212°, the extra one-degree concept reminds us that seemingly small, incremental changes can lead to significant positive outcomes over time and alter the course of a journey. A mere one-degree variance has a profound impact on both the boiling point of water and the landscape of healthcare. How do you get your healthcare team from bubbling to boiling to steam?  Partnerships!

Global health initiatives are crucial for addressing health disparities, promoting disease prevention, and improving access to healthcare services worldwide. By fostering collaboration among nations and organizations, these initiatives strive to achieve equitable health outcomes and enhance the well-being of populations globally.

I am employing the 212-degree analogy as a symbol for achieving optimal patient care and enhancing patient outcomes through cultivating partnerships.

Think of the patient as the pot, the team as the water, and the collective spirit or energy as the driving force to increase temperature. Adding just one additional degree of intensity to the water represents the distinction between mere heat and the powerful energy required to propel significant change. 

The collaborative effort and enthusiasm generated by partnerships act as the steam that propels the strategic plan forward. Each component is essential in realizing your ultimate goal: to achieve the GOLD standard and the 212-degree mark. This creates the steam that drives exceptional patient care. As healthcare providers, we strive to cultivate the steam necessary to deliver patient care that reflects your team's dedication and pride, knowing that this commitment will ultimately lead to improved patient outcomes.

Brocher’s Model of the six key principles to partnerships in global health

Essential to achieving a positive boiling point includes Brocher's Model, which includes six key principles for partnerships in global health. Dr. Thomas E. Novotny, the former Deputy Assistant Secretary for International and Refugee Health at the U.S. Department of Health and Human Services, and Dr. Peter J. Hotez, the Dean of the National School of Tropical Medicine at Baylor College of Medicine, proposed these principles. The model emphasizes the importance of collaboration and cooperation among various stakeholders to address global health challenges effectively, ensuring ethical practices, promoting sustainable interventions, and leading to more effective responses to global health challenges and improved health outcomes worldwide.

1. Mutual partnership with bidirectional input & learning

2. Empowered host country and community to define needs and activities 

3. Sustainability and capacity-building

4. Humility, cultural sensitivity, and mutual

5. Compliance with applicable laws, ethical standards, and codes of conduct       

6. Accountability for actions

Application to practice

In her keynote, Dr Lynch discusses these principles with examples from experiences in global health in Haiti and Rural Mississippi. The examples focused on global health partnerships, which had varying results in producing the energy to reach boiling.  She also discussed her recent publication in the Journal of Nurse Practitioners. In a small primary care practice in an urban, underserved area outside of Boston, a project was initiated to implement an evidence-based screening tool for Social Determinants of Health (SDOH) in primary care practice over 12 weeks. Another objective was to provide referrals and resources for those who screened positive.  In the study, evidence-based SDOH screening was implemented in a small urban primary care practice. This quality improvement project aimed to increase SDOH screening from 0% to 50%. The Protocol for Responding to and Assessing Patient Assets, Risks, and Experiences (PREPARE) tool is a validated SDOH screener administered by a community health care worker during annual physical examinations over 12 weeks. PREPARE was administered to 81 of 85 patients (95.3%), and 8 (9.9%) screened positive. Benchmarks were surpassed for SDOH screening, which resulted in referrals to community resources. Research should use community health care workers as care extenders and test SDOH screening to identify needs toward improved health.

The findings of this successful local partnership project were published in April 2024 in The Journal of Nurse Practitioners as “Social Determinants of Health Screening: Primary Care PRAPARE Tool Implementation.”

It Starts with Us

Each of us takes ownership of and is accountable for doing the right thing. We empower and trust each other to step up. We support each other and hold each other accountable in our work.​ Create the steam that delivers the patient care that you and your team are proud of because, in the end, you will move towards improving patient outcomes. 

Dr. Shelley Lynch, DNP, FNP-BC, is affiliated with the School of Nursing, The University of North Carolina at Chapel Hill, is a lecturer at the Department of Nursing, Salve Regina University, Newport, RI, is a family nurse practitioner at Internal Medicine Office and in critical care at Beth Deaconess Medical Center, Boston, MA. Dr. Lynch also owns ACLS Academy, an authorized American Heart Associate (AHA) Aligned Training Center. ACLS Academy has three convenient locations in Massachusetts – Quincy, Bridgewater, and Newton Center. ACLS Academy provides high-quality courses taught by instructors practicing in the medical profession for ACLS, TNCC, BLS, ENPC, NRP, PALS, Bloodborne Pathogen, HeartSaver CPR/AED, First Aid, and Instructor Courses. Please browse the catalog of courses.