For approximately 13 years I provided full time consultation services to multiple academic medical centers, health care systems, hospitals, physician practices and out-patient services across the United States.  The range of clients included some as notable as Stanford University’s Lucille Packard Children’s Hospital and New York Presbyterian Health System in Brooklyn to those as small as critical access hospitals in rural Kansas and Alaska.

Prior to that time my consultation efforts were focused on Governmental entities in the form of multiple presentations at HHS Regional Conferences or technical assistance visits to individual states, for approximately 37 states within the union, as follows:

• Idaho State Program for Children with Special Needs.  Developing statewide coordinated systems of community-based, family-centered care for families of children with special health care needs, the use of a multidisciplinary team approach to care, increasing parent participation in program planning and policy development, and general consultation related to public health nursing.  Boise, Idaho, March, 1990.
• Tri-Regional Conference, Regions VIII, IX, and X, Department of Health and Human Services.  Consultation was provided regarding the development of family-centered, community-based, statewide coordinated structures of care for children with special health care needs and their families. San Francisco, California, June,1989.
• Montana State Health Department, Children with Special Health Care Needs Program. Development and implementation of a family-centered, community-based, statewide coordinated care structure for children with special health care needs and their families.  Helena, Montana, May, 1989.
• "Developing Service Systems in Local Communities."  United States Public Health Service Region IV and VI Planning Conference, Developing A Strategy for Family Centered, Community Based, Coordinated Care for Children with Special Health Care Needs, New Orleans, Louisiana, November, 1988.
• "Care Coordination Models:  Michigan Locally Based Model."  Seeking Effective Ways to Coordinate Care for Children with Special Needs:  Wisconsin, Minnesota, and Michigan Experience. Model building, identifying unique strengths and barriers to accomplishment of family centered, community based, coordinated care in a variety of geographic locales, program implementation and evaluation. Madison, Wisconsin, May, 1988.

A series of papers were presented at an HHS Regional Conference aimed at providing participants with a broad range of information, they were:

• "Family Centered Care",
• "Planning and Organizing a Case Management System",
• "Children With Special Health Care Needs:  Developing Community Based Care Systems to Meet Their Needs",
• "Future Directions--The Role of MCH/CCS Nurses." Regions IV and VI Nursing SPRANS Conference--Case Management in Maternal and Child Health, Asheville, North Carolina, July, 1987.

Texas Department of Health, Bureau of Crippled Children's Services. Case management systems for chronically ill children and their families, development of policy, training, and data management systems.  Austin, Texas, December, 1986.

International

Clients included a privately held enterprise based in Mumbai, India who were embarking on the development of an offshore medical records coding company. Over several visits worked with a cohort of 57 trainees to provide education on basic human anatomy and physiology and introduction to medical records documentation and coding concepts and their application in the United States. 2013

Faculty, Department of Medicine, School of Nursing, Mahidol University and administrative and clinical staff of Ramathibodi Hospital, on a variety of topics related to administration and clinical practice.  A three day long invitational national conference, with 300 participants, wherein a colleague and I presented a number of papers and engaged in in depth discussions on nursing administration and advanced practice.  An additional week was spent working with faculty and clinical staff in small groups to discuss potential problem resolution, and to assist the Nursing Executive Committee in strategic planning efforts.  Bangkok, Thailand, May 15-30, 1997.

Australia Health Care System:  (1) Administrators and staff of the Departments of Pediatrics and Child Psychiatry, Adelaide Children's Hospital on the subject of Family-Centered Care; (2) Nursing Executives of the Hillcrest and Glenside Hospitals, Adelaide, South Australia, on the subject of Case Management, and (3) Members of the Health Industry Development Council, Ministry of Health, State of South Australia on the subject of planning, developing, implementing, and evaluating a statewide system of coordinated care for clients with chronic illness, including those requiring technological supports.  Adelaide, South Australia, March, 1991.

Department of Pediatrics, Ramathibodi Hospital & Department of Nursing, School of Medicine, Mahidol University.  Topic areas focused on the development of a system of discharge transitioning of clients from tertiary centers to community-based care who had chronic illness and needed technology-based life supports.  Case consultation provided regarding an 18-month-old child who was vent dependent and had never been discharged home since birth.  Bangkok, Thailand, February, 1991.