Nursing Shortage Solutions

Everything you "know" about preventing dementia is probably wrong. And that's costing lives. We tell people: Do crossword puzzles! Learn languages! Brain games! Meanwhile, over 7 million Americans are living with Alzheimer's. By 2050, this number is projected to rise to nearly 13 million Our prevention advice isn't working. Here's why: 1/ Crosswords don't save neurons ↳ They improve crossword skills ↳ Brain adapts to specific tasks ↳ No transfer to daily function ↳ Gives false security 2/ The real brain protectors we ignore ↳ Treating hearing loss (reduces dementia risk by 18%) ↳ Managing blood pressure in midlife ↳ Addressing sleep apnea aggressively ↳ Social connection (not Facebook) 3/ Exercise beats every brain game ↳ Increases BDNF (brain fertilizer) ↳ Improves vascular health ↳ Reduces inflammation ↳ Actually grows hippocampus 4/ The prevention paradox ↳ What works is boring ↳ What's sexy doesn't work ↳ Apps make money, not miracles ↳ Simple interventions get ignored Last month, a patient proudly showed me his 500-day brain training streak. His sleep apnea? Untreated for a decade. His hearing aids? In a drawer. We're playing games while our brains suffocate at night. The unsexy truth about prevention: Get your hearing checked and USE the aids Treat sleep apnea like your life depends on it Move your body every single day Maintain in-person relationships, not only online ones Control your blood pressure starting NOW Your brain doesn't need more puzzles. It needs oxygen, blood flow, and human connection. The next time someone sells you brain games, ask them about their sleep study results. ⁉️ What unsexy health issue are you avoiding that might matter more than brain training? ♻️ Repost to save someone from wasting time on digital snake oil 👉 Follow me (Reza Hosseini Ghomi, MD, MSE) for prevention advice that actually works

Two paediatricians couldn't figure out why children they treated for malnutrition kept coming back more malnourished than before. Their search for an answer led them to a place where over half the population, adults and children, had never had reliable access to care. This is the story of Dr. Pavitra Mohan and Dr. Sanjana Brahmawar Mohan, and how they built a healthcare model for people living at the margins. Both were paediatricians working at a government medical college in Udaipur but the more they saw, the more one question stayed with them - what happens to people who fall sick before they ever reach a hospital? In South Rajasthan’s remote tribal villages, the answer was painful. A fever could mean a long journey. A pregnancy complication could become a crisis. A child with malnutrition could go unnoticed for months. A family could spend more on travel than treatment. And when care was not close by, people turned to whoever was available. So in 2012, they started Basic HealthCare Services. What began with one clinic grew into a network of Amrit Clinics, built around a simple idea “bring affordable quality care closer to people”. Yet the most powerful part of the model was they placed nurses at the centre of primary healthcare. These nurses were diagnosing, treating, counselling, following up, and becoming the first trusted point of care for the community. Doctors supported them through training, supervision, visits, and teleconsultations. The result was a system that worked because it was local. The Amrit Clinics provided → Primary care → Medicines and diagnostics → Maternal and newborn care → TB treatment → Malnutrition care → Emergency support → Referrals when needed Still, Pavitra and Sanjana knew that health was far more than having clinics. So BHS also started Phulwaris, daycare centres where young children received nutrition, care, and early learning, while mothers got the support they badly needed. Over the years, the impact has been remarkable. BHS has: → Managed 5,500+ TB cases → Treated 3,335 children with severe acute malnutrition → Facilitated 1,514 safe institutional deliveries → Helped institutional births rise from 5% to 60% in areas like Bedawal The real achievement is in the fact that a woman no longer has to delay care because the hospital is too far. A child with malnutrition can be identified before it is too late. A nurse from the community can become the person people trust with their health. Their story is a reminder that affordable healthcare is not just about reducing cost. It is about bringing care close enough for people to actually use it. - I recently had the privilege of having Dr. Pavitra Mohan and Dr. Sanjana Brahmawar Mohan on The Health Worker Podcast by Azim Premji Foundation. The podcast link is in the comments. #Healthcare #BoundlessWithRamG

What If the Next Trillion-Dollar Healthcare Opportunity Isn’t a New Drug — But a New Mindset? A few years ago, a US-based healthcare group approached McKinsey with a critical question: 👉 Is it worth investing in the long-term prevention and management of metabolic disease—not just for patients already sick, but across an entire population? The result? A full feasibility study that started as a business case for one group… and became one of the most powerful public health reports in recent memory. McKinsey published the findings openly: 📘 “The Path Toward a Metabolic Health Revolution” — and it reads like both a wake-up call and a blueprint. What they uncovered is profound: 🔹 Path 1 – Treat obesity with drugs, surgeries, and structured weight loss programs. Important, but limited. 🔹 Path 2 – Target the root causes of metabolic dysfunction across the population, even before people are diagnosed. And the difference between the two? 📈 $5.65 trillion in annual global GDP by 2050 🧬 469 million healthy life years gained 🏥 And a total rethinking of what hospitals, investors, insurers, and public health agencies should prioritize. ⸻ The five calls to action in the report are as strategic as they are scientific: 1. Understand the full spectrum of metabolic dysfunction—not just BMI 2. Create robust measurement tools that span clinical, behavioral, and economic outcomes 3. Use AI and digital platforms to tailor care and prevention 4. Align financial incentives for long-term health (not short-term volume) 5. Engage communities to make metabolic health everyone’s responsibility ⸻ As a hospital CEO and healthcare strategist in the Middle East, I see immediate relevance here. Our region is disproportionately affected by metabolic diseases—and yet, we continue to spend most of our energy treating late-stage illness instead of preventing the early breakdowns. 💡 McKinsey’s report reminds us: Prevention is not just good medicine—it’s good economics. I highly recommend reading the full study—especially for those working in hospital planning, healthcare investment, or national health strategy. 🔗 Read the report here: https://lnkd.in/ew4SKu55 #MetabolicHealth #HealthcareLeadership #PreventiveMedicine #McKinseyHealth #HealthEconomics #PopulationHealth #MiddleEastHealthcare #GLP1Strategy #DigitalHealth #HealthPolicy

I posted recently on Action 7 of the WHO Global Action Plan for Clinical Trial Ecosystem Strengthening, which urges stakeholders to scale up use of pragmatic, RCTs integrated with the work of healthcare practitioners. Here I am sharing a concrete example of integrating research into clinical care using a cluster randomized design, and how this is reducing mortality outside the trial. There are many practical implementation questions that lend themselves to cluster randomization. A group of researchers and physicians, with input from policymakers, formulated the E-MOTIVE trial that sought to understand if early identification of post-partum haemorrhage linked to prompt administration of a bundle of already available WHO recommended interventions could reduce severe PPH and associated maternal mortality in parts of Africa and Asia that had persistent high PPH-related maternal mortality Importantly the intervention was co-designed with obstetricians and midwives working in the hospitals to ensure that it could be rapidly implementable if the trial was successful. https://lnkd.in/e4jTTSec The cluster RCT reported a 60% reduction in the primary outcome of severe PPH, maternal mortality from bleeding, or laparotomy for bleeding and implementation in labour wards has progressed quickly thanks to the co-design. The image below is a poster presented by an obstetrician in South Africa who worked with colleagues to scale up implementation in all labour wards in his region of South Africa WHO rapidly updated its guidance following the compelling evidence https://lnkd.in/ezXr5KYb, and has now integrated the identification/bundle into our overall PPH management guidelines, https://lnkd.in/ensWPBEZ.

The $50 billion Rural Health Transformation Program represents a historic opportunity to address America's rural healthcare crisis. But workforce isn't just one pillar of this strategy; it's the foundation that makes everything else possible.      With 300+ rural hospitals at risk of closure and nursing shortages set to triple in rural areas by 2027, we need to fundamentally rethink how we train healthcare professionals. The traditional model—requiring students to leave their communities for extended periods—actually works against rural retention.      The solution? Train healthcare professionals where they'll practice. When we develop talent from within the communities they'll serve, retention rates soar. Take Dr. Terrie Becker in Blythe, California, a town of 18,000 in the Sonoran Desert. Blythe had struggled with chronic nursing shortages for years, but as a three-time Chamberlain University graduate from a small town herself, Dr. Becker saw that the route to real, lasting change would be to establish the area’s first nursing program within 100 miles. Nearly a third of the graduates of the program stayed to work in Blythe’s only hospital – ending years of expensive travel nurse dependence.     States competing for RHT funding need to demonstrate not just what they'll build, but who will staff it. The governors who secure competitive funding will be those who show workforce solutions that make the other four pillars achievable.      Through our work at Adtalem Global Education , we've seen how flexible online and hybrid programs can let students gain advanced skills while maintaining community connections. Now we need the vision to scale these proven approaches.      Read my full commentary in Becker's Healthcare: http://bit.ly/3KPzsS9

Healthcare prevention is a logistics problem. Care homes are solving it faster than hospitals. Hospitals are built to react. Care homes can’t afford to. They don’t have resus teams, crash carts or waiting rooms. They have night shifts with two carers for 30 residents. Which means if you want to prevent deterioration. You need more than a digital stethoscope and goodwill. You need to change the workflow. Here’s what that looked like in Kent & Medway: Care staff were trained to spot subtle changes before symptoms snowballed They used a virtual ward platform (Feebris) to record structured assessments and trigger escalations Local NHS teams were looped in, with clear lines of clinical responsibility Data was used to evaluate effectiveness — not just tech uptake What happened? 73% fewer care homes had frequent hospital conveyances Ambulance usage and A&E attendances dropped There was a 5.2X ROI And most interesting: over-escalation fell by 50% (yes - less 111 calls, less inappropriate escalation) Why does that matter? Because it’s not just about avoiding harm - it’s about reducing volatility. In this pilot, 8X fewer homes experienced ‘unpredictable’ care needs. Which means you can plan staff more effectively, run the home more safely, and stop pushing people into crisis-mode because the system panicked too early or too late. Most prevention initiatives fail because they romanticise care staff and forget operations. Upskilling doesn’t work without pathway redesign. And digitisation is just a shiny mess if your escalation routes are unclear. If you want sustainable change - you can’t just give people better tools. You have to give them a better system. That’s what Kent & Medway did. And it’s a blueprint worth copying.

New report highlights need for sustained investment in #infection #prevention and #control programmes: Nearly 5 years since #COVID19 was 1st reported, a new global report on infection prevention and control (IPC) by the World Health Organization (WHO) shows there has been slow progress in addressing critical gaps to prevent #healthcare associated infections (HAIs) A large proportion of HAIs can be prevented with improved IPC practices and basic #water, #sanitation and #hygiene #WASH services, which are also a highly cost-effective "best buy" to reduce #antimicrobial resistance #AMR in health care settings. This report provides a baseline assessment for #policymakers, IPC #professionals, #health care workers and stakeholders to guide action The report finds that though 71% of countries now have an active IPC programme, just 6% met all of the WHO IPC minimum requirements in 2023-2024. This is well behind the target of more than 90% by 2030 set in the WHO Global action plan and monitoring framework on IPC. The report also highlights that patients in low- and middle-income countries (LMICs) have up to 20 times higher risk of acquiring infections during health care delivery than in high-income countries (HICs) “The COVID-19 #pandemic, along with #outbreaks of #Ebola, #Marburg and #mpox are the most dramatic demonstrations of how #pathogens can spread rapidly and be amplified in health care settings. These healthcare associated infections are a daily threat in every hospital and clinic, not only during #epidemics and pandemics,” said WHO DG, Tedros Adhanom Ghebreyesus. “Every country can and must do more to prevent infections in health facilities and control them when they strike.” HAIs prolong #hospital stays and result in complications such as #sepsis and in some cases #disability or #death. Addressing HAIs through improved IPC is also critical to reduce the risk of AMR, as recent estimates indicate that 136 million antibiotic resistant HAIs occur each year The report found that health care facilities face significant financial and resource challenges, including a lack of IPC professionals and budgets, especially in LMICs. Nearly a quarter of countries reported shortages in their supply of personal protective equipment in 2023   New #data from WHO and the Organisation for Economic Co-operation and Development estimates that up to 3.5 million patients could die each year from HAIs without urgent action. Improving IPC measures at every level will help to reduce the number of deaths. The modelling estimated that IPC interventions at the point of care in health facilities, coordinated by Ministries of Health or established networks, could avert up to 821 000 deaths/yr by 2050. Such an intervention would also yield annual savings in health care expenditure as high as US$ 112 billion  https://lnkd.in/ebijddfx

We Wait to Get Sick Before We Take Health Seriously. Today I went with my mother to visit her physician. Like most clinics in Pakistan, it was crowded. Patients waiting for hours. Doctors seated on their chairs continuously, consulting one patient after another, often for 12 to 14 hours without real breaks. As I sat there, one thing stood out clearly. Most doctors barely move during their working day. Long sitting hours. Rushed meals. Constant mental load. Over time, this shows up as central fat gain, poor posture, fatigue, and metabolic health issues. This is not criticism. It’s a reflection of the system. And the same system applies to most working professionals. Long desk hours. Back-to-back meetings. Meals eaten in a rush. Little movement. Sleep sacrificed. Stress normalized. In Pakistan, we are trained to respond only when a problem becomes a diagnosis: • High blood sugar → medication • High BP → medication • High cholesterol → medication Medicine becomes the solution once the damage has already started. That is cure. But most lifestyle diseases don’t start suddenly. They build quietly over years of: • Prolonged sitting • Irregular or unbalanced meals • Excess refined carbs and sugar • Low daily movement • Chronic stress and poor sleep By the time symptoms appear, medication becomes necessary. But prevention works much earlier than that. Cure: managing disease once it exists • Follow prescribed medication • Use nutrition to support treatment outcomes • Stabilize blood sugar and energy levels • Reduce further complications Medicine treats the condition. Lifestyle controls progression. Prevention: what busy professionals can do now • Break sitting every 60–90 minutes, even 2–3 minutes matter • Eat regular, protein-balanced meals instead of skipping or grazing • Prioritize fiber and whole foods to control blood sugar • Build daily movement that fits work life, not extreme workouts • Protect sleep as a non-negotiable Prevention is not about perfection. It’s about building systems that work with a busy schedule. Doctors save lives. Medicines are essential. But no pill can replace daily habits. Health should not begin at the hospital. It should begin long before that, in everyday work routines. If you’re a working professional waiting for a diagnosis to take health seriously, you’re already late. Small, consistent lifestyle changes today can reduce the need for lifelong medication tomorrow.

Heart failure remains the leading cause of hospitalization in the U.S. and a growing global epidemic. Too often, prevention and heart failure care are treated as separate silos. I am thrilled to share the 1st-ever joint Scientific Statement between the Heart Failure Society of America and the American Society for Preventive Cardiology (ASPC), now published in Journal of Cardiac Failure that challenges that paradigm, offering a unified, evidence-based framework for primary, secondary, and tertiary prevention—from the “at-risk” stages through advanced therapies like LVAD and transplantation. Key messages: 👉 Prevention is not just early detection—it’s a continuous process across all stages of heart failure and all ejection fraction categories. 👉 Traditional and nontraditional risk factors matter—hypertension, diabetes, obesity, CKD, coronary disease, genetics, sex-specific factors, environmental exposures, and psychosocial health all intersect in determining risk and outcomes. 👉 The Cardio-Kidney-Metabolic (CKM) syndrome framework is a powerful tool to understand how interconnected organ systems drive risk—and how we can intervene earlier. 👉 Lifestyle remains foundational: Life’s Essential 8—nutrition, activity, weight, sleep, cholesterol, glucose, BP, and avoiding tobacco—are relevant at every stage of HF. 👉 Multimodal strategies—including SGLT2 inhibitors, nonsteroidal MRAs, GLP-1 receptor agonists, and structured cardiac rehabilitation—are transforming prevention & management of comorbid conditions 👉 Collaboration between HF specialists, preventive cardiologists, primary care, and allied health professionals is essential for lasting impact. This is not just a document—it’s a call to action to reimagine heart failure care as a prevention-centered discipline. 📄 Read the statement here: https://lnkd.in/dAyUh7wH Martha Gulati James Januzzi Jagat Narula MD PhD Rob Mentz Erin D. Michos, MD, MHS LaPrincess Brewer Craig Beavers, PharmD, FACC, FAHA,FCCP,BCCP,CACP Sandra Dunbar Vanessa Blumer Pradeep Natarajan Fatima Rodriguez, MD, MPH Michael Shapiro Randall Starling Pam Rajendran Taub, MD FACC FASPC Jenna Skowronski, MD, FACC Quentin Youmans, MD, MSc, FACC, FHFSA Ryan Tedford Shelley Zieroth Francoise A. Marvel, MD Khurram Nasir, MD MPH MSc Lori-Ann Peterson Michael Felker John Barnes #HeartFailure #Prevention #Cardiology #HFSA #ASPC #CardioPrevention #CKMSyndrome #MultidisciplinaryCare

🔗Rural healthcare needs a connected system.🔗 Arkansas needs help. The state ranks 49th out of 50 in healthcare outcomes. Four counties have no physician. Eight more have only one. Alice Walton and a growing coalition of leaders are working to change that. Yesterday, leaders from Epic, Mercy, the Alice L. Walton School of Medicine, and the Heartland Whole Health Institute came together for a day of strategy and action. We explored how Northwest Arkansas could become a place to build, test, and refine a hub-and-spoke model of care, with the potential to scale what works to other states. At its center is a Whole Health model designed around the entire person, supported by value-based care, shared information, and technology. Even the physical campus is being built with technology and new models of care in mind, not added as an afterthought. And the exam rooms will have one large shared display for clinicians and patients. As Alice put it: “The issue rural America faces is this splintered system.” No single organization can solve that fragmentation alone. But bringing together leaders around a shared vision, connected infrastructure, and measurable outcomes is a powerful place to start. Thank you to Alice Walton, Judy Faulkner, and Steve Mackin for a day full of big ideas. And, as is the Epic way, we didn’t leave with only a vision. We left with owners, next steps, and momentum. Because strategy matters. But execution changes outcomes. Ari Rajagopal, Jeffrey Heerhold, David Argueta, Scott Richert, Sharmila Makhija MD MBA, Claude Pirtle, MD, MBA, MSACI #RuralHealth #WholeHealth #ValueBasedCare #HealthcareInnovation