The Nurse Keith Show · Keith Carlson, RN, BSN, NC-BC

Bridging the Gaps to Save Medically Complex Children

September 6, 2024·51 min·4 clips

Tiffany Simon reveals how paramedics' lack of training led to her son Austin's death, sparking a mission to save others.

This episode features Nurse Keith interviewing Tiffany Simon and Natalie McCauley, co-developers of Project Austin at Children's Nebraska. Tiffany and Natalie are pediatric nurses who created a program to support medically complex children living at home. The number of children with medical complexity has tripled in the past decade due to medical advances. Standard emergency protocols like pediatric advanced life support can sometimes harm these children. Project Austin works to bridge the gap in care between pediatric hospitals and community first responders. Tiffany's personal story is the program's foundation; her son Austin, who had a tracheostomy and complex heart disease, died after paramedics made an error during an airway emergency. Natalie's inspiration came from her father, a volunteer EMT, and her niece, who spent years hospitalized with cancer. The program started with 15 patients in 2015 and now serves over 2,000 children across an eight-state region. Project Austin partners with 700 EMS departments in Nebraska, Iowa, Minnesota, South Dakota, North Dakota, Wyoming, Kansas, Missouri, and Texas. The co-founders travel to these communities to create individualized emergency plans and build trust with local responders. Data shows the program has led to a 27% reduction in hospital admissions and a 23% reduction in ED visits for enrolled children. It has also achieved a 55% financial cost reduction across services, saving an estimated $221 million over five years. The program won the ANCC Magnet Prize, which includes funding to expand nationally. Tiffany and Natalie are launching a national collaborative to share their playbook, consult with other children's hospitals, and create a benchmarked database. The hosts discuss how their nursing backgrounds in the PICU, transport, and outreach prepared them for this work. Tiffany shares that she became a nurse after her son's death, initially to support other parents in the ICU. The tone is deeply personal, inspirational, and educational, focusing on turning tragedy into systemic change. Nurse Keith guides the conversation with empathy and professional curiosity. This episode would deeply resonate with nurses, especially in pediatrics, critical care, or community health, and anyone interested in healthcare innovation or patient advocacy. Listeners seeking a purely clinical or non-narrative discussion might find the personal stories less engaging.

As heard by us

A steady, useful look at Project Austin and the care gaps it is trying to narrow.

The episode centers on Project Austin, with Tiffany Simon and Natalie McCauley describing work at Children's Nebraska to build trust and give EMS and ED teams information they can actually use.

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Why you'd press play

You want a grounded look at health literacy in pediatric medicine and how Project Austin uses trust, usable information, and an assess-and-intervene model.

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