The Monroe Clinic Home Care team would like to nominate Amber Shelton for the DAISY award. Amber has been part of our team for over 3 years. It has been a pleasure to work alongside of Amber as she is a diligent RN Case Manager. We have seen first-hand the deep sense of compassion, empathy and kindness she shows for her patients.

Amber demonstrates patient centered through personalization and active involvement with patients and families in numerous patient cases. One of her many patient cases that exemplars exceptional care was with a cognitively disabled woman. Amber worked to foster a professional and trusting patient relationship with this patient and her sister for the last 9 months. She has worked closely with the patient's caregiver and sister to share her knowledge while educating on wound care. As a case manager, Amber masterfully orchestrates all disciplines involved in the patient's care, ensuring the lines of communication are open. She actively involves the patient's sister in all communication and decision making. The patient has substantial wounds, which she has been working diligently to heal. Amber collaborates with the patient's wound care doctor to ensure the correct treatment is being used. There was even a time the patient's doctor told Amber that the wounds would never heal. Amber's initiative and drive compelled her to consult a wound certified nurse and research evidenced based data regarding wound healing. Due to Amber's dedication, persistence and holistic approach, the patient's wounds are healing. Amber maintains the utmost respect for patient's needs and preferences. She even went to great lengths to ascertain a necessary pressure relieving mattress for the patient; enabling the patient to have some relief from these painful pressure ulcers. Family/caregivers have voiced their appreciation for all that Amber has done for the patient. The foundation Amber has laid and her resolve in advocating for the patient is the embodiment of patient-centered health care.

Amber has excellent clinical skills and decision-making capabilities. She possesses the whole package, but one of her strongest skills is her intuitiveness. Amber's intuition occurs in response to knowledge and is a trigger for nursing action and reflection. She has an uncanny sense to see a pattern in a patient disease process. Amber uses experience, confidence, holistic approach and knowledge of resources to empower the patient and their family. Amber is not afraid to communicate her concerns and act on them. For example, our department struggled with our current staffing model. The current staff model required a RN to be on call while having a full day of patient visits on the weekend. So, a RN would be in a patient's home performing weekly care and get a triage phone call from another patient. Amber's passion for quality patient care inspired her to speak up and bring the issue to our team. A committee was formed to address staffing models used by various Home Care agencies. Amber was a key member and leader in this committee; supplying data that supported a change in the current staffing model. She showed up to every meeting with positive, patient centered ideas to improve the staffing model. Amber was an active participant and inspired our new patient care/staffing model: one RN performs visits on the weekend, while another RN will only take triage calls. This adjustment in the Home Care patient care model is intended to impact all four of the Lean diamonds - Satisfaction, financial, time, and quality.

Amber is very compassionate and kind to patients and families. Amber saw an opportunity for a patient to have the right environment for healing. Amber was a Case Manager of a patient that did not possess a bed to lie down in. The patient was obese and suffered from multiple skin issues on her bottom and abdominal folds. Her home was infested with fleas. Amber's holistic approach and compassionate heart saw an opportunity to enhance skin healing by improving the environment. Amber recognized the patients' inability to wash herself and change position to alleviate pressure. Amber immediately contacted her Doctor to coordinate getting a hospital bed into the home. This allowed the patient to lie down and relieve pressure on her bottom. She also followed through with other agencies to provide personal cares and alleviate the flea problem. We have seen first-hand the deep sense of compassion, empathy and kindness she shows for her patients.

Amber is a professional and collaborates well with all members of the Home Care team. Amber's interdisciplinary approach allows patients who suffer from debility to manage health care right from their home. She manages the EPIC inbox, makes telephone calls, providing extraordinary patient care all from the patient's home. Amber's input is respected and appreciated. Amber encourages a collaborative framework in the Home Care department. She is approachable and available for questions from her team members. She shares willingly and honestly. Team members feel comfortable when asking her for help. Amber's participation in improving the patient experience cultivates a mutual respect among team members and different disciplines. She is a role model that practices with a team approach providing safe, efficient, effective and equitable care for all patients.

Amber is committed to the profession of nursing and our community. Amber is currently participating in the professional development program as part of the preceptor track. Amber is determined to make the orientation process fruitful for each new nurse. She strives to organize and provide a safe learning environment for the new staff. This will directly impact the patient experience. With reimbursement moving from quantity to quality outcomes and Monroe Clinic trying to meet the new demands of value-based care; Amber is a leader by providing quality care, reducing errors and increasing patient safety. Amber chooses to participate, she strives to meet performance standards that address crucial elements of Home Care operations; patient care, medication safety, infection control and patient rights. When we think of Amber the following expression describes Amber's nursing practice: Sometimes you make choices in life and sometimes choices make you.

Amber strives for excellence and continually volunteers to work on improvement projects. If you ask Amber to do something, you can count on it being accurate and substantial. She contributes diligence, enthusiasm and promotes seamless care of the patient. She may be performing a visit with a patient that she does not case manage. She will make sure a concern or issue is followed through, to provide an exceptional experience for the patient. Amber is direct and not afraid to bring up areas of improvement when it comes to patient care. Amber along with a peer has systematically built a Home Care supply ordering framework. Amber is accountable and holds her team members accountable as well. This framework has increased efficiency and effectiveness around supplies for Home Care.

Our Home Care team is honored and privileged to work alongside Amber. She is a leader and an asset to the nursing profession. Amber emulates and is the very essence of a DAISY nurse.