Reinventing transitional care

Nursing professor Mark Toles discovers his knack for entrepreneurship through his passion for transitional care.

Mark Toles talked with a woman while reading a Connect-Homes book.

As the boomer population ages, more people are called to serve as caretakers for their parents. Yet many such caretakers don’t have the skills to meet the needs of patients who are newly released from the hospital.

When patients leave the hospital, they hope they’re on the road to recovery. For too many, however, that road becomes winding and bumpy, detoured by a gap in care that exacerbates their illnesses or leads to other compounding health issues. And, before long, patients find themselves back in the hospital rather than at home.

Mark Toles, an assistant professor in the UNC School of Nursing, had an idea that could help solve this problem. His plan brought more questions. Who could help him move his idea forward? What resources are available? What funds might be out there? And how might he balance his teaching and research responsibilities with a desire to turn his idea into something real?

Toles found answers to these questions — and his passion for innovation and entrepreneurship — by working with Innovate Carolina on a program he designed to keep patients healthier after they leave the hospital. His evidenced-based transitional care process Connect-Home helps patients and their caregivers manage serious illnesses at home. The goal is to improve function and prevent re-hospitalizations.

Toles is partnering with Lutheran Services in America to implement Connect-Home, a set of protocols and tools that guide post-acute care providers through a four-step process. This step-by-step process prepares patients and their caregivers for their transition home.

The problem Toles is tackling isn’t a small one. Each year, more than 1.5 million adults are discharged from a hospital to a nursing facility for post-acute care before going home. Often, they need nursing care and rehab therapy for a few weeks to resolve medical problems and get stronger. Many patients may require complicated care at home during the transition back to full health, and their caregivers may not have the medical knowledge they need to provide adequate care.

As a nurse practitioner, Toles understood the challenge of transitional care. He saw his idea for Connect-Home as an answer. Like many faculty, he wasn’t sure how to take the next step.

Making the idea real with Innovate Carolina

Toles brought his idea to the Chancellor’s Faculty Entrepreneurship Workshop, an annual, invite-only event for UNC-Chapel Hill faculty hosted by Innovate Carolina. Nominated by deans, workshop participants are invited based on the promise they show toward entrepreneurial thinking. Throughout the workshop, Toles learned skills he could apply to his idea, including how to identify opportunities and develop solutions, think like customers, build an effective team and create pitch presentations.

“After kickstarting the idea at the Faculty Entrepreneurship Workshop, I started working with Innovate Carolina to see how I could scale the idea,” he said. “I developed Connect-Home using a scientific approach but needed to figure how to scale it. How can we get more impact from what we’re learning? What is a good partnership? What is a brand? How do I find the funds to make it happen? There were many things to learn outside of just the research. I needed to figure out the nuts and bolts.”

Working with Innovate Carolina, the University-wide initiative for innovation and entrepreneurship, Toles refined his vision for Connect-Home. The Innovate Carolina team helped Toles with innovation strategy and guidance as well as market and competitive research. Toles also received support for legal incorporation and guidance, copyright guidance, IP-related grant assistance, technology and partner development strategy, as well as communications, branding and logo development for Connect-Home.

“What you need may change over time. Starting out, I needed help with conflict of interest and learning about commercializing the work. The Innovate Carolina team was vital in helping me brand Connect-Home making the right connections,” Toles said. “From market research to creating the logo and brand, to copyright guidance, the team provided a different level of real expertise.”

His work with Innovate Carolina also shifted his thinking and approach to innovation and entrepreneurship.

“It’s a big change in mindset. The very thought of moving my idea out into the world – that for me was a great big change to my mental map,” Toles said. “The way I think about things – I didn’t know how I was going to make time for this. When I’m doing my research, I’m in control, so I can see if my new tool or protocol is working. But when you scale up, you’re having to say it’s not all me. I’m going to lose a lot of control. That’s a big learning curve.”

Bolstering research with entrepreneurship

Connect-Home is in of its second phase of development, and the program is already seeing positive results.

“There are more than 15,000 nursing homes in the US that deal with what we are studying to improve each day,” Toles said. “Although results from our efficacy trial are still ongoing, we are receiving positive feedback from some nursing homes using the tools. There is strong evidence that transitional care for patients and their caregivers can prevent hospital readmission.”

As Toles continues to grow Connect-Home, he faces the challenge of figuring out how to balance full-time teaching and research responsibilities with his interest in innovation and entrepreneurship. As challenging as it is to balance time between serving as a faculty member and growing entrepreneurship skills, Toles encourages other faculty members to take that first step.

“I have discovered entrepreneurial work causes the intervention to be stronger. That investment in the entrepreneurial side is not taking you away from your research,” he adds. “Doing the entrepreneurial work makes your research better. It’s challenging to take time away from your research, but the time I have pulled away from it has made my research stronger – that’s been a great lesson.”

Learn more about Connect-Home on Innovate Carolina’s website