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My pitch: what's the worst that can happen?

Advocate Aurora Healthcare Chief Strategy Officer: Call to Action

Nedden, Becca Thu 5/20/2021 5:45 PM To:

  • Sitafalwalla, Shoeb


  • Skogsbergh, Jim

Good morning Mr. Sitafalwalla, My name is Rebecca Nedden, and I am a current employee of AAH. Several weeks ago, I saw the e-mail that highlighted Jim introducing you into the strategic role for the organization. Throughout this past year of challenges and growth, I have reached out to Jim directly several times and have been absolutely astounded with his openness, response, kindness, and accessibility. So, I thought that I would take a chance and reach out to you with some of my thoughts. I understand that you are in a role of enormous responsibility as this organization is large, spanning several states with varying regulations, touching hundreds of thousands of lives, and involving too many moving parts to count, but... I have a vision. Integrative primary care. I envision a genuine and progressive approach to wellness that provides primary care to our general patient population by marrying the science of evidence-based medicine with the care of the whole person: a focus on primary prevention, spiritual/energetic body wellness, living life with purpose, caring for self, building an authentic relationship with your primary care provider, and transition away from the "pill popping" culture of simply managing disease - quantity over quality. It is my wholehearted belief that MANY healthcare consumers are desiring a holistic approach that both works to manage disease progression and seeks to assist the patient in correcting the modifiable root causes of illness. Primary care that educates and models the importance of nutrition, mind-body-spirit connection to self and others, resilience, fosters a bond with nature, and creates a healing, comfortable environment in which to receive care. The need for healthcare, for PRIMARY CARE, to pivot has never been clearer. As we emerge from the global trauma of the pandemic, experiences of incivility, inequality, and social unrest, the need for WHOLE PERSON care is blatant. I know that our fledging behavioral health system cannot expand capacity to meet a need this great. Physicians and healthcare providers are experiencing burnout and moral distress within the current model of primary care delivery, often finding that the constraints of the system (legal, financial, societal, political, etc.) fail to provide an environment that allows them to confer the care that they desire to give. We pursue careers in medicine with one very basic intention: to help people. However, the current design leaves many healthcare providers feeling disillusioned, uncoordinated, overwhelmed with unrealistic expectations, inadequate, dissatisfied, and unfulfilled. These sensations of shortcomings place primary care at an even greater disadvantage in an arena that is already experiencing a shortage of providers. Consumers feel trapped or helpless to exert their preferences because the financial burden of healthcare forces them to seek care within their approved insurance networks which are failing to provide them with a valued, authentic primary care experience that not only promotes health, but enriches their lives. A healthcare home that supports & nurtures their human potential, meets them where they are without bias (Jean Watson's Theory of Caring), and enables patients to feel uplifted, hopeful, and empowered at conclusion of their primary care experience. With society, and therefore consumers of healthcare, increasingly identifying as spiritual (not religious), becoming increasingly aware of their metaphysical body/spirit, and increasingly conscious of the perceived value of their financial investments, there is a greater need to provide SERVICE to our patients: time, comfort, education, reassurance, energetic investment, and to hold a sacred space for them. No one wants to be treated like another cog in the wheel, a number, a burden, or have an experience of being belittled, subordinate to a medical professional, or undervalued as a human being. The current culture of healthcare creates the verbiage & sets the intention of providing individualized/personalized care, promoting diversity & inclusion, yet continues to experience a mismatch between intention and result. Patients are seeking care and investing billions of dollars into naturopathic, functional, integrative, and concierge medical services which are frequently performed as consultations rather than the established long-term relationship with that is forged with a primary care provider, through which continued growth can be experienced and shared. My nursing career began at Aurora, and I have always anticipated remaining within the system in which I've grown as I finish my education as a family nurse practitioner (anticipated program completion of 2/2022). Going into the program, I did not know what I wanted to do when I was done...but I did know one thing: I did NOT want to work in primary care. However, turning inward and reflecting on my career, I have come to identify a common thread: the one thing that I resist the most is the direction that I am called to take. I strongly believe that the future of healthcare lies in providing this type of service, presenting an opportunity for patients to choose Advocate Aurora because they desire to come here and not as a necessary obligation. Just as patient's have choice on which hospital to deliver their child at; I envision a soothing, healing, calming and aesthetically pleasing atmosphere with views of/access to nature if desired. Think about how you would feel if you were handed a bathrobe to put on for your yearly physical instead of a ratty, ill-fitting, dehumanizing hospital gown (or having your provider not even have you get into a gown for your "complete" exam). Although the gown is necessary for inpatient care and vascular access/maintaining dignity in the critically ill, it does not hold an esteemed place within outpatient, ambulatory, primary care. A bathrobe is soft, familiar, comfortable, warm, and perfectly facilitates a physical exam. The room itself is awash in natural light, with a sleek mid-century modern chair. Its handsome wooden arms and worn cognac leather are inviting you to take a seat and cover yourself with the cream-colored throw over its back. The only items on the smooth quartz countertop are an otoscope and an ophthalmoscope. It is sleek, clean, and unthreatening. You take a seat on the exam table and gaze out the nearby window to the nearby creekside that is surrounded by lush ferns, a breeze laces through their branches as they wave at the sky. In the distance, you can see a marshy clearing along a tree line where black birds flit up from the wildflowers. Imagine finishing your physical assessment, stepping onto the patio outside your exam room, and taking a seat to have an engaging conversation about your preventive care, your connection to self and purpose, fulfillment and engagement, nutritional & medicinal education, goal setting, or to just sit and receive a 10-minute guided meditation with reiki from your primary care provider. THIS is what I hope to give to my patients and what I would desire to receive. For years now, the inpatient hospital experience has integrated these concepts through the privatization of rooms, soothing aesthetics, accessibility to healing gardens, concealed medical equipment, and prioritizing a quiet and calm environment with reduced interruptions. However, this has only just begun to spill over into the outpatient realm as medical providers realize the need to attract and/or retain patients with elements that inspire comfort, confidence, respect, and trust. The hospital being built off highway 43 in Kohler, Wisconsin is incorporating concepts to support staff wellness such as private outside access from breakrooms and "Zen Dens" that were introduced during the pandemic to provide reprieve from the stressors of constantly extending oneself to others. I have found support and positive reinforcement within AAH by reaching out to develop relationships with others practicing integrative care. Rebecca A. Schultz, a practicing integrative nurse practitioner and a clinical professor of integrative care, has been instrumental in both inspiring and reinforcing my aspirations to provide integrative primary care. She has also provided further insight into the self-care aspect needed to personify and model this type of balanced lifestyle, better equipping the provider to deliver care of this caliber. I have also spoken with Dr. Sara Pierce, Director of Integrative Health, and received both encouragement and insight into the organizational state of integrative health at AAH. My hope is to remain within the AAH system as a provider: elevating care delivery, living out my vision, and take up the torch on the path that those before me, like Rebecca Schultz, have forged. After completion of my MSN, I desire to continue my education and become one of the 26 --> 27 fellowship trained integrative providers within the AAH system. I would like a seat at the table; an opportunity to contribute to a new era of western medicine. Warmly & in love and light, Rebecca J. Nedden Extraordinary Exam Rooms That You Wouldn't Mind Going To — Etactics Extraordinary Exam Rooms That You Wouldn't Mind Going To. Matt Moneypenny. September 15, 2020. Patient Engagement. We know that patients don’t like coming to their appointments, that’s not a secret. There’s a reason why strategizing new ways to engage with clients exists. As a whole, though, the healthcare industry can sigh in relief.

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