2023 ANA Innovation Award Honorable Mention: Denise Hopkins-Chadwick, PhD, RN

US Army Corporal Denise Hopkins-Chadwick, PhD, RN, spent 30 years as an army nurse before retiring with maximum military service in 2016. Over those three decades, the combat veteran worked as an ER/NICU transport nurse, a clinical researcher at academic medical centers, and finally as vice provost at a military ancillary medical school. What came next for Hopkins-Chadwick might surprise you.

After her mentor encouraged her to leverage her experience, love for teaching, and aptitude for coaching, Hopkins-Chadwick started her own consulting LLC. A multitude of referrals followed, and one client kept calling on her expertise: Kathryn Walker, CEO of Revitalist.

“She was the first one of my clients who was a nurse and a CEO,” she said. “I found it so rewarding to work with this nurse team, and our CRNA backgrounds aligned.” Hopkins-Chadwick ran the psych mental health preparation for the army, so her familiarity with that added to their symbiotic relationship.

Coming out of the military, she began exploring medical modeling and simulation ideas and thinking about innovation more. Mental unwellness had been at the forefront since 9/11, and Hopkins-Chadwick took interest in how she could apply her expertise to move the field forward. Her work with Revitalist as a consultant was so rewarding that she accepted an offer to become senior vice president of research and development at the firm.

Revitalist is on the cutting edge of evidence-based treatments for mental unwellness. The firm researches and provides psychedelic treatments (MNDA, ketamine, classic psychedelics, and cannabinoids), using a nurse-led model to address safety and efficacy. Established in 2018, the firm’s model allows nurses to assess, treat, and follow patients who suffer from anxiety, depression, suicidality, post-traumatic stress, sleep disorders, and pain, employing CRNAs for IV Ketamine infusion and monitoring and PMHNPs to administer therapy before, during, and after infusions.

“When I came on, they didn’t have the capability to do studies, but it was Kathryn’s vision all along,” Hopkins-Chadwick said. “She was amassing a cadre of CRNAs, opening clinics at hard-hitting areas of the U.S. – including 10 clinics across six states – and they were generating a lot of evidence the right way.”

Revitalist was collecting GAD-7 scores, PCL-5 scores, and other reliable evidence metrics in an automated way, but it lacked a scientist to guide the analysis of that data. Shortly after coming on board, Hopkins-Chadwick secured an independent Institutional Review Board and began helping Walker implement her vision. Johns Hopkins agreed to partner with the firm to perform research, a major milestone for the firm.

One of the chief innovations at Revitalist is the model pioneered by Walker. Seeking to help her community in Tennessee that was struggling with mental unwellness, Walker decided to find a way to administer ketamine – which was recently FDA approved in certain situations and offers significant therapeutic benefits*. She assembled a delivery team that uses a therapist/nurse model, unlike others that use a medical aide. CRNAs administer the drug, while the psych mental health practitioners perform therapy in a pre, during, and post-therapy cadence. The CRNA/PMHNP team assesses the patients before the infusion, then the patient is administered the IV infusions for two weeks. Follow-up care occurs at three, six, and nine months followed by an aftercare program. The whole process occurs in a spa-like setting.

The result of this approach is compelling. In a sample of 124 patients, 52% saw a significant improvement in PHQ-9 scores (depression). In 61 patients, 59% saw significant improvement to GAD-7 scores (anxiety), in 54, 19% saw significant improvements in PCL-5 (PTSD) scores, 28% showed clinically significant improvements in pain scores post-treatment. While demonstrating efficacy, this model (CRNAs & PMHNPs) also had no serious adverse effects reported. Data indicates that the nurse led CRNA & PHMNP model is a safe and effective way to deliver psychedelics for mental wellness.

When asked if her innovation journey has changed her perspective on nursing, Hopkins-Chadwick says it’s the contrary. “My journey has confirmed and validated my perspective. Nurses should be leading these clinics and running these companies. They are best suited to do so,” she said.

For nurses just beginning their innovation journey, Hopkins-Chadwick suggests that you consider your team carefully.

“At least one person on your team needs to think almost completely opposite of you,” she said. “Start small until you create revenue, but don’t be afraid – if you go big and you need to pull back, that’s what you do. No good idea is ready before it’s time, and who knows if the time is right if you don’t start trying.”