Susan has worked tirelessly to develop this innovative nursing role, leveraging her case management, clinical expertise, and care coordination skills to become the central resource for patients and families the first 30 days after discharge.  She identifies barriers in the discharge process, and she works diligently to find solutions for these families during this crucial time. Since January 2020 she has completed almost 600 patient outreach encounters and of those visits over 450 are telehealth visits.  She has worked with a total of 409 patients from Anschutz and Colorado Springs locations.

Susan has the amazing ability to build relationships with the healthcare teams, bringing awareness of this work across the organization.  She has captured the voice of our patients and families by documenting the barriers and issues our medically complex patients are experiencing after discharge.  This collection of patient experiences succinctly captures opportunities in the discharge process and allows us to share this information with service lines, care teams, and leaders in a meaningful way.  

Susan embodies the Children’s Hospital Colorado Values of humble expertise, generous service, boundless creativity, and caring community with each patient and family interaction in the nurse-led telehealth project.  She develops a trusting relationship with the family while the patient is in the hospital because of her ability to listen and uses that information to build understanding.  During enrollment, the first question she will ask is, “What are you concerned about?” and will continue to follow up on this concern over the course of their participation in the project.  Another key piece of her work is spending time with families, helping them use the MyChart application and telehealth platform more efficiently.  This additional time spent with families has produced positive results and is displayed in the experience she had with a grandfather with low technical literacy.  By the end of his participation in the project, he had joined multiple telehealth visits and was sending MyChart messages to the g-tube nurse about the patient's needs.  Families walk away empowered after participating in this project because of the support and education they get from Susan on how to navigate this complex medical system.  I recently called a mother whose primary language was Spanish to complete a project survey. When asked to comment about the project she stated, “Susan was kind and patient.  She helped me get a new prescription filled and scheduled follow up appointments for my child.  I hope everyone gets to work with Susan”.   

Without Susan's investment in this work, we wouldn’t have such an impactful project to serve the patients and families in our state and across the region.  Susan is deserving of this award for all the dedication and work she continues to do for patients and families.