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Holistic Acuity, a Hackathon Product
Episode

Nathanael Rosenberg, Charge Nurse at Froedtert Hospital & Samu Mhlabib, Founder & CEO at NurseBrain

Holistic Acuity, a Hackathon Product

The last SONSIEL Hackathon pushed forward a great tool! This episode features two nurse innovators, the developers of Holistic Acuity! 

 

This week’s guests on the SONSIEL Podcast are Nathan Rosenberg and Samu Mhlambi! Last November, they teamed up at SONSIEL’s Hackathon and launched Holistic Acuity, a virtual tool that takes in different factors and calculates a score to determine a patient’s true non-medical acuity besides taking into account the medical acuity. They talk about the process of coming together and bringing different practices and knowledge to the table to create the acuity scale and questionnaire. They also share how SONSIEL provided a network and mentorship that helped them during the process. Samu and Nathan enthuse about the opportunities and possibilities that nursing innovation has at the moment, and they encourage nurses to trust their instinct and voice their ideas to develop them and bring innovation to their practice. 

 

Tune in to this episode to learn about innovation in the nursing space! 

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Holistic Acuity, a Hackathon Product

About the Guests

Nathan Rosenberg

Nathan is a Charge Nurse at Froedtert Hospital in Milwaukee, Wisconsin. He got his BSN and RN at Wisconsin Lutheran College and is currently working on his master’s in leadership and management at the Milwaukee School of Engineering. He has a true passion for supporting nurse innovation. Last November, he joined the nurse hackathon and came up with Holistic Acuity. 

Samu Mhlambi

Samu is a registered nurse and a software developer. He’s been a nurse since 2010, first as an LPN, and LVN, and then he got his R.N. in 2015 with his BSN. He then did his nurse residency at Stanford University and worked in other hospitals as well since then. During the pandemic, he learned how to code and was able to build his first MVP. Last November, he joined the nurse hackathon and came up with Holistic Acuity. 

 

SONSIEL_Nathan R & Samu M: Audio automatically transcribed by Sonix

SONSIEL_Nathan R & Samu M: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.

OR SONSIEL Intro:
Welcome to the SONSIEL podcast, where we host interviews with the most transformational nurse scientists, innovators, entrepreneurs, and leaders. Through sharing their personal journeys, we create inspiration, provide guidance, and give you actionable ideas you can use to be a catalyst for change.

Mary Lou Ackerman:
Okay, so let’s open up this podcast today then, and welcome Samu Mhlambi from, one of our track winners from the last SONSIEL Hackathon. So maybe, Samu, we can start with you introducing yourself and telling us a little bit about your background.

Samu Mhlambi:
Hi, good morning. My name is Samu, and I’m a registered nurse and I’m also a software developer. So, I’ve been a nurse since 2010, first an LPN, LVN, and then I got my RN in 2015 with my BSN, and then I did my nurse residency at Stanford University, and then I’ve worked in other hospitals too as well since then. So I joined the group for the nurse Hackathon last November, and we came up with Holistic Acuity. So that’s just a little bit of my background.

Mary Lou Ackerman:
Great, great. Thank you. So I’m Mary Lou Ackerman, I’m the VP of Innovation at SE Health, which is one of Canada’s largest home healthcare organizations, and also a founding member of SONSIEL. So thank you so much for joining us at last November’s Hackathon, there are always exciting events. So can you share with us what sort of inspired you to work in the healthcare environment?

Samu Mhlambi:
So what inspired me is I’ve always had this desire to help people, and so nursing was a perfect fit because it allowed me to help others, it allowed me to nurture my interest in the sciences and biology, but it also gave me the flexibility to have a work-life balance. And so it just all came together, and nursing seemed to be the perfect fit for myself.

Mary Lou Ackerman:
Great, good. Yes, I’ve been a nurse for the past 40 years, actually, and have loved every moment of it so, it is one of those careers that offers so many options and career pathways as you continue to, through your journey of nursing. It’s also interesting that you mentioned that you’re a software developer. Was that prior to being a nurse or did that come after becoming a nurse? And what brought you, those two pieces together?

Samu Mhlambi:
So it came, it’s a little bit of both. Since middle school, I had been doing web design, but I didn’t really get too deep into it, and so during nursing, in fact, it was during nursing school where I was, where I would see challenges in healthcare. And I thought, huh, you know, I think software can really solve this, I think software can really improve this. But I just didn’t have the chance to actually go and learn how to code and also say, 2019 where, I was in nursing, I just switched to a new department. And so I was using a piece of paper called a nursing brain sheet or nurse report sheet, so I was customizing one to myself. Why am I using paper? And so I said, okay, you know what? Maybe now I can finally, I can finally have a project that can push me to actually really learn how to code. And so the pandemic happened a few months afterward, so it was a really good excuse to just spend all this time learning how to code. So during the pandemic, I learned how to code, and I was able to build my first MVP, and then I just kept on making improvements to it. So by the time I joined the Hackathon last year, I had about a year or so of real coding experience of actually having developed the product that was pushed to the place towards, to Apple App Store and the Google Play Store. So that’s how I was able to merge my interests of technology and nursing.

Mary Lou Ackerman:
Right, a true sign of an innovator, that curiosity and then the drive to look at opportunities for improvements and you even took that one step further in learning a new skill to be able to solve the problem on your own as well. Well done.

Samu Mhlambi:
Thank you.

Mary Lou Ackerman:
Can you tell us a little bit about the product that you launched at the Hackathon?

Samu Mhlambi:
So the product we launched at the Hackathon, it’s called Holistic Acuity. So, Nathan, the group leader, is a Charge Nurse, and so his main job description or duties are to create assignments for his nurses. And so inevitably, there are some times when he would make assignments that the nurses felt like were not created in a way that represents the true acuity of those patients, and so through brainstorming and talking about it, we realized that there are other factors that are not being captured when hospitals are creating the acuities for their patients. So, for example, the amount of time spent at the bedside, or if there’s a patient who’s really challenging, maybe the patient’s family are not as helpful in helping you provide care for that patient. So there were very different factors, different factors that were affecting the true acuity, not just the medical acuity, but also the social factors, too, as well, and the other factors that were not so tangible. And so what we decided to do is we decided to create an algorithm, to create a scale that can capture some of these elements that are not so readily captured in the current acuity systems found in various EHRs and used by various hospitals, and so we built our tool. It’s currently available at HolisticAcuity.com, where we ask, where we have, where we ask the nurse three questions and those, and then the nurse enters information, or they answer those three questions, and then we give them a score. And that score is then used to determine the non-medical acuity for that patient that should be considered in addition to the medical acuity, the one the Charge Nurse or the nurse manager is creating the staffing assignments.

Mary Lou Ackerman:
Wow, great. I’m sure that that’s really helpful in balancing out workload and likely has an impact on staff satisfaction as well. I see, yeah, and I see Nathan has joined now. So Nathan, welcome to the podcast.

Nathan Rosenberg:
Hey, I apologize for that. I was clicking on the link to come in and they kept routing me to that, meeting was in progress, there was a meeting in progress. I had the passcode in and realized I had to click on the location to open the correct meeting. So I do apologize for that. I was having some technical issue.

Mary Lou Ackerman:
No problem. No problem. Maybe you can just take a minute, Nathan, to give us a little bit of information about your background.

Nathan Rosenberg:
Yeah, thanks for having me on. My name is Nathan Rosenberg. I’m a Charge Nurse at Froedtert Hospital in Milwaukee, Wisconsin. I am currently working on my master’s in leadership and management, but with a true passion for supporting nurse innovation. I came into this event with SONSIEL and the Nurse Hack for Health because I’ve just consistently seen doorways for nurses to be asked about their ideas and kind of move them forward, but then they never really get to be pushed anywhere. So I just wanted to see what it was all about and see how I could contribute to nurse idea sharing and seeing what kind of opportunities could result from it.

Mary Lou Ackerman:
Well, it sounds, Samu just spent a couple of minutes sharing with us the product MVP, and the development that you’ve worked around Holistic Acuity, sounds like that was a great problem to address. Certainly, we’re seeing all kinds of issues with staff retention and nurses’ workload and the impact that that’s having on our ability to keep nurses working in the health system. So it’s a great opportunity and it sounds like a really good solution. So when did you, maybe Nathan, you can answer this question, when did you recognize that you were an innovator?

Nathan Rosenberg:
I think I’ve always been kind of known among my friends and my family of, somebody that’s always bringing up things and not really sure where what direction I’m going with it. I was never somebody that just enjoyed the status quo in any job that I’ve had growing up. I kind of look at, okay, here’s what we’re doing. Is this the best way you could do it? How could I do it a little bit differently? And I’ve just applied that … to different aspects of my life. As I came into the nursing world, it obviously became a little bit more real because now I’m here in a career, I’m trying to take care of my patients, but also day after day, realizing that there’s more frustrations that exist in that work environment. So I’ve just applied those skills that I’ve learned over my youth and schooling and family interactions, friend interactions, and brought that to the practice to really question what we’re doing. Is there a different way to do it? Is there, we don’t have to completely do things a different way. How can we apply different learnings from other fields into nursing practice? So I think I’ve always had that be part of me. When I look at my strengths and what characteristics I have, I very much fall into the innovator futuristic mindset. I’m a learner, so I take all those aspects and apply it to practice.

Mary Lou Ackerman:
Yeah, great, great. Definitely, I feel that we are seeing more and more nurses who are inspired through some innovation and have that curiosity of how to do things better and make life better for not just themselves, but also for the patients and the families that are part of that circle of care. So a question for both of you is, as you started down this innovation journey with Holistic Acuity, what were some of the biggest challenges you faced?

Samu Mhlambi:
I would say, I’ll say probably one of the biggest challenges was just trying to narrow down the scope of the project since we had a limited amount of time to come up with something, to present it, and to hopefully have an MVP. So it was just a matter of narrowing down the scope into three questions that we can ask versus asking 20 or 30 questions in order to develop the acuity scale.

Mary Lou Ackerman:
And how did you determine that those three questions were the right three questions versus 20 questions? I’m just curious.

Samu Mhlambi:
…., yeah.

Nathan Rosenberg:
A lot of things.

Samu Mhlambi:
Go ahead.

Nathan Rosenberg:
So that opening night, we have people just coming through the sessions in the Hackathon event, and with that, it’s just, it was just constant brainstorming. So as Samu spoke to that, we’re trying to boil down what is this true problem that we’re trying to solve. And on that Friday night, it was question after question of like, okay, that’s how can we simplify this more? We’re taking our different scale assessments such as like delirium or falls, patient interactions, nurse frustrations. And everybody’s throwing this into this few hours session, boiling down a problem statement, and we realized, you know, we can’t take on everything. So we had to really narrow down what we wanted to do. So we asked that we would take that back to our colleagues. I made a short survey monkey, sent it out to our peers on social media, coworkers, through email, and then we took that feedback from one night, one night only of what are those biggest frustrations? I think our question was, what are the frustrations at bedside? What frustrations do you have at bedside for providing the care that you need to provide to your, for your patients? And it was just single answers people would give us like interactions with family, not having the orders that I need, and so we then congregated that information and developed our three categories.

Mary Lou Ackerman:
Oh, great, amazing. I love the idea of doing that quick crowdsourcing. It’s also, when I participated in my first Hackathon, the in-person one a couple of years ago, I was just amazed at what people accomplished in 48 hours. So you’re right about this just, this flood of information and the idea of focusing in on the problem that you’re trying to solve to help manage the scope is so important in these types of events to get to some quick but quality solutions. So how has SONSIEL helped you in your journey?

Nathan Rosenberg:
I think the biggest factor, two things that really come from SONSIEL that I’ve realized. First, we’re not in this alone as nurse innovators. There is a group of nurses and it’s not whole institutions, you know, it might be just one or two nurses from an institution that are just starting to come together and network about the concept of nurse innovation. You’re seeing what people have done in the past, what people are currently working on, and then you have these new individuals also coming into this. So now we’re really establishing this network of individuals that are thinking similarly, addressing some similar problems, but also addressing very different problems. So that’s just the first, is the network for me. And then the second thing is the mentorship. I was blown away about how the Hackathon event was ran, but then also the amount of mentorship that you had coming through, the team leads yet coming through building up the tearing down of our ideas, the formal mentors, the informal mentors, the random coaches, all these individuals really build this community for us, and that helped just to that encouragement to have to continue to push our ideas in our projects.

Mary Lou Ackerman:
Yeah, we’ve seen quite a few successes coming out of the Hackathon events, and learning from each other, I believe is one of the biggest ones in bringing this group together who are like-minded and have the same passions and the same focus on healthcare and nursing in particular. I think it’s been really great to have the growth that we’re seeing in SONSIEL over the last couple of years. Samu, maybe you can comment on what is most exciting for you about the nursing innovation space?

Samu Mhlambi:
So the nursing innovation space, I believe that there’s so much room for innovation. Nurses are innovators by default. There are so many examples on a daily basis where nurses have to figure out a way to take care of their patients, whether it’s due to limited supplies, limited resources, limited staffing, technology that’s not working as efficiently. So it’s a really exciting field because there’s so many opportunities and I think nurses need to know that they do have the ability, it is possible for them to be able to reach out to organizations like SONSIEL to take courses from Drexel, to join Hackathons, to learn how to code, to, I think we need to encourage more nurses to be innovators because they are by default, by the nature of the job description, they have to be innovators. So I just think that nurses need to be shown what else is possible. It’s not just the small hacks that they’re doing, but if they really put their minds to it, they can accomplish much, much more.

Mary Lou Ackerman:
It’s true. We do call nurses the MacGyvers of the health system.

Samu Mhlambi:
Exactly.

Mary Lou Ackerman:
Nathan, do you have anything to add to that?

Nathan Rosenberg:
Absolutely, the, at the beginning of this, Lara, Rachel, Samu, and myself, we would have never known each other, but the fact that we were able to all come together. I originally pitched an idea because I wasn’t seeing what …, I did not see the idea that was really frustrating me at the bedside. But then you have these nurses that also kind of say, hey, I can help with this, also, I’m feeling this way too. All brought different strengths to the team. We all, I mean, Samu being able to make an MVP over the course of 48 hours that is completely functional and have that idea brought back to the team and say, hey, this is what’s going on, how do you want it to work? How can it? What’s that user experience? I mean, none of us really have that gift, but he did and he brought it to the team. And then such like Lara with her experience at bedside and just being able to think across the continuum of how these things affect patient care and her passion for supporting this innovation, great asset to the team. And then with Rachel too, just she was living this probably the most when we talked about the passion and the frustration of it. I was seeing it from an angle of a Charger Nurse, she was experiencing it from the angle of the bedside nurse. And all those perspectives and teamwork brought together for 48 hours, awesome to see it happen through the partnership with SONSIEL.

Mary Lou Ackerman:
Nice. Yeah, it’s nice when you can really build off each other’s lived experiences. I think it just makes the work you’re doing more authentic and therefore the solutions more realistic as well. So that’s really great to hear. What’s one thing that you, one piece of advice that you would leave the audience with today? And maybe we can start with Samu on that as well.

Samu Mhlambi:
One piece of advice I would say is, is to not be afraid to make your voice heard and to not be afraid to demand change or to pursue change. There are definitely resources out there. There are ways for you to get the attention you need to the problem that you’re raising. So if you see something that’s wrong, if you see something that’s not efficient, do not be afraid to voice your opinion and do not be afraid to seek help. It might not always come from within your department and sometimes maybe not even from your own hospital, but reaching out to resources like SONSIEL and these other organizations that are meant to help foster nurse innovation, they can provide you with mentorship and guidance, how to approach the stakeholders, how to do the elevator pitch, you know? How to make your concerns and your ideas heard. So if you see something that’s not working, don’t just keep the solution to yourself or the idea of what the solution could be, voice it out and find ways to bring that solution to life.

Mary Lou Ackerman:
Great, thank you. And Nathan, the same question to you.

Nathan Rosenberg:
As we’re speaking to an audience of nurses, or at least I believe most of our audience is nurses. We have that kind of gut instinct, right? And that’s something that we, have some confidence in that. When I first started this whole journey for myself prior to the Hackathon, I was working a project on my unit alone. So the nurses were expressing their frustrations, so I stepped back, took a look at how I did my assignments and started piloting my own project. You know, it wasn’t official, it was very trial and error, but I kind of believed in something that like I was starting to see. And then I joined the Hackathon, continued to listen to other people’s problems, and that’s where, you know, I was like, okay, actually, you do need to trust your gut, you know, put something forward, present in the way that you’re seeing it from the angle that you’re currently seeing, and then people are going to come in and start tweaking it a little bit and giving you some other advice and bringing skill sets that you’ve never seen or experienced before, and then see what you can do with that. So, biggest piece of advice, trust yourself as a nurse, do a little bit of experimentation, trial, and error, and then keep pushing it from there.

Mary Lou Ackerman:
Excellent, great advice. I want to thank you both for joining us today for through the podcast and sharing your story. We definitely have talked a bit about how we learn from each other, and through these podcasts, we hope to share these stories with other nurse innovators as well. Also want to congratulate you both on being Hackathon track star winners. That’s great, a great recognition for the work you’re doing and also for the problem that you chose to focus on, putting some solutions together, so congratulations on that. Hopefully, we’ll see you both at the SONSIEL conference in person this fall in Niagara Falls. It would be great to meet you, as well, I’m not sure if you’ve been joining the meetups, the one, the monthly meetups, but those are also great ways to share your story, so, anything else you’d like to add today?

Samu Mhlambi:
I just want to say thank you for this honor. We’re really grateful and honored to have been chosen as one of the track star winners. So thank you for this opportunity and we appreciate all the resources and the mentorship, and we look forward to being more involved in the future as well. Thank you so much.

Nathan Rosenberg:
And just to echo that from the whole HolisticAcuity.com team, we couldn’t do this without what you guys have built for us as a platform to network. And as we continue to see SONSIEL grow, I’m excited to be part of it. You mentioned joining those meetup sessions as a midwesterner, it’s a little hard with my work schedule, but we will definitely make it happen.

Mary Lou Ackerman:
Oh, good. Well, we are looking at flexing the times a bit because we are getting more people from the West, which is great as well. So we do want to make sure it’s something that we can have a little bit more inclusive. So hopefully we can make the time work and we’ll see you there. All right, thank you very much, and enjoy your day.

Samu Mhlambi:
Thank you, you as well.

Mary Lou Ackerman:
Bye bye.

OR SONSIEL Outro:
Thanks for tuning in to the SONSIEL podcast. If today’s podcast inspired you, we invite you to join our tribe or support our mission by visiting us at SONSIEL.org. That’s S O N S I E L .org.

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Things You’ll Learn:

  • Many different factors are not being captured when hospitals create the acuities for their patients, including social factors and others that are not very tangible.
  • Holistic Acuity asks the nurse three questions and then provides a score that can be used to determine the non-medical acuity that should be considered in addition to the medical acuity for the patient.
  • Different learnings from many fields can be applied in nursing practices.
  • Many nurses are curious about how to do things better and make life better not just for themselves but also for the patients and the families that are part of that circle of care.
  • There is a group of nurses starting to come together and network about the concept of nurse innovation, addressing and bringing solutions to very different problems.

Resources:

  • Connect and follow Nathan on LinkedIn.
  • Connect and follow Samu on LinkedIn.
  • Use the Holistic Acuity Tool.