UVA Health Team Member’s ‘Relentless Advocacy’ Changes a Life AND Sparks Change to Help Many More
The "compassion, tenacity, and unwavering commitment to excellence" of Shannon James "truly embody what it means to be excellent every day!"
UVA Health University Medical Center Chief Medical Officer Reid Adams, MD, and BEE Committee Chair Samantha Shifflett surprised Shannon James, Transplant Scheduling POD, with a BEE (Being Excellent Everyday) Award.
Tessa Williams, BSN, RN, CCTC, nominated James:
"Shannon was involved in the care of a patient listed for a transplant in addition to a rare and complex diagnosis. The patient met very strict and center-specific criteria for transplant, but when Shannon submitted the insurance authorization request for formal listing, the patient’s federally managed insurance denied the request and refused to allow a peer-to-peer discussion.
"Recognizing the urgency of the situation, Shannon refused to take 'no' for an answer. She knew that without her continued advocacy, this patient could lose a lifesaving opportunity. Over the following weeks, Shannon spent countless hours communicating with the insurance company, gathering extensive provider documentation, guidance, and policies to support the case.
"During one of her many calls, Shannon discovered that the insurance company was using exclusionary guidelines from 2008, which were outdated and not reflective of current transplant standards. Undeterred, she continued to advocate, and after extensive communication, successfully arranged a peer-to-peer review between our transplant provider and the insurer’s medical team.
"Because of her persistence and advocacy, the case was ultimately escalated to the chief of clinical oversight, who personally reviewed and approved the insurance authorization for transplant. The chief shared that without the diligence of Shannon, the patient’s approval never would have happened. Even more remarkable, as a direct result of Shannon's efforts, the insurance company is reviewing and updating its transplant exclusion policies to better serve patients in the future!
"The relentless advocacy of Shannon not only changed one patient’s life, but it also sparked systemic change that will help many more. Her compassion, tenacity, and unwavering commitment to excellence truly embody what it means to be excellent every day!"
Know a Deserving Team Member?
The BEE Award recognizes UVA Health University Medical Center team members who work alongside our nurses to impact patients' experiences — just as bees and flowers depend on one another.
Every month, the Nursing Professional Governance Organization (NPGO) honors up to two UVA Health University Medical Center team members with this award. Submit a nomination.
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