Paige Twenter

The American Academy of Nursing recently recognized five nurse-designed care models that aim to reduce costs, improve quality of care and enhance patient experience. 

The models, known as Edge Runners, were highlighted in a July 15 post from the American Hospital Association.

1. Post-triage care

At the University of Sydney in Australia, the History, Infection risk, Red flags, Assessment, Interventions, Diagnostics and reassessment/communication (HIRAID) Emergency Nursing Framework is a post-triage tool. Among 2,211 ED patients, HIRAID resulted in fewer deterioration events and improved the patient experience. More than 130 emergency departments across Australia have developed the framework. 

2. Memory care

An Integrated Memory Care model developed at Atlanta-based Emory University delivers primary care-based services to patients with dementia and their caregivers. By integrating medical, social and caregiver support, the outpatient care model has reduced hospital admissions from 6.7% to less than 2%, saving an estimated $1.1 million each year for a 550-patient panel.  

3. Online nurse residency program

The University of Iowa, based in Iowa City, created the first fully online transition-to-practice program for new graduated nurses. Since 2014, 54 organizations across 13 states have adopted the program, improving clinical outcomes and increasing first-year nurse retention by nearly 20%. 

4. Trauma-informed care

The Sexual Assault Forensic Examination Telehealth System connects local healthcare providers, particularly in rural areas, with sexual assault nurse examiners via telehealth. The SAFE-T system also offers forensic tools to improve evidence collection, survivor support and legal outcomes, according to the AHA. The model has a 75% retention rate and 94% patient satisfaction. 

5. Emergency training simulation

A second nursing education program at the University of Iowa was honored. The program, Simulation in Motion-Iowa, is composed of three mobile units that provide emergency training to rural and critical access clinicians. In its first three years, the program has conducted 650 simulations and delivered more than 2,500 hours of free education to 11,000 people, boosting emergency care readiness.
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HealthPartners, an eight-hospital system based in Bloomington, Minn., has reported early results from a care coordination clinic for patients with complex healthcare needs.

The system’s Advanced Care Primary Care Clinic is designed to reduce costly emergency department visits and hospital admissions. Among patients who went most often last year, the clinic helped avert 60% of avoidable ED visits, according to a June 14 HealthPartners news release. 

Many of these patients face challenges such as inadequate social support, food insecurity or other barriers that limit access to healthcare, the release said.

Primary care clinicians refer patients to the clinic, which coordinates care across primary and specialty care, home care, pharmacy, palliative care, social work, behavioral health and care management. 

Each day, staff review recent visits, prepare for upcoming ones and promptly follow up on ED visits and hospitalizations. The team also ensures patients receive all eligible benefits and services. 

The clinic is located within Park Nicollet Clinic and Specialty Center St. Louis (Minn.) Park.  
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The One Big Beautiful Bill Act signed into law July 4 established federal loan limits for medical students. 

Effective July 1, 2026, the maximum amount a medical student can borrow from Federal Direct Unsubsidized Stafford loans will be $200,000. A previous version of the bill proposed a $150,000 cap. 

The law will also terminate graduate and professional PLUS loans, which covered graduate students’ tuition and living expenses after finishing their direct loans. 

In 2023, medical students in the U.S. graduated with an average debt of $206,924, according to data from the Association of American Medical Colleges. 

Of the 70% of medical students in the class of 2023 who graduated with educational debt, more than 80% incurred more than $100,000 in debt, and 54% graduated with at least $200,000 in debt. At some schools, students incur more than $270,000 in debt.
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The number of emergency department visits for COVID-19 is growing across 11 states and likely growing in 14 others, according to CDC data published July 11. 

The data helps visualize whether the number of new respiratory infections is growing or declining, but the model does not provide the actual number of current SARS-CoV-2 infections. 

COVID-19 infections usually peak during winter months and late summer, according to the CDC. Nationally, wastewater data shows COVID-19 activity is “low.”

However, ED visits for COVID-19 are increasing in Alabama, California, Florida, Hawaii, Kentucky, Louisiana, Maryland, Mississippi, Ohio, Texas and Virginia. They are likely growing in Delaware, Georgia, Indiana, Iowa, Maine, Minnesota, Missouri, Nevada, New Hampshire, North Carolina, Oklahoma, Pennsylvania, Utah and Wisconsin. 

An emerging COVID-19 variant, NB.1.8.1, could be contributing to the recent increase in COVID-related ED visits. One symptom of NB.1.8.1 is a severe sore throat, which has been nicknamed as “razor blade throat,” according to ABC News. 
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In the last four years, Beth Israel Lahey Health has expanded its primary care physician workforce by 30%, but its specialty workforce has remained relatively stagnant, according to its chief clinical officer, Rob Fields, MD. 

There are a few factors for this recruitment issue, he said.

For one, some medical students tend to avoid specialties known for lower pay, which translates into certain specialties failing to keep pace with patient demand. Private equity and venture capital are investing in the more lucrative specialties, Dr. Fields said, further exacerbating the gap. 

The 14-hospital system struggles to recruit endocrinologists, neurologists, gastroenterologists, anesthesiologists and, to some degree, radiologists. With an average $526,000 salary, as of 2025, radiology is the third highest-paid specialty. Gastroenterology and anesthesiology average more than $500,000 per year.

Neurologists earn on average $332,000, a 3% decrease in the last year, according to Medscape. Although diabetes and endocrinology physicians saw the largest pay increase among specialties, at 7%, they are among the least lucrative, at $274,000 per year. 

A significant share of the U.S. population is entering retirement age, too. 

“You have a shrinking workforce, higher demand,” said Dr. Fields, who also serves as executive vice president of the Cambridge, Mass.-based system. “It’s like, whoa, a significant mismatch of supply, demand.”

“The other sort of phenomenon of an aging population is that they utilize so much more healthcare than a commercially insured patient,” he told Becker’s. “So in the hospital services, it can be three to four times the amount of a working age adult. That’s a huge amount of demand that’s being created every day as more people age into Medicare.”

To buck this trend, Dr. Fields said Beth Israel needs to compete harder to recruit the small pool of physicians in these specialties. It might not be able to create more gastroenterologists, he said, but the system can tweak the delivery model to cut inefficiencies and create a culture that attracts specialists.
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