It’s an inauspicious start to a nurse-patient encounter. But what happened right before? Why are they both so disgruntled?

The answer is the basis for two short, animated videos, which are intended to help patients and nurses empathize with each other in an era when incivility in hospital settings is on the rise.

The videos were produced by associate dean for practice and community partnerships Carolyn Dickens, PhD ’17, ACNP, FAANP, with Eileen Knightly, MHA, RN, vice president and chief nursing officer at OSF HealthCare Little Company of Mary Medical Center in Evergreen Park, Illinois. The project had grant funding from the Community Health Advocacy program.

Knightly says the videos are designed to promote empathy. “When patients and families arrive for care at hospitals they are scared, vulnerable and anxious. Our Mission Partners (employees) also have life challenges of their own and might not feel their best and when met with anger or anxiety multiple times a day it is not easy to serve with compassion, says Knightly.  "These videos serve as a reminder that meeting people where they are and leading with kindness makes every situation better.” 

Hospitals, clinics and care settings are encouraged to download the videos in and use them to promote civility between patients and nursing staff.

'A Nurse's Day'  

The video series, called The Silent Exchange, largely relies on visuals so that the message is accessible to everyone, regardless of language.

The two videos, “A Nurse’s Day” and “A Loved One’s Day,” offer insights into both sides of the same nurse-patient interaction.

In “A Nurse’s Day,” a nurse arrives at work to see an unrelenting patient schedule and sets out to respond to a non-stop barrage of call lights from sick and angry patients.

The video is intended for viewing by patients and families to highlight the pressures and demands on nurses that are largely invisible to those they serve.

“Our goal is for hospitals and clinics to download and disseminate these videos widely – to nurses, patients and their families,” Dickens says. “We’ve seen a rise in incivility between patients and staff in hospital settings, and we know this has led to staff burnout and nursing shortages. It’s detrimental not only to the well-being of nurses, but also to patient care and outcomes.”

‘A Loved One’s Day'

In “A Loved One’s Day,” a harried woman must leave work in the middle of the day and find childcare for her daughter so she can go to the hospital, where her father has been admitted. An attempt to ask for help using the call light goes unanswered for 40 minutes before the nurse arrives.

The video is intended for viewing by nursing staff to remind them of the fear and frustration patients and their families feel in unfamiliar clinical settings when they or a loved one is ailing.

Both videos end with the same message: “Everyone’s stressed. Let’s help each other.”

“We want these videos to be a reminder of what may have preceded the interaction that patients and clinicians have in the hospital room, and we’re hopeful they help patients, families and staff treat each other more kindly,” Dickens says.

Short clip of video from A Loved One's Day

QR Codes for ‘A Nurse's Day' and ‘A Loved One's Day'

Answer a few questions on a social media quiz and it’ll tell you which character on Friends you’re most like. That’s the same concept behind a new healthcareers.guide developed by OSF Innovation and the Illinois College of Medicine at the University of Illinois, Chicago (UIC).

The health careers guide is aimed at creating awareness and helping middle and high school learners understand the types of skills, length and cost of education, and potential earnings for a chosen health-related career. Noël Adams, vice president for academic collaborations and operations at OSF HealthCare says the easy-to-use guide allows young people to explore careers on their own or filter according to a few questions about their personality.

“They can also go in and answer a few questions that relate to their personality like, ‘How do you feel about blood?’ or ‘Are you introverted or extroverted?’ Adams continues, “Then, we map those types of skills to the different health care careers. So, after they answer those, it’ll return a whole list of types of careers that would fit those particular personality types.”

The guide can be accessed easily according to Adams.

“It’s mobile friendly so that can do that through a phone, or they can do it through their Chromebooks at school. We really tried to make the content school-friendly so that schools can help promote this version of learning and what these different types of careers are through their own curriculum.”

Adams says despite a nation-wide shortage of critical health professionals such as physicians and nurses, there is not easily accessible educational content to reach young people, particularly in underserved communities where those professions are needed the most.

OSF HealthCare, through its Innovation division, has developed free STEAM programming focused on health careers and the National Center for Rural Health Professions (NCRHP) at UIC has led innovations in health career pipeline programming to address the significant disparities in underserved areas. The Center has established programs in rural and urban underserved high schools, community colleges and four-year universities throughout the state of Illinois.

App is unlike any available

“This is a really innovative approach in reaching today’s generation of learners who often access information online and in interactive ways,” said Hana Hinkle, Hana Hinkle, PhD, MPH, UIC’s assistant dean for Rural Health Professions. She continued, “We aren’t aware of any other program available in the country that leverages this this type of platform and algorithm and we are very grateful for the partnership with OSF Innovation and through the CHA programming to make this idea a reality that so many students will benefit from.”

The health careers guide was created with support from a Community Health Advocacy (CHA) grant, a partnership between OSF HealthCare and UIC that brings together faculty researchers and health care professionals to develop innovative solutions to health-related problems in urban communities.

Adams says the guide is unique – unlike what is available at most schools or career centers. It uses technology developed by the OSF Innovation Medical Visualization team and content from an existing, extensive guidebook used regularly to support additional education through the Rural Health Professions Center at UIC.

The platform allows the user to drill down into jobs to learn far more than what’s available from a typical brochure.

Adams explains, “It helps youth understand what a job is all about, how it works, and then gives lots of detailed information like how much school you need, how much you might get paid, how long it takes to train, and then helps find job openings on different websites.”

Throughout development of the health careers website and app, researchers had students attending career events, beta test the app and provide feedback for improvements. Adams says not many tweaks were needed.

“We received many positive comments from youth test groups about how we've used pictures to explain information related to careers instead of having too much text in the application,” Adams says.

Researchers have sought CHA grant funding for phase two which would focus on adding more careers to the app and tapping into existing regional networks to provide direct mentorship, coaching and support to identified students.

Video clips with  Noël Adams

B-roll of health career guide

Peoria, Illinois-based OSF HealthCare is partnering with the University of Illinois Chicago (UIC) to award six grants totally more than $460,000 to support projects funded through the Community Health Advocacy program, with a goal to improve outcomes and reduce health care disparities. The latest grants seek to generate solutions focused on new models of care that improve access and reduce barriers for individuals from all racial and ethnic backgrounds. The projects also explore prototypes that can transform care and community-based initiatives that address the social determinants of health. The CHA program is also aimed at improving outcomes and reducing health care disparities.

The CHA program is a partnership between OSF HealthCare and The University of Illinois Chicago (UIC).

The funding supports research involving clinicians, engineers and social scientists to rapidly develop technologies and devices that could revolutionize medical training and health care delivery. A requirement of the grant applications was for solutions that could be deployed quickly, within four to six weeks.

Spring 2023 CHA Grant Projects

Automated Seizure Detection in Ambulatory EEG

• Huan Huynh, MD, OSF HealthCare
• Biswajit Maharathi, PhD, University of Illinois Chicago

Ambulatory EEG is a powerful tool to evaluate seizure propensity in patients with epilepsy within natural community settings and residential environments. This goal of this pilot project is to build a semi-automated seizure screening system using modern machine learning-based computational approaches to significantly reduce the physician’s time evaluating these events by providing faster and more accurate screening methods and improving the patient care experience.

BRIDGeS (Building Resourceful Interactions Despite Grief and Stress)

• Eileen Knightly, MHA, RN, BSN, OSF HealthCare
• Carolyn Dickens, PhD, APRN, ACNP-BC, University of Illinois Chicago

This project addresses the growing issue of violence and incivility in the community and its impact on patient care in hospitals. It utilizes findings from a 2022 community health needs assessment to address cultural and communication barriers affecting nursing staff and patients. Nurse burnout, caused by prolonged stress, has worsened due to staffing shortages, documentation burden and increased violence.

Developing Tools to Empower Patient Understanding, Management and Communication of Condition

• Jonathan Handler, MD, OSF HealthCare
• Michael J. Scott, PhD, University of Illinois Chicago

This project will focus on social determinants of health (SDoH) and consider solutions that empower the patient to more accurately track and communicate their conditions before they reach the reactive state. The approach is to change the way patients engage with their health-related data and provide better tools to convey this information to their care provider.

Harnessing Mobile Technology to Diagnose Migraines in Rural Communities

• Hrachya Nersesyan, MD, PhD, OSF HealthCare
• Yelena Nersesyan, MD, PhD, University of Illinois Chicago

The goal of this project is to test and improve the MiGRO app that enables providers to quickly and accurately diagnose and treat migraines, resulting in better health outcomes and improved patient satisfaction. The app also streamlines the referral process, allowing providers to quickly refer patients to migraine specialists, reducing medical costs and improving access to care in rural areas.

Improving Cancer Screening in Underserved High-Risk Populations

• Lisa Barker, MD, FACEP, OSF HealthCare
• Elizabeth Papautsky, PhD, MS, University of Illinois Chicago

This project seeks to characterize the current barriers to completion of screening recommendations among patients at high risk for breast cancer, then use that data to create and pilot test an “intervention bundle” to optimize rates of breast MRI completion for eligible high-risk patients. With attention to the underserved communities within the OSF service population, this project will contribute to reduced health disparities by reducing barriers to care in the context of timely breast cancer diagnosis.

UI Health Pancreatic Cancer Screening Initiative

• Jason Bill, MD, OSF HealthCare
• Paul Grippo, PhD, University of Illinois Chicago

The project aims to develop an infrastructure of early community engagement with clinical trials for all types of cancer. The goal is to address the increasing technological development in screening modalities without simultaneously widening the gap in morbidity rates of cancer within underserved communities. With this health care protocol in place, the team hopes to increase accessibility of clinical trials using methods that are showing promising results in pancreatic cancer detection.

The latest round of grants will fund 10 projects, leveraging OSF Innovation expertise and faculty from 16 colleges and health sciences at UIC. Grant recipients are expected to create solutions that can be deployed quickly, within four to six weeks.

The projects will examine patient experience for at-risk individuals who use the emergency department at OSF HealthCare Little Company of Mary Medical Center in south suburban Evergreen Park, explore ways to build a pipeline for allied health and first-line health care providers, develop a plant-based diet that would appeal to Black men at risk for prostate cancer and expand communication tools for exploring social needs for patients, particularly for non-English-speaking individuals and those with special needs.

Other projects will launch a pilot in homeless shelters, use an artificial intelligence (AI) -based tool to check for diabetes-related vision problems and develop AI curriculum for medical students. Another will focus on creating the best strategies to communicate the risks of cannabis consumption on women of child-bearing age before, during and after pregnancy.

“Given the massive workforce shortages across the industry, our focus is on using technology and evidence-based approaches for strategies to serve our patients most effectively and solve some of the biggest challenges that prevent individuals from achieving better health and wellness,” says 
Dr. John Vozenilek, chief medical officer for Innovation & Digital Health at OSF HealthCare. “We’re also attempting to make sure we reach all populations that deserve a holistic approach to improving their health and their experience with health care.”

TJ Augustine, vice chancellor for Innovation at UIC says, “As Chicago's only public research university, we are uniquely positioned to address a wide range of community health challenges. Having OSF HealthCare as a partner is key to implementing solutions that make an impact. We’re proud that our partnership will yield best practices that help not only UIC and OSF, but that also support community medical providers who serve diverse populations.”

Here is a complete list and description of the projects receiving CHA grants.

Highlight Project: Prenatal Cannabis Exposure: Investigating Reasons and Messaging  
With cannabis laws changing at a rapid pace, traditional media and social media are saturated with positive messages about recreational or medicinal use of cannabis, and many people think it is safe because it’s marketed as being “natural.”  Dr. William Bond of OSF HealthCare is working with co-lead Erin Berenz, PhD, of the University of Illinois at Chicago on a Community Health Advocacy (CHA) grant to investigate women’s risk perceptions of using cannabis in pregnancy.  Read more.

Legalization of cannabis has led to increased use by the general population, in addition to a rise in use by pregnant women. Cannabis is the most used drug during pregnancy in the United States and yet many doctors don’t talk about it with their patients who are pregnant or thinking about conceiving.

One study found about 20% of pregnant women age 24 and under screened positive for cannabis. Dispensaries that sell the drug for recreational, and in some cases medicinal use, promote various strains for mood enhancement, sleep issues, loss of appetite, and in some cases, relief of morning sickness.

“One study using hidden shoppers found that cannabis dispensaries were actually giving advice to pregnant women to use cannabis for their nausea and pregnancy. So that type of advice is very much concerning to us.” 

William Bond, MD, is a physician in the emergency department at OSF HealthCare Saint Francis Medical Center and director of simulation research at Jump Simulation which is a collaborative effort with the University of Illinois College of Medicine Peoria. He is co-lead investigator on a project to recruit approximately 200 women ages 21-40 to create and test media messages about cannabis risk in pregnancy. The women will evaluate each message for believability, persuasiveness and the potential to increase intention not to use cannabis during pregnancy.

Dr. Bond is working with co-lead Erin Berenz, PhD, at the University of Illinois at Chicago (UIC) on a Community Health Advocacy (CHA) grant as part of a joint initiative to address health and wellness challenges in urban communities. Berenz is an associate professor in the UIC Department of Psychology and directs research at the Chicago Alcohol and Trauma Laboratory.

Cannabis laws are changing at a rapid pace across all 50 states and U.S. territories. Dr. Bond says the challenge is that traditional media and social media are saturated with positive messages about recreational or medicinal use of cannabis, and many people think it's safe because it’s marketed as being “natural.”

There is also evidence that doctors don’t have the same conversations about cannabis as they do about alcohol and tobacco.

Dr. Bond points out, “We need to come to the point that we realize that cannabis use is every bit as prevalent as alcohol and tobacco, and in fact, in some populations maybe more prevalent, so we need to have that conversation with our pregnant patients as early as possible in pregnancy, if not before pregnancy.” 

The risks of prenatal cannabis use are not completely understood, but it is associated with lower fetal growth, preterm birth and neonatal intensive care unit admission. Dr. Bond says more research is needed, but women need to consider the unknown risks.

“Modern cannabis products have a much higher THC concentration than older products so the old research may not be applicable. Also, there may be co-ingestions of tobacco, and so if someone has smoked tobacco, then that also has bad effects on the baby.” 

The cognitive impact on infants isn’t well known because there are few long-term studies of the development of babies of women who used cannabis while pregnant.

The research team of Dr. Bond, Erin Berenz, and other UIC Psychology faculty members, Mayra Guerrero, PhD, and Robin Mermelstein, PhD, will use focus groups, surveys, and software to extract themes and principles relevant for creating messages and figuring out the best way to deliver them.

The research will address what information sources women trust. The messages will be structured for women, but providers can use them to help start conversations about the unknown and known risks.

“If use in pregnancy hurts the developing baby or makes a mother less able to care for her just-delivered child, then you create a disadvantage for that child that may follow them for the rest of their life. Thus, there are equity issues in the risk of exposure, in getting the message and believing the message, and then the ability to mitigate the risk through access to counseling.” 

Dr. Bond says the year-long effort is about building healthier individuals and communities and giving patients the best information to make an informed decision.

Video clips with Dr. William Bond, director of simulation research, OSF Jump Simulation