Nurses Leading with Care by Reaching Beyond their Walls

This month we honor our nurses who go outside their clinics for patient care. 

Karen Koenig, RN
Care Management Department Manager
Alcona Health Centers
Northern Michigan

As the department’s manager, Karen Koenig supervises seven care managers at Alcona Health Centers (AHC). This dedicated team supports hard-to-reach patients living in the upper peninsula of Michigan and the northern lower rural communities there.

For AHC patients, transportation has long been a barrier to receiving recommended health care services. When the COVID-19 pandemic began, Karen and her care management team welcomed the opportunity to quickly transition to new service delivery options including telehealth visits, audio only visits, or parking-lot visits. Telehealth has eliminated the need for their patients to travel to the clinic, and it has allowed hard-to-reach patients to connect with their care managers. For patients who have access to transportation but have no internet service or smart devices, the clinic adopted the use of tablet-based appointments at one of AHC’s parking lot “hot spots.” Karen has appreciated the chance to make care management more accessible for more rural and hard-to-reach patients with these new and more accessible service delivery options.

In spite of unprecedented challenges throughout 2020, Karen and her team have been able to increase Medicare patient engagement in care management services by 11%. With AHC’s 5500+ Medicare patients, this represents quite an accomplishment! “With our large, dispersed Care Management Department, we’ve been committed to drive the Triple Aim at Alcona Health Centers, and we’re pleased to see how much our patients appreciate what we do,” says Karen.

Karen recognizes that it takes a team to provide the excellent patient care that she is being recognized for. Karen says, “My staff deserves recognition for all they do to make our department and organization successful!  Health care is a demanding field and delivering quality health care has been even harder with the pandemic. Still, I am so proud of how my staff stood-up to the challenges and work every day to provide top quality care and education to our patients. We all feel rewarded when we can support our patients as they reach their health goals.”


Working upstream to address the patient and the system

Courtney Pladsen, DNP, FNP, RN
Clinical Director
National Health Care for the Homeless Council
Portland, ME

Seventeen out of every 10,000 people in the United States were experiencing homelessness on a single night in January 2019 during HUD’s Annual Point-in-Time Count. These 567,715 people represent a cross-section of America- through every region of the country, family status, gender category, and racial/ethnic group. While Courtney Pladsen can’t help all these 567,715 people, she tirelessly takes care of Portland, Maine’s homeless population.

As a Nurse Practitioner, Courtney has spent the past eight years working at federally qualified health centers. For the past 2 years she has worked at Greater Portland Health’s Healthcare for the Homeless Clinic, a community health center providing primary, substance use, and mental health care.  Courtney recognizes coming into a health care facility can often be overwhelming for some patients. Greater Portland Health partners with the Milestone Recovery outreach team and they goes out in a van in the field to find unhoused patients. She visits encampments, woods, and drives around the streets. “I literally meet them where they are. I want to be sure the walls aren’t a barrier,” she said.  Once she locates her patients, she and other medical staff work to build relationships and provide much needed medical care. By decreasing the barriers to care, this develops a trusting relationship and makes it less overwhelming to access care at the health center.

Her work has been especially challenging these past few months. “COVID-19 has just exacerbated the inequities in our health system,” Courtney said. Almost half the Black people in Maine are immigrants, the highest share in the nation. She notes that in Maine, where Black individuals represent only 2 percent of the population, they represent 22 percent of those who have tested positive for COVID-19. The reasons, Courtney explained are compounded by systemic racism, densely populated shelters, front line jobs with no job security, and limited access to health care. COVID-19 has also increased the existing opioid crisis by fueling social isolation and anxiety. The number of overdose deaths in Maine have increased in the first quarter of 2020 compared to 2019. Providing medical, mental health, and substance use treatment with a health equity focus for Pladsen has been more important now than ever.

Courtney approaches advocacy as an essential piece of her work. In 2019 Courtney helped advocate for a bill by testifying before the state legislature to pair funding for substance use treatment with housing. This bill became law and Greater Portland Health, in partnership with the social service organization Preble Street, was awarded the grant. “The advocacy of our organizations that you ‘cannot have recovery without housing, because Housing is Healthcare” was a powerful message and ultimately we were heard. These partners will launch this program this fall that will provide much needed substance use treatment and housing for our patients, “ she said.

Courtney is ready for her next challenge. She accepted a position as the Clinical Director at the National Health Care for the Homeless Council. In this role she will be supporting the over 230 Health Care for the Homeless clinics across the country through research, policy/advocacy, technical assistance, and education. As she steps into this national role she will happily keep her roots in Portland, Maine and continue to see patients at Greater Portland Health one day a week. Her ultimate goal is to put herself out of a job. She explains, “I hope that one day that we will see the end of chronic homelessness, and that health care for the homeless will no longer be necessary”. She will continue her advocacy and working towards system change until this is realized.

Working with kids, you are helping to protect their future

Ashley McCoy, RN
Pediatrics Clinical Manager
Tandem Health
Sumter, SC

Ashley McCoy, RN, is a busy Pediatrics Clinical Manager at Tandem Health Center in Sumter, SC. While pediatrics is often looked at as a fun and easy setting to work, Ashley describes it like this: “ People think I’m just playing with babies all day. Quite the opposite. There is very little room for error when it comes to kids and you need to be on your game the whole time. Working with kids, you are helping to protect their future. They may be able to lead a healthier life because of you.”

And that’s just what Ashley has done. Between leading daily huddles with the team, addressing obstacles the day before or adjusting workflows for the current day, Ashley also has also participated in longer term projects that help to address the health of her community. One of these examples is her management of the Reach Out and Read Program, a national non-profit organization which promotes daily reading and other language-rich activities, for her patients. Ashley also became a nationally certified Child Passenger Safety Technician so that she could be a resource for not only her patients but for all children in the community to provide education and hands on assistance with the proper use of child restraint systems and seat belts.

A highlight for Ashley and Tandem Health was their participation in an HPV Vaccine learning collaborative. It was through the HPV Vaccine learning collaborative that Ashley and her team looked at their adolescent HPV vaccine rates, which were 38% at the time. Through innovations alongside her team, including increased communications strategies, a back-to-school event and clinical team training, Tandem Health raised their HPV immunization rates to 78% and were named as a “HPV Vaccine is Cancer Prevention Award” winner by the CDC.

Ashley’s work with the children in her community is a strong example of how a nurse can lead with care to positively affect a child’s future.