor health outcomes and mortality and put additional strain on health systems. Now more than ever, we need novel solutions and care models to help tackle the inequities existing in the U.S. and around the world. Nurses see these challenges every day and also the opportunities for action.
Out of hundreds of applications, our two awardees stood out for their innovative approach and commitment to improving access to care: Erin Athey, DNP, FNP, RN, FAANP, founder, CEO of C3: Community Concierge Care, a place-based care model led by nurses and delivered to residents of public and affordable housing and Christina Calamaro PhD, PPCNP-BC, FNP-BC and her team from Emory University Nell Hodgson Woodruff School of Nursing and Children’s Healthcare of Atlanta (Imelda Reyes, DNP, MPH, APRN, CPNP-PC, FNP-BC, FAANP; Theresa Kiblinger, DNP, MPH, CPNP-AC/PC; Michael P. Fundora, MD, FAAP; Margaret Gettis DNP, CPNP-PC, EBP-C), who created a unique, interactive nursing communication application aiming to help nurses respond more efficiently to provide care to limited English proficiency (LEP) patients.
"Nurses’ invaluable hands-on experience, combined with their compassion for their communities and creative mindsets, makes them see things differently, in a way no one else in the healthcare field can," said Lynda Benton, Senior Director, Global Community Impact, Johnson & Johnson. "These crucial insights and know-how help nurses to uniquely solve some of our greatest healthcare challenges—like ensuring everyone has equitable access to high-quality healthcare. I’m thrilled to see what Erin and Christina are doing and look forward to watching the further development of their work."
"Accessing quality healthcare is a huge challenge for so many, and it's an issue that has been especially relevant this past year and a half," said AANP President April Kapu. "We’re proud to support nurses and help bring their innovative solutions to life."
"Even in the midst of an incredibly challenging time, nurses continue to demonstrate their commitment to accessible, quality patient care for all," said Zenobia Harris, DNP, MPH, RNP, President, APHN. "Public health and nursing go hand in hand, and nurses’ unique capability to lead transformational change not only improves access to care but also can improve the overall health of their community. It is our responsibility and privilege to empower them to do so."
While both innovations aim to improve access to care, each is distinct and unique in its delivery.
Bridging Care from Under-resourced Communities
In the Ward 8 neighborhood of Washington, D.C., just three miles from the White House, the average life expectancy drops approximately 15 years compared to surrounding areas.2 For over a decade, nurse Erin Athey has dedicated herself to caring for this community, through her work as a nurse practitioner at the local community hospital, by facilitating health literacy programs and, most recently, by pioneering a community health program that utilized mobile units. The success of this program has led Erin to establish a new organization called C3: Community Concierge Care.
"I have worked in this community for over a decade now. The health disparities are really shocking, but what is more unsettling is the lack of improvement in health outcomes. All I want to see is the people who live in these communities to be healthier and have more reliable and trusted access to care," Erin shared.
C3 aims to do just that. Erin’s innovative approach is to take the previously ad-hoc services offered through the mobile units and go one step further, making them into permanent clinics to better deliver care in communities that traditionally do not have easy access to care. This approach is rooted in the notion that providing consistent, quality care allows nurses to build a relationship and trust within the community, which could ultimately have a positive impact on preventative health and wellness.
By having an onsite RN and a telehealth nurse practitioner working alongside each other, she aims to modernize the nursing model of care by pairing an existing community health model and using technology including apps and data collection to improve the quality of care and to have a wider reach.
"The idea is to have high touch on the front end and high tech on the back end. We saw this unmet need to take a more personal approach. As a nurse, we’re trained to treat the whole person and meet them where they are. Something small like going out to the patient’s home and meeting them directly to help them take their medication makes all the difference. Even riding with a patient to their medical appointment can ease discomfort or anxiety. It’s really about the personal connection you have with patients that increases their level of trust and allows them to be more engaged in their care," Erin noted.
"With C3, we’re taking a person-centered approach and really pushing the boundaries of what it means to be a nurse," she continued. "In the long run, this could help save costs by preventing emergency room visits and hospital admissions while simultaneously improving quality of care."
Hear more from Erin Athey in her own words:
Enhancing Communication to Improve Access to Care
Like Erin, nurse Christina Calamaro and her team witness the challenges—and opportunities—of delivering quality care to vulnerable communities. From administrative issues to large-scale treatment challenges, they have a clear line of sight into the processes that can deter or slow improved access to care. While it may seem like a big issue to tackle, Christina and her team have shown that improving access to care can sometimes be improved through a relatively simple innovation to the patient-practitioner experience.
One night, a critical care nurse at Children’s Healthcare of Atlanta, was caring for a patient who had Limited English Proficiency (LEP) and who was experiencing great frustration at not being able to communicate with his care providers. Unable to reach an interpreter and determined to find a way to help the patient despite the language barrier, the nurse had a lightbulb moment. Instead of trying to use words, she used pictures.
This experience inspired her to collaborate and develop culturally appropriate and gender-neutral visual icons that would resonate with people of all ages—and be highly useful to nurses and all healthcare providers as a way to bridge communication when interpreters aren’t available. The visual icons were specific to point-of-care tasks by the nurses or requests by the patient. The “Visual Communicator Tool” was quickly adopted by many members of the team at Children’s Healthcare of Atlanta, who were then able to share a board with visual cues and have their patients point to what they were specifically trying to communicate. Being able to offer LEP patients and those with any kind of literacy or speech struggles this effective and simple tool of communication has improved these nurses’ ability to deliver quality point-of-care at the bedside and in the clinic—especially when an interpreter is not on hand.
"We don’t go into nursing to provide suboptimal care. We want to give the best care to patients that we possibly can. Nothing feels worse than when you leave for the night knowing that you might have missed something with a patient because you weren’t able to fully understand them, because of language barriers. I see our tool as quite a novel concept; one that can help nursing in every area of care," Christina shared.
Hear more about this innovation from teammate Imelda Reyes:
The Skills to Succeed
Both Erin and Christina credit their nursing background and expertise with giving them the insights necessary to come up with their innovations. Alongside that is having the drive, courage and work ethic to bring it to life.
"As nurses, we have great ideas, sometimes we just need a little push to validate it and get this feedback," said Erin.
Erin believes that being a QuickFire Challenge awardee can help push C3 to the next level, and hopes that it can become a scalable model for other communities that suffer from a lack of access to equitable care.
Christina also hopes that her team’s innovation can increase access to care in many healthcare settings across the country by turning it into an interactive phone app. She’s already met with colleagues in other hospitals who are eager to try out the tool.
"I’ve always believed that nurses are the best innovators—we’re at the bedside day after day, we take the time to listen to our patients and understand what their needs are," said Christina. "I always ask myself—how can I make care better?"
As for advice for other nurse innovators, Erin and Christina encourage nurses to lean on their experience and expertise, as well as their drive to improve patient outcomes.
"Keep sharing your ideas. Innovation is an iterative process, if you see a need to make a change, keep talking—even if your idea isn’t perfect. Sharing your ideas gets you the feedback to refine it," said Erin.
Christina echoes that sentiment and believes the best thing a nurse with an idea can do is "just go for it."
"As nurses, sometimes we may believe our ideas are not that creative or innovative when they are!," said Christina. "Find a mentor, find the funding and have the confidence to make it work."
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Footnotes:
1 subject to the execution of the necessary agreements and documentation with Johnson & Johnson Innovation, LLC
2 WAMU. (2020, November 12). "D.C.’s Black Residents Make Up Less Than Half The Population, But 80% Of Coronavirus Deaths."
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