On Thursday, June 16, three Gillette Children’s employees were honored as Health Care Heroes. The Minneapolis/St. Paul Business Journal hosted the event that put a spotlight on Twin Cities individuals who put innovation, care, dedication and compassion to work to improve the human condition.
The Gillette honorees are:
- Tammy Sinkfield-Morey, DNP, for Health Equity Champion
- Ashley Karlen, for Nonclinical Health Care Staff Member
- Chantel Burkitt, PhD, for Innovator
Read more about these amazing Gillette team members and their recognition-worthy achievements.
Tammy Sinkfield-Morey, DNP
Tammy Sinkfield-Morey is a Doctor of Nursing Practice (DNP) and one of eight inpatient nursing supervisors at Gillette Children’s. She has worked at Gillette for 25 years.
- Tammy received the Diversity and Advocacy Award from the March of Dimes in 2021. Tammy’s contributions to furthering awareness and education in racial diversity and equity, both in the community and at Gillette, were commended.
- Honored as MN Hospital Association’s Caregiver of the Year in 2019 and received March of Dimes 2018 Distinguished Nurse of the Year Award
- Member of Gillette Black and Brown Employee Resource Group
- Adjunct nursing instructor at Augsburg
- Member of the Epilepsy Foundation of MN Professional Advisory Board (PAB) and their Diversity, Equity, and Inclusion (DEI) Committee.
She is well known by patients, families and fellow staff members alike for the compassion, kindness, joy and empathy she brings to her work and the care she provides. She also known to offer hugs.
Tammy says: “I get a lot of joy from work.”
She became a nurse after her husband died from cancer. When Sinkfield began her career as a nurse at Gillette, she was the first Black woman. Through the years, she’s been a tireless advocate for building a more diverse, equitable and inclusive workplace at Gillette and among health care providers.
In 2018, she was selected to participate in the Josie R. Johnson Leadership Academy through the African American Leadership Forum. As an Academy Fellow, she had to develop a platform to effect change.
Her inspiration came from attending Nursing Salons in which she was the only African American nurse. The issues on her mind about nursing were quite often not the same as those of the white nurses present. The experience of being “the only” was nothing new to her; she had spent most of her life as the only person of color in the spaces she inhabited.
So, Tammy created a new Nurses of Color salon in her home on Juneteenth 2018, to engage in conversations about the challenges they face as nurses of color and about racism. Tammy organized a series of salons for nurses and other health professionals of color, in which participants are given safe space for conversations about their experiences with social justice, systems of oppression and racism, health equity and well-being. She and another colleague wanted to provide a safe space to talk and ask questions and better prepare colleagues to navigate cultural interactions. She has written about and taught this model.
“I recognized how powerful these conversations could be.”
After the killing of George Floyd, she offered to host a salon for Gillette employees, transitioning the salon from her home to virtual because of COVID and transitioned the salon from nurses of color to any Gillette employee. Between June and September of 2020, after George Floyd was killed, she held 11 salons. There has been a total of 26 salons with 300 participants.
Each salon is guided by the following rules:
- Equal time to share what’s on your mind and in your heart.
- Confidentiality! A safe space where EVERYTHING discussed remains within the group.
- Desire to talk about the actions related and subsequent to George Floyd’s death.
- Compassion and respect for others’ feelings, emotions, and beliefs.
- No judgment.
Tammy also encourages people to share their stories to engage nurses with their patients, especially where there are cultural differences. She recently served as a guest co-editor for the first issue of the 2021 Creative Nursing Journal in which her guest editor article documents a series of conversations focused on methods for creating safe dialogues between people of different races to inform collective understanding.
“During my 20 years as a registered nurse, I was struck by the power of story, and what can happen when you share yours with another human being. Time and time again, it seemed that individual stories could bridge divides and differences that previously seemed intractable.”
Ashley Karlen is the Director of Charge Integrity (Revenue Cycle) for Gillette Children’s.
After working in revenue cycle roles at Allina Health and HealthPartners - Park Nicollet, Ashley joined Gillette in 2018.
“I am passionate about advocating for our patients. I listened to a mom crying because she’s talked to 10 people without an answer, and I said I’m not going to pass you along. I’m going to get the history, and information and do the research,” Ashley said. “I do a lot of three-way calls with insurance companies and our patients’ families.”
In 2019, Ashley proposed the creation of a financial advocacy program to assist families with financial assistance eligibility and applications and obtain prior authorizations and in-network rates from insurers.
Ashley estimates they have approved 300-400 patients per year for the Gillette Assistance Program.
She led a team in revitalizing the Gillette Assistance Program (which is Gillette’s financial assistance program -- also traditionally known as a charity care program) and expanded the number of patients who would qualify. Gillette provides financial assistance to patients who are uninsured, underinsured, ineligible for any government health care benefit program, or unable to pay for part or all of their care.
She created the role of financial advocate and increased staff available to reach out to parents on the front end before they receive services and to be available to talk with families. The team ensured that there was follow-through on prior authorization requests and appeals.
“I wanted to make sure we had time to spend with families -- make sure we make time to sit down with them.”
Ashley’s team’s mission is to be more proactive in getting families into the Gillette Assistance Program and to obtain prior authorizations where needed. “What we don’t want to do is deliver services and then have to appeal a denial of coverage because a prior authorization was not obtained,” said Ashley. “This results in fewer patients getting a big bill. We also don’t want Gillette to have to write off debt that a patient can’t pay.”
The team’s work, in collaboration with Gillette’s social work team, is to assess eligibility for all Gillette’s patients, enrolling them on public programs, like Medicaid, if they are eligible or to determine what their commercial insurance will cover before services are provided so there will not be surprises or denials of coverage.
“Even patients with commercial insurance may not be able to afford their high deductibles or co-pays making them eligible for our financial assistance. In addition, there is, unfortunately, a stigma in receiving charity care,” Ashley says. “We think patients would qualify but there is still a stigma in asking for financial assistance. Our program makes it easier to determine eligibility.”
Ashley oversees 6 teams of more than 60 staff with a lot of coordination with the patients’ providers to obtain clinical information that is needed for insurer's approval of services.
“We want patients to be able to access care without worrying about those high bills. We want to make sure there is no surprise billing (which the federal government now prohibits). We never balanced billing, which means that we never sent patients a bill for the difference in what the insurance company covered and what we charged.) We have a price estimator tool and shoppable services on our website.”
If an insurer denies coverage, we may appeal and we will also make sure that our patients’ families apply for financial assistance if we cannot get the insurer to cover a service. This gives parents information up-front.
Chantel Burkitt, PhD
Chantel Burkitt is a clinical research scientist with Gillette Children’s Pain and Comfort Research Program. Burkitt explains that there are only a few scientists that study pain in children with disabilities. According to Burkitt, there was little attention paid to pain in children with disabilities until the 1980s. An idea persisted that kids who have disabilities were not as sensitive to pain because of slow processing speeds. Now there is growing evidence that they are more sensitive to pain because they’ve undergone numerous procedures or surgeries and have multiple conditions. There is more awareness and momentum recently to address pain in kids with disabilities, especially children who are nonverbal.
Burkitt says her dream is for there to be no unnecessary pain for Gillette patients.
Burkitt was instrumental in forming the International Association for the Study of Pain (IASP) Special Interest Group (SIG) dedicated to advancing the understanding and treatment of pain among individuals with neurodevelopmental disabilities. This is the premier group that studies pain. They’ve worked to revise the definition of pain to be more inclusive.
Burkitt is dedicated to pain in the most vulnerable. “We are not always assessing pain the way we should. There has not been a methodology or science of how to treat pain in children with disabilities. The best ways of treating pain include physical therapy, occupational therapy, non-pharmaceutical approaches and relaxation. The approach needs to be multidisciplinary including non-pharma and pharmaceutical treatments.”
Many people who have intellectual and developmental disabilities can’t communicate or express pain in typical ways, making it difficult for care providers to recognize and interpret patients’ experiences. People who have disabilities often have other chronic health conditions and undergo procedures that are likely to cause pain. This means they’re at risk for experiencing undetected or undertreated pain.
To manage pain more effectively in people who have disabilities, Burkitt’s research focuses on deciphering pain and pinpointing pathways in the sensory system that trigger pain in the body. This involves finding new, non-invasive ways to document pain experience, pain expression, and function in people who have disabilities.
Burkitt has been studying the use of virtual reality (VR) for pain management in children since 2016.
She believes it is helpful by increasing relaxation and distraction. “One of the best ways to get through pain, is if you are excited about something. We’re seeing anecdotal and great success stories of how awesome and effective it is.”
“So many of our patients have limited abilities regarding their movement. If you don’t have hand function, it’s hard to play with toys to distract, and if you don’t have verbal abilities, maybe you can’t engage in singing or some of the other interventions that we use to try to distract. I wondered if VR headsets could help provide distraction in those cases.”
The anxiety that comes with the expectation of pain can make procedures even worse for children.
One of her studies is using VR during Botox injections for patients who have cerebral palsy. The patients in the study considered their pain and anxiety well managed with or without VR but rated the overall experience to be considerably better when VR was used.
The distraction provided by the virtual reality headsets allowed care providers to reduce the amount of medication used during the procedure while still effectively managing the pain. This helps push Gillette towards the goal of lowering the use of medications for certain procedures. Nitrous oxide, for instance, has side effects of hallucinations, nausea and vomiting. The reduction of nitrous, in association with VR use, has eliminated or reduced hallucinations for some patients.
"I am passionate about my research at Gillette because I want to improve life for people who have disabilities and complex conditions by finding innovative ways to reduce pain and improve comfort. Ultimately, I hope my work will support advances in pain detection and successful management to ensure people who have disabilities can fully engage with their families and in the activities they enjoy."
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