Vermont Business Magazine A new book by Billie Lynn Allard, MS, RN, FAAN, follows her and her team at Southwestern Vermont Health Care (SVHC) as they attempt to solve the most pressing healthcare delivery problems in America today. Titled INSPIREd Healthcare, the book is available now from Sigma Publishing.
“I am so proud to have led a team of nurses toward a new way of delivering care and to have seen our community benefit,” Allard said. “And I am overjoyed to have the story of this critical work in a single place and available to nurses, nursing students, and healthcare leaders to use and, I hope, replicate.”
As early as the 1990s, healthcare has been shifting from inpatient units to outpatient clinics. The story of the book begins with the task to reassign highly skilled nurses from inpatient units, where the number of patients no longer required as many veteran nurses, to an outpatient role. The effort coincided with a mandate to fulfill what is commonly known within the healthcare industry as the Triple Aim: improving the patients’ experience of care, improving the health of populations, and reducing per capita healthcare costs.
The first step was a meeting with the medical home case managers, home care agencies, skilled nursing facilities, and community partners. The goal was to avoid duplication, identify the gaps in care coordination, and deliver care as one community health team.
The reassigned nurses increased contact with high-risk patients in partnership with local primary care offices. The highly skilled nurses met patients wherever they received care—including their primary care office, the Emergency Department, inpatient unit, and nursing home—and smoothed the way. The Transitional Care Nurses, as they became known, even went to patients’ homes to ensure they had everything they needed to live and recover successfully.
The nurses were able to identify and quickly rectify many of the issues that had caused readmissions, including social determinants of health. Using data collection and evaluation, the nurses saw that readmissions went down. At the same time, patients’ experience of health care improved, healthcare quality improved, and spending decreased. The program was working. It quickly received national attention for its innovative approach and breakout success.
While the nurses found that they could solve some problems easily, they also identified several harder-to-fix problems that required new partnerships and programmatic changes throughout the continuum of care. Positive results from the initial effort justified additional resources, including social workers, clinical pharmacists, physical therapists, and diabetes educators. The nurses recognized the critical role of community agencies and welcomed their help and expertise in the creation of community care teams. They called the expanded program an accountable community of health.
The program’s additional success garnered more attention from such organizations as the American Hospital Association, the American Nurses Credentialing Center, American Organization of Nurse Leaders, and others.
“I was invited to speak all over the country, but it was difficult to get the whole story into a 45-minute podium presentation,” Allard remembers.
She was disbelieving when the publishing arm of Sigma Theta Tau, the international honor society for nurses, called to say that they had seen an article she had written and that they would like her to write a book proposal.
“I thought it was a crank call,” Allard says.
Once she had verified the call, she agreed and spent every spare moment working first on the proposal and then, once accepted, the manuscript. Transitional care nurses and other colleagues served as contributors to this effort. The book outlines the entire process from start to finish, including how she and her team originated and implemented the programs and how the programs have affected each of the patient populations involved.
“The INSPIRE Model that the nurses at SVHC created provides an evidence-based blueprint for other healthcare systems hoping to solve the complicated problems surrounding care transitions and health promotion,” said Dustin R. Sullivan, publisher at Sigma.
SVHC’s Chief Nursing Officer Pamela Duchene, PhD, APRN, is grateful for the visionary work Allard has done to improve care locally and nationwide.
“The passion and intellect we have seen from Billie Lynn and her team have already made such a tremendous impact on the lives of our patients and the lives of the professionals she has reached,” Duchene said. “We hope that her book will go on to become a classic in the healthcare profession and that it is just the beginning of much-needed changes throughout our nation’s healthcare system.”
Allard is the administrative director of Population Health and Transitions of Care at Southwestern Vermont Health Care. As a nursing leader for the past 35 years, Allard has spent her career leading innovation in community hospital settings, serving as director of Cardiopulmonary Nursing, director of the Emergency Department, and chief nursing officer. Her visionary leadership style inspired nurses to function at the height of their capabilities, achieving 100 percent certification; implementing cutting-edge, evidence-based practice; transforming care delivery; and improving patient satisfaction and clinical outcomes. In the past decade, Allard has led the implementation of an Accountable Community of Health as part of an all-payer model in Vermont.
Those interested in obtaining a copy can visit www.sigmamarketplace.org/sigmabooks or their favorite bookstore.
Southwestern Vermont Health Care (SVHC) is a comprehensive, preeminent, health care system providing exceptional, convenient, and affordable care to the communities of Bennington and Windham Counties of Vermont, eastern Rensselaer and Washington Counties of New York, and northern Berkshire County in Massachusetts. SVHC includes Southwestern Vermont Medical Center (SVMC), Southwestern Vermont Regional Cancer Center, the Centers for Living and Rehabilitation, and the SVHC Foundation. SVMC includes 25 primary and specialty care practices.
Source: BENNINGTON, VT—August 4, 2020—SVHC