Clinical Partner Spotlight: Nuvance Health

How One VP of Population Health Operations is Collaborating with SHU and Community Organizations to Improve Patient Outcomes

We sat down with Dawn Myles, MS, MSN, RN, CPHQ, CPHRM, vice president, Population Health Operations, at Nuvance Health, to discuss her career, the current health care landscape and how the robust partnership between Nuvance and SHU is meeting today's challenges and advancing clinical education and care.

Tell us a little bit about yourself and your role at Nuvance Health.

I have worked for Danbury Hospital/Western Connecticut Health Network/Nuvance Health for 35 years. My clinical background is in psychiatric nursing, including 15 years as an APRN. I began my career working in inpatient psychiatry, where I helped establish an adolescent program and a progressive adult treatment track. I transitioned into behavioral health service line nursing administration and oversaw the inpatient and outpatient psychiatric and chemical dependency services, as well as the crisis intervention and assertive community treatment teams. That was during the time when long-term state residential facilities were closing and patients who had been institutionalized for much of their adult lives were being transitioned into outpatient settings. We focused on providing intensive outpatient programs and worked with patients to help them develop the necessary skills to function well in the community.

After designing a quality structure for behavioral sciences, I was asked to run quality improvement for the health system. I spent almost two decades overseeing hospital quality, safety, risk management and service excellence programs. In that capacity, I had the opportunity to implement transformational programs related to patent-centered care, just culture, high reliability and patient safety.

I have been working in the population health space for approximately seven years. In my current role, I have the pleasure of partnering with many community agencies and academic institutions to collectively improve the health and wellbeing of our communities. I help design and implement programs that support primary, secondary and tertiary prevention, in a context that recognizes the impact of the social drivers of health. We manage programs that navigate vulnerable patients in the community, assist high-risk patients in their homes, promote health education and self-reliance, manage transitions between health care settings and optimize care in medical offices. We also analyze population and member-level data to measure intervention impact and identify additional opportunities for improvement. Over the past three years, this work has also included administering COVID-19 testing and vaccination in collaboration with community partners across western CT and eastern NY.

What made you interested in nursing as a profession?

I knew I wanted to work in a profession where I helped people and I enjoyed working with children. I originally thought I would have a career as a school psychologist. When I graduated with my bachelor’s degree in psychology and was pursuing my master’s degree in school psychology, I began working on a hospital inpatient psychiatric unit at Danbury Hospital. It was there that I was mentored by a very talented and engaging psychiatric/mental health clinical nurse specialist. I had never had that level of exposure to the nursing profession. I was taken by the holistic approach to physical and mental wellbeing and was fascinated by the neurochemistry of the brain. I was impressed every day with the care and compassion shown by the nursing team for patients who were in their most fragile states. While I was still finishing my first master’s, I enrolled to go back to school for my degree in nursing.

What are some of your biggest challenges in your role as vice president, Population Health Operations?

An overarching challenge is that there is a high level of community need and insufficient funding. Health outcomes are linked to many factors that have little to do with traditional healthcare, but rather are related to social and physical environment factors such as housing, transportation, interpersonal violence, employment status, access to green spaces and high air quality, education, income, etc. Healthcare organizations trying to improve the health of populations need to partner with community organizations in innovative ways. For example, we know that eating healthier foods supports improved health outcomes, but these types of food are often more expensive and may not be as available in certain communities. In response to this, Nuvance Health is partnering with others to offer Food As Medicine (FAM) programs, supported by local and federal grants. Identified patients will be given “prescriptions” to shop in markets that provide free healthy food.

Some patients are high utilizers of emergency department and inpatient services due to the contribution of non-medical factors, so we facilitate forums where community service providers come together to collectively solve for the issues interfering with optimal health. An intervention can be buying an air conditioner for a COPD patient who is struggling to breathe in the warmer weather. Sometimes the action is helping someone apply for benefits or get into a residential facility. To support this work, we rely on the generosity of donors to pay for the staff that work directly with these patients. We also have a small amount of funding to organize transportation for patients who need assistance getting to their medical appointments.

Tell us about Nuvance Health’s relationship with the Dr. Susan L. Davis, RN, & Richard J. Henley College of Nursing, particularly regarding the iCAN initiative.

Nuvance Health has had a strong relationship with Sacred Heart University for many years. When our president and CEO read an article about “student hotspotting” in the summer of 2016, he charged me and a physician colleague with developing a similar program by the spring school term. He wanted to better serve vulnerable populations and address what he perceived as gaps in traditional training programs with regard to understanding the impact of social drivers of health and the value of interprofessional teams. The article highlighted the work done by Dr. Jeffrey Brenner in Camden, NJ, whose model included multidisciplinary teams of students providing direct outreach to high-risk patients in the community. We immediately thought of partnering with SHU and reached out to the dean of nursing, Mary Alice Donius. We were meeting together within a week and initiated the program in time for the spring 2017 term. Including SHU MSW and RN to BSN students, we have been collaborating on what’s been named the “iCAN” (interprofessional Community Academic Navigation) project ever since.

We have had SHU nursing students in our hospitals and ambulatory settings for years. When it was time for Nuvance Health to stand up COVID vaccination clinics with a few weeks’ notice, once again, SHU was one of our first calls. SHU nursing students tirelessly vaccinated tens of thousands of patients with us from the first to the last weeks of the clinics. We couldn’t be more grateful.

What are some of the key ingredients for an effective academic-clinical partnership?

I feel like the answer to this question is found if you look at the “recipe” for the SHU/Nuvance Health relationship: Aligned missions, shared visions, mutual respect, creativity, commitment to academic and patient care objectives and a desire to serve those with great need.

What advice would you give our students to help them become successful nurses?

Since you are attending a high-quality university, you will graduate being very well trained. How you apply what you’ve learned is up to you. Lead with your desire to connect with others in meaningful ways.

Be open to opportunities that come your way and enjoy the journey!