UW Health’s Black/African American Employee Resource Group first met on a frosty morning in January 2020 at Wingra Clinic, shortly before the twin pandemics of COVID-19 and racial inequity swept the world.

The idea was to create a support network at UW Health, where the nursing workforce is about 96 percent white. The group is open to any employee who identifies as Black or African American.

“The isolation aspect is huge, the stress of being Black in predominantly white spaces, and coping with the ignorance about what the experience of being Black is like,” says group co-chair Jessi Kendall, BSN, RN, who works with cancer patients on B6/6. “Being able to come together and speak about the challenges in a safe space is so helpful.”

Since the COVID-19 pandemic, the monthly meetings have gone online, but the need to support each other has become even stronger, says co-chair Adrian Jones, a program manager for community health improvement.

“We are very intentional in the meetings about how we can work to support each other in the era of COVID-19, and the racial inequity pandemic, and how that is all interconnected,” Jones said. “We want to make sure everyone has resources they need. The reality of what is going on deeply impacts everyone in our organization.”

Jones participates and serves as an additional resource in the Today Not Tomorrow Pregnancy and Infant Support group led by UW Health newborn hospitalist, Dr. Jasmine Zapata. Jones is also a board member at the Wisconsin Alliance for Women’s Health and Foundation for Black Women’s Health, where Kendall is a health ambassador.

Kendall, a Madison native, went back to nursing school as an adult, and says she’s experienced the impact she has on Black patients.

“When I walk into the room, I see their shoulders relax, and they say, ‘I can actually tell you what I’m feeling.’ This is what quality of care looks like to the patients, it’s not an extra,” Kendall says.

Part of improving care, she said, also involves having “frank conversations” with co-workers to improve care for Black patients. Kendall has been a Diversity and Cultural Congruence Resource Nurse, and has spoken to the Cultural Diversity Resource Group, which Tracey Abitz, DNP, RN, CTN-B, NEA-BC, and director of nursing, helped start about eight years ago.

Abitz says the work grew out of a need to care for patients in a culturally congruent manner. She worked with nursing councils to choose and implement the Purnell Model, to guide nursing practice. In addition, cultural humility elements were woven into nursing orientation, competencies, education and documentation in Health Link. At the state level, she founded the Wisconsin Chapter for Transcultural Nursing in 2013. The global work for the organization has been accelerated by the hiring of Shiva Bidar-Sielaff as UW Health’s first chief diversity officer.

“We know that bias exists and that it affects health outcomes,” Abitz says. “We’ve made some movement forward, but there’s still work that needs to be done. It’s a journey, and we need to actively engage and commit to lifelong learning, self-reflection, and partnership in order to eliminate disparities in health outcomes.”

View the full nursing annual report:

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Patients and family members often say how thankful they are for the care they received at UW Health.

Their gratitude is sometimes focused on a nurse who left a memorable imprint on their hearts forever. So much so that they regularly express their appreciation by writing “thank you” letters in the form of DAISY Award nominations.

Because their heartfelt words speak volumes about the special way nurses touched their lives, we asked several grateful patients and family members to read these notes of appreciation to their nurses, on camera, as a special surprise for their nurse. What the readers didn’t know is that they would be the ones being surprised.

Sue and Amy

Louise, Maribeth and Katie

Jamie Hartwig and Luray Ford

https://youtube.com/watch?v=02EOtmg_Xmw%3Frel%3D0

Nathan Fox and Brandon Bendall

https://youtube.com/watch?v=ZnQn1HBWaLc%3Frel%3D0

Maria Christina Jackson and Amber Vozka

https://youtube.com/watch?v=Y3GXAaNBS84%3Frel%3D0

Amber Noggle and Sam Griesser

https://youtube.com/watch?v=h4JW7YuHwqM%3Frel%3D0

Another way we recognize our remarkable nurses is to ask them to read “something” on camera, and they soon discover that it’s a “thank you” from a patient or family member.

Ann Arnold

https://youtube.com/watch?v=4GLSbIuAKq0%3Frel%3D0

Neelam Shrestha

https://youtube.com/watch?v=Ny4ye2UuH6M%3Frel%3D0

Thank you to all UW Health nurses. You are remarkable.

Triage nurses on the frontlines of the COVID-19 pandemic are charged with making complex decisions as patients call in with lists of symptoms and nurses work to ensure that patients receive timely and appropriate care, which may require being seen in person or monitored differently.

This balancing act is further influenced by the reality of working with a previously unknown virus, which results in often changing guidelines and resources to guide care, and the concern of overburdening hospitals and clinics – all the while recognizing the potential consequences related to the spread of the pandemic and individual patient outcomes.

Élise Arsenault Knudsen, PhD, RN, ACNS-BC, is a co-investigator at UW Health for a multi-site study to better understand and model how nurses make triaging decisions during the COVID-19 pandemic.

“We’re interested in how nurses are making decisions and what resources are available to them in their work environment to guide their decision-making,’’ says Arsenault Knudsen.

She was invited to join the study by colleagues at the University of Iowa, including principal investigator Priyadarshini Pennathur, PhD, and co-investigators, Laura Cullen DNP, RN, FAAN, and Stephanie Edmonds, PhD, MPH, RN. The study team has received funding from the National Science Foundation (NSF) through a rapid response research grant to explore what resources nurses use for decision-making, understand the cognitive work of triage nurses, and how nurses’ perception of risk influences their decisions during a pandemic.

After attaining Institutional Review Board (IRB) approval, the researchers plan to use transcripts of phone calls during the peaks of the COVID-19 pandemic and analyze non-clinical data from those calls. They also hope to use screen capture technology to show which resources nurses use, and likely toggle between, to guide their decision making. They will then interview between 40 and 60 triage nurses at UW Health and the University of Iowa to understand their cognitive process and their perceptions of risk.

“Our goal is that once we understand how decisions are being made, we can design tools to help facilitate decision making and better support our triage nurses,’’ she says.

Arsenault Knudsen is the clinical nurse specialist for research and evidence-based practice at UW Health. Her job is to support nurses across the healthcare system to do research and to use research evidence in their practice. Her program of research explores ways to support nurses to change their practice, while accounting for the dynamic context in which nurses work, to optimize patient outcomes.

She says during the COVID-19 pandemic, she has seen research the timelines for research accelerated, including at UW Health.

“Traditionally research studies take months and even years to get off the ground, but NSF funded us in a matter of weeks and the approval processes, including the IRB, are moving at lightning speed,’’ she says.

UW Health is a site for multiple clinical trials involving COVID-19 treatment, which means nurses are not only caring for these patients, but they are also supporting research protocols that will help us to learn more about how to treat them.

“It’s been fascinating to see how quickly studies are getting up and running, patients are being enrolled, and the teams are coming together to accelerate knowledge and treatment for patients here, and all around the world,’’ she says. “These nurses are doing amazing things.”

In late 2019, the World Health Organization deemed 2020 “The Year of the Nurse.” Although it may seem as though COVID-19 has overshadowed this theme, we think it has amplified why 2020 is The Year of the Nurse, more than ever.

During National Nurses Week, May 6-12, we thank and honor all UW Health nurses for banding together in the face of this worldwide pandemic, with grace and dedication. They are on the frontlines bravely facing whatever comes their way. They are heroes and we are forever grateful.

Nurses Week also gives us a distinct opportunity to pay special recognition to a few exceptional employees who exemplify compassion, skill and an outstanding commitment to patient care and the professional practice of nursing.

We are proud to announce our 2020 Nursing Excellence Award recipients and nominees.

Meet Our 2020 Nursing Excellence Award Recipients

Support Staff, Clinical: Catherine Jones, Medical Assistant	Support Services, Non-Clinical: Patrick Van Eyck, Health Unit Coordinator	Rising Star: Fiona Bennett, BSN, RN, Pediatric ICU
Clinical Nurse, Clinics: Anna Bast, BSN, RN, Family Medicine	Clinical Nurse, Critical Care: Angela Kurth, BSN, RN, Cardiac ICU	Clinical Nurse, Home Health and Coordinated Care: Amber Brunner, MSN, RN, Coordinated Care
Clinical Nurse, Medical: Eden Larson, BSN, RN, Medical and Surgical	Clinical Nurse, Pediatrics: Katie Elmer, BSN, RN, Pediatric General Medicine/Surgical	Clinical Nurse, Surgical: Alyssa Holt, BSN, RN, Medical/Surgical and Short Stay
Clinical Nurse, Surgical and Procedural Services: Sally Temple, RN, Operating Room	Primary Nurse: Ann Shefchik, BSN, RN, Pediatric ICU	Leadership and Advanced Practice: Nicole Kalscheur, MSN, RN, Employee Health and Wellbeing

2020 Nursing Excellence Award Nominees

UW Health recognizes all nominees for their valued contributions to patient care:

Amy Alexander Kimberly Ashford Parvin Bandarabad Cheryl Bass Anna Bast Ann Bellings Melissa Beltran Fiona Bennett Kristi Birkle Mary Blum Jessica Brockner Amber Brunner Whitney Buss Barbara Byrne Andreya Carman Tami Cecil Susan Chandre Anya Collard Jennie Corey-Heinrich Suzanne Daugherty Ann Dehn Ariel Demont Shiloh Dolphin-Mack Brittany Douglas Steven Drevlow Rachel Edwards Jennifer Ekezie Kathryn Elmer Aja Elvord David Erickson Cynthia Essex Rikki Flint Renee Floyd Angela Foster Sarah Frank Nicole Gardner Jennifer Goodwin Kelli Gross Jennifer Hackenmiller Alma Hajdari Pamela Hall Tyler Hardyman Kaitlynn Harkonen Mary Herman Emily Hertel Alyssa Holt Meghan Holum Carly Hood Susan Hopkins W. Steven Hughes Christy Hunter Heather Hustad Elizabeth Johnson Catherine Jones Jennifer Kakuske Nicole Kalscheur Catherine Kellihan Sarah Keyes Stephanie Klock Jennifer Kooiman Mohr Jacob Kopmeyer Angela Kurth Karen Lacy Erika Lang Sara Larsen Eden Larson Earlene Laudin

Nicole Laufenberg Caroline Ledbetter Carrie LeMahieu Janna Lewis Jeremy Lins Wittnee Linscheid Peter March Emily Maritato Janean Marr Karen Marvin Nicole Marx Courtney Maurer Linda McKenna Ro Mean Alicia Meier Marguerite Milanowski Eden Miller Dawn Mills Marcie Mitchell Lisa Moyer Janessa Muchow Ann Nelson Elizabeth Niblack-Sykes Andrea Noeske Mary Ellen O’Leary Arianna Opsahl Christopher Plampin Laura Potamousis Carrie Pulvermacher Joseph Ramia Rohenie Ramnarine Brooke Ramsey Shelly Reyzek James Russell Robert Scheel Megan Schroeder Melissa Schwab Ann Shefchik Jenna Shinstine Erik Sikora Sara Stewart Brittany Stombaugh Justin Strom Mary Sutter Sally Temple Kusumam Thayyil Nancy Tschoeke Patrick Van Eyck Danielle Varnell Michele Voss Teresa Wagner Kelsey Walsh Michele Warnke Joan Watson Megan Webber Jennifer Weber Heide Weiss Kathryn Wellenkotter Mary Faith Welling Sara Westra Jacqueline White Steven Wiese Terrance Wilde Emily Wilhelmson Samyej Xiong Hushee Xiong-Vang

Rudy Jackson, DNP, MHA RN, CENP Senior Vice President, Chief Nurse Executive Rudy Jackson came to UW Health in August 2020 and brought with him a fresh perspective on nursing leadership. This resulted in the expansion of UW Health’s executive nursing leadership structure to include a total of four Chief Nursing Officers to improve access and support to direct care RNs in all practice settings. In addition, Rudy fully embraces a transparent nursing shared governance structure to ensure that RNs are partnering with leaders in shared decision-making to help further shape and improve professional nursing practice and patient care at UW Health
Michele McClure, MSN, RN Vice President, Chief Nursing Officer-University Hospital	Anne Mork, MS, MHCDS, RN Vice President/Chief Nursing Officer, Ambulatory and Nursing Support Services
Luke Sticht, MSN, RN, CNML, CCRN-K Vice President/Chief Nursing Officer, American Family Children’s Hospital	Nicole Kalscheur, MSN, RN Chief Nursing Officer, East Madison Hospital

On Oct. 12, 2017, at the national Magnet conference held in Houston, Texas, UW Health nurse Susan Gold, BSN, RN, ACRN, was named “Magnet Nurse of the Year” for Exemplary Professional Practice, by the American Nurses Credentialing Center – one of the top honors a nurse can achieve.

Gold, who received the Nelson Mandela Fellowship earlier this year, was honored for more than 25 years of exceptional nursing practice and her educational efforts in Africa, to raise awareness among adolescents about HIV and AIDS.

Gold was joined at the Magnet conference with UW Health nursing leaders and colleagues.

“I felt so honored and reminded, again, why UW Health is the best place to be a nurse,” stated Gold. “This award is a reflection of all the support I’ve gotten from nursing co-workers, managers and nursing administration over the past 26 years.”

During her introduction of Gold at the Magnet conference, Beth Houlahan, DNP, RN, CENP, UW Health Senior Vice President and Chief Nurse Executive, said:

“At the intersection of the art and science of nursing, all roads lead to Susan Gold. While she came to the profession of nursing later in life she did not waste any time improving the health and well-being of the individuals and communities she served both locally in Wisconsin and across the globe in East Africa. Susan embodies all the tenets of a Magnet nurse.”

On Oct. 18, 2018, at 11:30 a.m., the Magnet Commission for the American Nurses Credentialing Center (ANCC) called Beth Houlahan, DNP, RN, CENP, UW Health Senior Vice President and Chief Nurse Executive, who was anxiously waiting with a room of approximately 300 UW Health colleagues, to announce that UW Health has once again, been re-designated as a Magnet® organization.

This is very exciting news for UW Health and its patients, considering that the Magnet re-designation application process gets more rigorous each time an organization re-applies, every four years. Fewer than 10 percent of all registered hospitals in the United States receive Magnet designation or re-designation.

Jeanette Ives, Erickson, DNP, RN, NEA-BC, FAAN, Executive Committee Member for the Commission on Magnet Recognition, ANCC, delivered the exciting news to Dr. Houlahan, congratulating her and the organization, and making a point to call out some of UW Health’s impressive exemplars.

In an emotional speech following the announcement, Dr. Houlahan stated, “I’ve worked for many other organizations and I have to say that UW Health – our nurses, staff and faculty – are simply the best. Thank you for all you do.”

Other leaders shared the same sentiment, thanking all UW Health teams for all they do to make UW Health Magnet.

What is Magnet?

Magnet designation is the most prestigious title a health care organization can achieve for nursing excellence and quality patient care. UW Health is one of 10 Magnet organizations in Wisconsin and one of 448 in the world.

In simple terms, Magnet is a big deal for patients and families – knowing they will receive the highest level of care at a Magnet hospital. For health professionals, Magnet shows that UW Health is set up for excellence. This leads to a sense of pride among faculty and staff in working here, and even more pride in contributing to our vision of providing Remarkable Healthcare to patients and families, near and far.

NPs Bring Peace of Mind and Better Outcomes

83-year-old Shirley Ward takes a deep breath as nurse practitioner Elaine Makarowski listens to her lungs. But the checkup didn’t happen in a clinic. It happened in assisted-living facility Waunakee Manor, where Ward lives.

Makarowski, NP, is one of 10 UW Health nurse practitioners who provide care for patients at 19 long-term care and rehabilitation facilities throughout Dane County. The goal of the program is to take primary care services to skilled nursing facility (SNF) residents so they don’t have to leave for care.

That’s important to Ward.

“It means a lot because otherwise I’d have to go across town (to a clinic),” said Ward.

Makarowski said Ward is one of 550 assisted living, long-term care facilities and rehabilitation facilities residents who benefit from the service.

“It provides a picture into her life and the lives of other patients. This is their home. So I get acclimated and get to know them,” explained Makarowski. “My days are flexible. So if a patient needs care, I can find time to see them almost immediately.”

The nurse practitioners say the program reduces stress, improves resident and family satisfaction, increases safety and provides continuity with nursing facility staff.

NPs stay connected and in contact with residents’ UW Health primary care physicians and specialists to deliver care that utilizes both physicians’ and nurse practitioners’ skills and expertise.

Makarowski, who provides care at two of the 19 facilities, said care for both short-term and long-term residents runs the gamut.

“We deal with everything from acute issues and end-of-life discussions to managing prescriptions and hospital orders to make sure they’re correct and clarified,” said Makarowski. “We also ensure safe discharges from SNFs to either home or assisted living, advocate for patients by attending care conferences and many other things.”

The care is identical to the care provided in clinic and that improves patient outcomes, said Makarowski. The NPs have full access to x-rays, ultrasounds and laboratory services.

“Since we get to know our patients very well, we can identify even subtle changes that may indicate a change in condition,” said Makarowski.

UW Health has found that bringing these primary case services to SNF residents has not only reduced emergency department visits and hospital readmissions, it has saved at least $2 million in readmissions.

The program started 20 years ago with one nurse practitioner and has now grown to 10 NPs. And assisted-living residents like Shirley Ward continue to count the program as a blessing.

“It makes me feel great,” said Ward. “I can’t even explain it.”

Inpatient Staff Lives Up to the Promise

From the time that UW Health at The American Center was merely an idea, the goal has been to create and sustain a truly patient- and family-centered culture in which healthcare addresses the needs of the whole person.

The most recent Press Ganey Guardian of Excellence Award confirms that UW Health at The American Center is living up to the promise.

In November 2017, UW Health at The American Center received the award, given to organizations that sustain performance in the top five percent of those surveyed during the year. To qualify, organizations must perform at that 95th percentile during all reporting periods in the award year. UW Health at The American Center was recognized in the “Patient Experience” category for inpatient care.

Delivering a high-quality patient experience involves managing many diverse components of that experience. Vicki Hill, vice president of clinic operations at The American Center, says that the work begins with data: monthly Press Ganey results are shared in the daily unit huddle and posted on the “huddle board.” Teams discuss the findings and use process-improvement tools to identify and address problems and measure the outcomes.

For example, data showed that more than six percent of specialty clinic patients at The American Center did not have their medical records available for the provider when the patient was in clinic. That resulted in an inefficient workflow and dissatisfied patients. A team including RNs, NPs, schedulers and management identified where the problem was occurring and the root causes underlying it, such as a lack of a central location for hard-copy records.

After implementing three changes in the workflows of schedulers and RNs, the team checked the results, which showed that the number of patients missing information related to their appointment had dropped to zero.

Hill said that transparency about Press Ganey results has prompted several successful improvement projects across teams. The commitment to continuous quality improvement reflects the overall idea behind The American Center site: Well before the building was even designed, groups of patients and family members offered ideas about what it should provide, how it should be laid out and what kind of services and amenities patients would appreciate.

The UW Health Patient and Family Experience Promise sums up the approach. Its three simple principles – listen with compassion, communicate effectively and treat patients with respect – encapsulate what patients and families should be able to expect from UW Health.

“Our staff is continually focused on the well-being of our patients as exemplified by their individualized, compassionate care,” says Senior Vice President, Chief Nurse Executive Beth Houlahan. “When providing our patients with an excellent experience, our staff is always mindful of meeting their needs relative to their mind, body and spirit.”

UW Health and UnityPoint Health – Meriter Partnership

Today’s healthcare industry is changing at a dramatic pace, often propelled by mergers, acquisitions and partnerships allowing healthcare systems to provide care and services to larger regions of consumers.

These changes can seem confusing and complicated to the average person, and even to those who work in healthcare. Concerns can arise about potential depersonalization of care, resulting with patients feeling like they might be treated as a number, that they won’t get to know their provider(s), or that they’ll feel shuttled around.

Fortunately, Christine Schmidt, RN, a patient representative with Meriter, can attest that UW Health and UnityPoint Health-Meriter refuse to let that happen as a result of their joint operating agreement (JOA) and are determined to make it smooth and seamless for patients. A defining goal of the joint operating agreement is to ensure that the right care is provided at the right location.

“I meet with anyone who gets transferred to Meriter from UW Health as part of a pilot to see what process improvement might be needed,” says Schmidt, who’s been in her patient representative role for four years after serving as a labor and delivery nurse for 32 years.

“Medical and cardiac patients over the age of 60 are the main populations that have been transferred from the emergency departments (EDs) at University Hospital and East Madison Hospital. Transitioning these patients to Meriter allows us to place the right patient in the right setting where the care they need can be best provided.”

Since the implementation of the pilot in 2017, Schmidt has met with nearly 40 patients.

“Patients have been extraordinarily kind about the transitions and say that their transfers were smooth,” says Schmidt. “Not one complaint has been voiced.”

This positive feedback reassures Schmidt and leaders of both organizations that the JOA is proving successful in this area, thus far.

“The most important piece of our partnership is to ensure that patient care is not disrupted or compromised in any way,” says Sue Rees, DNP, RN, CPHQ, CENP, Vice President, Chief Nursing Officer-Inpatient. “The work Christine and the service excellence group are doing serves as a great ‘pulse check’ for us, and we’re confident that this success will carry over into all areas of care that we provide jointly.”

Older adults are one particular patient population that Schmidt says “are handled with extra TLC at both UW Health and Meriter.”

“The elderly patients say they feel so taken care of, which is reassuring to hear,” says Schmidt. “They are typically fragile and there is some extra kindness involved in getting them from point A to B very carefully, and in the best way possible. Not one older patient has ever said ‘this doesn’t feel right.’ There literally have been no questions, no qualms.”

Throughout the pilot, Schmidt recalls some instances when little things seemed to matter most.

“There was a 94-year-old patient who was very particular about her hair,” Schmidt said. “She misplaced her Velcro rollers in transit, so I ran out to purchase some for her. She was thrilled.”

Schmidt also comments that one particular gentleman was extremely appreciative of the nightshift nurse who wrapped him “extra tight” in a blanket when he couldn’t seem to get warm.

In addition, it’s communicated to patients that the transfers are not billed to them in any way.

“We let them know that UW Health and Meriter are picking up the tab,” says Schmidt. “These little things and the extra special treatment seem to be the most appreciated.”

Future plans for Schmidt include meeting with infusion patients, to see how services can be improved, given the recent move of some infusion services from UW Health to Meriter.

“Change can be difficult,” says Schmidt. “The key is to continuously review our processes and improve the patient experience to ensure the care each person receives is seamless. Our hope is to make it better than ever before.”