May 12, 2017 § Leave a comment
When Elizabeth Shaw of Commonwealth Care Alliance discovered that her patient’s Nebulizer treatment wasn’t working, she knew she had to get the situation fixed as soon as possible. The patient had been misleadingly marked as “non-compliant,” leading many caregivers before Liz to ignore the patient’s complaints. Patients given this designation often feel ignored by the overloaded healthcare employees that are responsible for them, making the development of their care plans more difficult. No one had taken the time to listen to the patient and discover why her asthma treatment was not working the way that it should.
“‘Non-compliant’ was written everywhere so people stopped trying to see a solution,” Liz remembers about the patient. “Most people who are labeled ‘non-compliant’ would rather be compliant. If given the means and the tools, they will be.”
Liz worked hard to establish a trusting relationship with the patient. By listening to what worked and didn’t for her, taking the time to get to know the patient, and establishing what her actual goals were, Liz was able to find ways to make her become more invested in her own health. Once Liz discovered that the patient didn’t have a phone and was unable to read, she was able to arrange a much better care system for the patient’s obstacles.
After nearly four decades in the field, Liz has worked in almost every type of nursing environment, including hospitals and rehab facilities. She prefers the gravity of the work she is doing now with CCA, out of Charlestown. “I think this is the biggest job I’ve ever had,” she says.
In the field, Liz faces a series of socioeconomic factors that directly affect the health of her patients. “Probably 70 percent of people I take care of suffer from generational poverty,” she says. They also often suffer from a wide variety of behavior and mental health issues. To overcome these obstacles, Liz uses a simple approach: she establishes trust with her patients before trying to input medical advice.
“We take care of the whole person and not just one part of them,” she says. This holistic approach has guided her success.
At home, Liz faces a different set of challenges that make every day feel just as rewarding: She takes care of the developmentally delayed daughter she adopted from the foster care system 26 years ago. This experience has only helped to shape her views of the patients she cares for on a regular basis.
Balancing her work and home life has shown Liz the importance and power of being flexible when working in the healthcare industry. “You make a plan for the day,” she says. “And you have to be willing to let it go.”
Liz would encourage anyone that is interested to enter this career track. “I wouldn’t be anything else than what I am,” she says. “This is a great field.”
May 11, 2017 § Leave a comment
One of Anita Santana’s first patients at Commonwealth Care Alliance never told her nurse she was blind. Like most CCA patients, the woman dealt with a variety of complex issues. She spoke only Spanish, had no family, and suffered from numerous medical and behavioral health concerns. Because she was unable to manage her medications and control her health problems, she was frequently hospitalized.
Anita, a registered nurse who lives in Springfield, visited the woman in her home a couple of times a week, earning her trust and trying to figure out how to deliver the right care. Eventually, she asked the woman to show her how she measured her blood sugar levels.
“It was clear right away that couldn’t see,” says Anita. “She couldn’t read the screen, she couldn’t administer the test right – she couldn’t actually measure her blood sugar or administer the insulin.”
As Anita learned, the woman was legally blind in one eye, and had impaired vision in the other. Anita referred her to the Mass Association for the Blind, and they provided magnifying glasses and other tools. Anita helped the woman get a glucometer with a Spanish display and instructions, and insulin pens that we easier for her to use.
“For the first time in her life, this woman was receiving the care she needed,” Anita says. “This wouldn’t have happened through the standard ten or fifteen-minute office visit. I had to really get to know her and understand her socio-economic needs.”
After more than sixteen years in nursing, including nearly eight at CCA, Anita has seen a number of changes in healthcare, and worked in hospitals, community health centers, and patients’ homes. At CCA, she treats members in Springfield, Holyoke, and Chicopee, and prefers the long-term impact of in-home patient care, particularly for underserved populations.
“You get to see the patient through from beginning to end,” she says. “Plus, when you are treating someone at home, you can help identify barriers to care, and spend more time on healthcare education and prevention than on just acute treatment.”
She has also learned a number of lessons about nursing.
“Good nurses look at their patients as a whole,” she says. “Especially when you’re dealing with vulnerable populations, it’s critical to understand that healthcare may not be their primary concern. Learn about their environment and their circle of family and friends. Listen to what they tell you.”
As for any advice she would give people considering a career in nursing, Anita says, “the education process is difficult. But the outcomes once you’ve completed school are much more rewarding.”
May 10, 2017 § Leave a comment
In his keynote address at the d.Health Summit this morning, Dr. David Blumenthal, President and CEO of The Commonwealth Fund, cited Commonwealth Care Alliance’s model of care as one of the “foremost and most hopeful approaches for caring for the frail elderly.” He also stated that CCA has been effective in “reducing hospital and nursing home use and improving care experiences” for this population.
The d.health Summit, convened annually, is a national forum for healthcare leaders, entrepreneurs, technology firms, policymakers and senior care advocates to exchange ideas, create new relationships, and foster disruptive technological and process innovations to improve the lives of the nation’s aging population.
The Commonwealth Fund is a private foundation that aims to promote a high performing health care system that achieves better access, improved quality, and greater efficiency, particularly for society’s most vulnerable, including low-income people, the uninsured, minority Americans, young children, and elderly adults.
May 10, 2017 § Leave a comment
For Safiatu Sam, a nurse at Commonwealth Care Alliance, the most challenging part of giving care to her patients is not necessarily a health issue – it’s how poverty restricts their access to care. This, among other socioeconomic factors facing patients in western Massachusetts, can make it difficult for patients to follow a strict health regimen. The lack of access to healthy meals and dependable transportation, combined with the inability to get outdoor exercise in unsafe neighborhoods, often leads to worsening health and behavioral issues.
Programs like Commonwealth Care Alliance allow opportunities for the patients to overcome these obstacles with the help of their caregivers.
“If someone has difficulty with accessing quality food,” Safie says, “CCA can help by providing rides to the grocery store.” The organization also offers transportation to medical appointments and an adult day program where the patients can socialize with other people facing similar obstacles.
Safie has developed a strategy, rooted in flexibility, which allows for optimal care to be given to the patients who face these challenges.
“I don’t go into the home dictating what I want to do,” she says. “I ask what their priorities are and what they want to do. If a patient wants to clean out a closet, but you need to talk to them about diabetes, you won’t be able to do so until you discuss cleaning the closet.”
Patient stories like this have been common throughout Safie’s time at CCA in Holyoke. “Poverty is a big factor in how patients are able to care for themselves and where that care falls in the larger spectrum of their basic needs,” she says. “This is where CCA comes in. We work to remove these barriers – like access to food, housing and transportation – and meet their health needs.”
When Safie came to the United States from Sierra Leone in 1990, she got a job as a certified nursing assistant that worked well with her first priority of raising her children. Since then, Safie has spent more than two decades in the field and the last five years at CCA. Her tenure at CCA has allowed her the benefit of creating long-term relationships with patients that ultimately lead to better, more effective care. “You know the person and their family inside and out,” Safie says. “I am a liaison between the patient and their primary care provider. I also try to foster their independence and encourage them to take part in their own care.”
Eventually, she hopes to retire and return to Sierra Leone and use her skills to help the people there.
Safie notes that advancing technology is imperative toward taking care of patients, both in the United States and abroad. New technology has made it easier for providers to share more information and provide better continuity of care. Additionally, the nursing profession is expanding rapidly as new opportunities become available throughout the field. With the realization that nurses’ roles in healthcare are critical to effective care, more specialties are needed.
“Nursing is evolving every day,” Safie says. “What I was doing five years ago is completely different now. To improve and be a leader you have to be willing to change and grow.”
When giving advice to people who are thinking of going into nursing, Safie says, “Nursing is one of the most rewarding careers. This isn’t just what I do, it’s who I am.”
May 9, 2017 § 2 Comments
Family has always shaped Maggie Hillaire’s passion for nursing. Growing up in Haiti, she knew she wanted to follow her mother into the profession.
“I wanted to wear a uniform like her,” she jokes now, after more than 24 years in healthcare. Maggie entered the field as a home attendant after moving to New York in the 1980s. She learned English and put herself through school to become a nursing assistant, and eventually a licensed nurse practitioner.
For the past several years, Maggie has treated members of CCA. CCA members are among the most complex and vulnerable patients in Massachusetts, and their healthcare challenges often create barriers to treatment. That’s where Maggie comes in.
Working out of CCA’s Lawrence clinic and treating patients throughout Merrimack Valley at their homes, Maggie has developed a specialty in reaching members who have pushed other nurses and doctors away. She has a unique ability to convince patients to open the door and trust her. She develops a rapport with them, and offers a willing ear.
“Most of our members are living in poverty,” Maggie says. “They have poor housing. They don’t have access to proper nutrition. We can really help these people. So I spend time with them. I sit down and I listen. I smile and I give them choices so we can work on their problems together.”
Maggie’s approach stems from a tragic personal experience: Her oldest son passed away at the age of 22. The morning before he died, he was found wandering his college campus without clothes. No one thought to inform his family. Maggie didn’t know anything was wrong until she was called to come and identify her son’s body.
“Every time I think about my son, I wish there was someone who had seen him and said something,” she says. “I look at every scenario now as, ‘this could be my son; this could be my father. I do the best I can for my patients because I wasn’t able to help my son.”
Her personal approach and ability to relate has made her a critical part of the healthcare community in her hometown of Chelmsford and throughout the Merrimack Valley. And more than two decades after she first put on the uniform she so admired as a child, Maggie maintains her passion for the job.
“When I get home, I lay down and I know I did something good – to someone, somehow.”
May 8, 2017 § Leave a comment
Nurses are the backbone of our healthcare system, as they work in tandem with doctors, clinicians, patients and families to ensure the best possible care for any and all who need medical treatment. This week is National Nurses Week, which is a time to honor and celebrate the great work of these extraordinary individuals who are on the front-lines of the healthcare system.
From spending one-on-one time with members and providing a shoulder to lean on, to education and help navigating the often complex healthcare system, you’d be hard-pressed to find any nurse at Commonwealth Care Alliance (CCA) who doesn’t go above and beyond for the people they work with on a daily basis. At CCA, we’re focused exclusively on serving Medicare and Medicaid’s most complex beneficiaries, with the mission to provide the best possible care, tailored individually to the members we serve throughout Massachusetts – elders and adults across the age spectrum with special healthcare needs.
For many of our members, their healthcare challenges often create barriers to treatment. Some mistrust the healthcare system, others deal socioeconomic factors such as access to education, food and housing, and nearly all deal with a general inability to navigate and manage their own care. This is where our nurses come in.
Working with the most vulnerable individuals in Massachusetts, our nurses have learned to identify when a person has fallen through gaps in the system and think outside the box to develop individualized care plans that work best for that specific individual. By taking time to meet members where they’re at – medically, physically, emotionally and socially – and listening to what the member’s priorities are, rather than just dictating a plan of care, our nurses are developing relationships built on trust, respect and dignity that our members often don’t see elsewhere.
Throughout the week, we will highlight the great work done by some of our nurses in different regions around the Commonwealth. So stay tuned for more!
Day in and day out, we celebrate and appreciate our nurses here at CCA, but to all of the hardworking nurses, we wish you a happy Nurses Week!
May 4, 2017 § Leave a comment
Lori Tishler, MD, CCA’s Vice President of Medical Affairs, was a panelist at the 14th Annual World Health Care Congress, held April 30-May 3, 2017, in Washington, DC. She and the other panelists, national healthcare executives and stakeholders, discussed ways to improve care for the population of patients who are dually eligible for both Medicaid and Medicare benefits. Reporting on the Congress, The American Journal of Managed Care (AJMC) notes Dr. Tishler’s comment that “coordination disconnects persist beyond just Medicaid and Medicare for this population.” The AJMC also reports that CCA’s program “uses a high-touch approach that looks at each member’s whole needs, including social determinants of health, and forms partnerships with community-based programs that can help the Alliance’s community health workers fit healthcare into the lives of the patients.” On the subject of telemedicine, Dr. Tishler was quoted as saying that “technologies shouldn’t drive the process, but processes should support technology.”
Read the entire story, “Coordinating Care for Dual-Eligible Medicaid-Medicare Beneficiaries.”
The American Journal of Managed Care is the leading peer-reviewed journal dedicated to issues in managed care. AJMC.com distributes healthcare news to leading stakeholders across a variety of platforms.