A Nurses’ Email Discussion List, Delivered by Mail-List.com:
Helping to Save Lives &
Improve Patient Care Via Email

Nurses Save Time While
Getting More Done for
Hospitals and Patients

A busy oncology nurse in
Lewisville, Tx. got help determining protocols for
DIEP flap monitoring to ensure successful recovery for a breast
cancer patient, without taking hours out of her work schedule. She just sent an email to the group:
“Does anyone have any protocols for DIEP flap monitoring? Thanks in
advance!”
Help came within a few hours from a colleague half a continent away at UCLA Medical Center.
“We do Q1 hour flap/temperature checks for the first 24 hours, then Q 2
hour for 24 and then Q 4 hour until discharge. We monitor for temperature
differences (no>3 degrees between flap and control), color, etc. I hope this
helps.”
An ICU nurse at WakeMed Health & Hospitals sent an email to the group, seeking other's experience in Covid visitation in ICU.
“I am interested in finding out what other hospitals are doing for families
of dying patients in COVID ICUs. Are they allowing families at the bedside
in PPE? Do you limit the number and/or by relation? If so, are you willing
to share your visitation policy? Thank you all in advance for your help.”
“When members have a question about a policy they are developing
or some new procedure, or a new piece of technology, they throw the
question up on the list and . . . they will get an answer within at the
most usually hours.”
— Dr. Lisa Hopp,
NACNS List Moderator

In just minutes she got her answer from a colleugue at University of Illinois Hospital & Health Sciences System nearly 1,000 miles away.
“We encourage video visiting but allow one person to visit for one hour one
time after appropriate screening (symptoms and temperature check: no visitor
with symptoms allowed). We provide Ipads to assist in video chats ( facetime
or duo) . . .”
Globally, nursing is one of the most demanding industries.
Technologies are constantly updating and best practices evolving with them. Nurses need to stay connected to stay up to date.
Reaching out to colleagues outside their own facilities also adds
For more than 30 years, members of the National Association of Clinical Nurse
Specialists have been using an electronic mailing list to tap the knowledge and
experience of colleagues across the nation get answers to critical nursing
questions.
broader experiences and vision to internal viewpoints and opinions so they don’t become myopic.
In today’s age of the Internet, you might think these nurses
are communicating in an online discussion group, a Facebook
group or via Twitter feed. But for more than 30 years, members
of the National Association of Clinical Nurse Specialists (NACNS)
have been using an electronic mailing list served up by Mail-list.
com to tap the knowledge and experience of colleagues across
the nation get answers to critical nursing questions. With over
1,700 members currently on the CNS mailing list, a single e-mail
— sent from the convenience of a smart phone, tablet or work
computer — can be seen and replied to by anyone among hundreds of members in as little as a few minutes.
Over 1,300 Members
— All of which are
clinical nurses at
hospitals across the
United States
Coast to coast,
members have access
to a wide range of
knowledge and
experience
“Its purpose is to share clinical information. Our members are
really very committed to it,” said Dr. Lisa Hopp. A professor of
Nursing at Purdue University Calumet and director of the Indiana
Center for Evidence Based Nursing Practice, Dr. Hopp is moderator of the CNS mailing list. “When members have a question
about a policy they are developing or some new procedure, or a
new piece of technology, they throw the question up on the list
and if there are other members that are doing the same thing,
they will get an answer within at the most usually hours.”
Staying on Top of Critical Issues
In addition to connecting hundreds of clinical nurses to get
questions answered and problems solved, Dr. Hopp said the email discussion group helps her as an educator of nurses. Monitoring discussions and debates on the list helps keep her and other list members abreast of hot topics and issues in the industry.
“It feeds me professionally,” said Dr. Hopp. “I need to know
what the issues are at the front line, such as what clinical nurses
are making decisions about. I am not practicing in an organization as a CNS, so this gets me as close to it as I can be.”
“We talk about clinical topics mostly, but we will also get into
professional issues. Clinical specialists have a lot of professional
issues and a lot of emerging national changes in terms of our
regulation that people need to talk about. We’ll have some pretty
hot conversations sometimes.”
For hospitals and their patients, giving nurses fast, easy access to the experience and expertise of professionals with diverse
backgrounds and specialties potentially reduces trial and error
when implementing new technologies and can save time and
money, ultimately resulting in better patient care and improved
patient experiences.
“I need to know what
the issues are at the
front line . . . this gets
me as close as I can be.”
— Dr. Lisa Hopp,
NACNS List Moderator
Advantage of Email in the Social Media Age
When the CNS mailing list got started in the mid 1990’s e-mail
discussion groups were the height of technology for discussing
topics amongst a far-ranging and geographically diverse population with shared interests. But in the last decade online forums
and social media have become prominent in the group discussion
arena while e-mail lists have been largely relegated to use as a
means of distributing electronic newsletters and advertisements.
So why continue to host discussions between clinical nurses via
e-mail?
For the nursing community as well as numerous other nonprofit and commercial communities, e-mail offers several advantages that facilitate their high-security workplace environments:
- Members can utilize work e-mail accounts to access discussions whereas many workplaces prohibit use of social media
sites and discussion forums while on the job or while using
company computers.
- Email is more accessible as messages can be sent or received via smart phone or tablet as wells as by computer
and are more readable than many other platforms when using mobile devices.
- Many users are already logged into e-mail, avoiding the
need to log-in to an additional website as forums and social
media groups require.
- Members can opt to receive e-mail related to all topics or
just the topics they’re interested in — no sorting through
numerous discussions to find something interesting.
- Members can opt to receive all e-mail in real time or choose
to receive daily or weekly digest e-mail that include the best of discussions as rated by other members
- Discussion e-mail arrive right in their e-mail inbox or smart
phone so they don’t have to remember to log in and search
through the latest discussions.
- Nurses in critical positions often get answers to their questions faster and with less hassle than they would by doing
research or scouring online discussion groups.
E-Mail Lists Offer:
- Security-friendly deliverability
- Easier to read on mobile
devices
- Usually accessible on
company computers
- No additional log-in needed if already logged into
e-mail
- Weekly digest e-mail option — avoid cluttered
inbox
- Specify topic discussions
to be received
- No need to remember to
check for new discussions
— automatically received
in e-mail inbox
- Faster answers with less
hassle
- No interruption of work
tasks while waiting for
responses
Mail-list.com’s 100% Deliverability, Flexibility and
Highly Responsive Service Yield Extraordinary
Levels of Participation and Reliability
With over 20% of the list’s 1,300 members contributing to discussions each month and an average of 23 messages posted each
day, the CNS mailing list group boasts a highly unusual level of
activity and participation. Considering the critical nature of many
of the group’s discussions, getting those messages delivered reliably without bogging the system down or getting black-listed by
Internet Service Providers is incredibly important.
“Because members open and read the messages, ISP's rate Mail-List.com high in engagement, and deliver our emails to the inbox.”
— Mark McCreary, Mail-list.com
Dr. Hopp and her
nationwide network of clinical
nurses, Mail-list.com achieves a remarkable 100% delivery rate
that is virtually unheard of among e-mail distribution services.
Mail-list.com founder and developer Mark McCreary employs a
three-fold strategy for ensuring the success of the firm’s discussion lists:
60% of Members
have Posted at Least
One Message
20% of Members
post a Message in an
Average Month
Approximately 11%
of Message are Sent
Via Smart Phone
Nurturing a Positive Reputation Among ISP’s
— Focusing exclusively
on discussion groups and avoiding use of his servers for newsletter
distribution or marketing campaigns, which are often
interpreted as spam, Mail-list.com e-mail enjoy high responsiveness from
recipients that generally puts the domain on the White List of most Internet
Service providers.Monitoring and Resending Rejected Messages
— Rejected messages are
automatically reformatted and resent from a different internet service provider (ISP). To increase deliverability, the reformatted message includes just a link to an online version
of the message. Recipients can click through to view the
message online and circumvent finicky spam filters.Internal Inbox Monitoring System
— Each discussion group includes
several in-house e-mail addresses monitored by an automated system to ensure each message is being received.
Messages that fail to reach the inboxes trigger an alert so
the problem can be investigated and remedied.
“Because members open and read the messages, ISP's rate Mail-List.com high in engagement, and deliver our emails to the inbox,”
says McCreary.
An Affordable Package of Simplicity,
Power & Support
When Dr. Hopp took over moderation of the list from a retiring predecessor in 2006, she found she also needed to find a
new host for the list, which
had previously been hosted on a university’s private servers – a university Dr. Hopp had no personal
connections with. Though she enjoys using the latest computer
technology, Dr. Hopp had no experience moderating an e-mail
discussion list. She sought out a service provider who could handle the massive quantity of e-mail fielded by the list’s members
“I really had no
experience with
managing a list, so I
needed to have a real
simple approach and
support. It was very
obvious from my first
conversation with
Mark that I was going
to get that from him.
He is really patient
with me.”
— Dr. Lisa Hopp,
NACNS List Moderator
without requiring too much time or technical know-how from herself, as
moderator, or her members. After talking with Mark McCreary at Mail-list.com,
Dr. Hopp realized she had found her solution.
“I really had no experience with managing a list, so I needed
to have a real
simple approach
and support,”
said Dr. Hopp. “It
was very obvious from my first
conversation with Mark that I was going to get that from him. I
can have some real knucklehead questions that I probably have
had answered before and he is really patient with me.”
She found that the Mail-list.com interface was easy to navigate and use, minimizing the time it takes her or a member
to find what they’re looking for and interact with a discussion
thread. On average, Dr. Hopp spends only a half-hour each week
tending to the list. But even more importantly, the system was
capable of handling all that her highly active group demands of it.
“The interface that you as a moderator use and that the members use is dirt simple,” she said. “But behind that is all the power
you need. That is sort of the ideal in technology.”
Affordable Solutions
As a non-profit group, pricing was also an important consideration in the quest for a mail list host. With per-member pricing,
rather than per 100 members or per 1000 members like other email lists, and special rates for non-profit agencies, Mail-list.com
once again surpassed Dr. Hopp’s expectations.
“The interface is dirt simple. But behind that is all the power
you need. That is the ideal in technology.”
— Dr. Lisa Hopp, NACNS List Moderator
95,318 Total Messages Since 2006
Average Reply
Time: 1.5 Hours
Fastest Reply Time:
7 Minutes
Average Time per
Week Spent Tending
List:
30 Minutes
“We are always kind of living on a pretty tight budget,” Dr.
Hopp said. “Mark offered a very reasonable price. It was something our organization could afford.”
Responsive and Pro-active Support
But to meet customers’ high expectations, powerful platforms
with easy-to-use interfaces and affordable pricing must be backed
by support that responds quickly to customer needs. Dr. Hopp
found that support from Mark McCreary and Mail-list.com not only
responds to the needs of her and her group but often anticipates
them ahead of time, adding features and capabilities that fit the
way the CNS mailing list members use the service.
“Mark continues to be highly responsive. He sort of watches
from behind the scenes and keeps nudging and improving the
technology to meet needs that we may not even know we have,”
Dr. Hopp said. “He will tell me things that I am not aware of and
say, ‘Hey, this is going on with the list, it looks like your users are
moving in this direction, so I am adding this new capability to the
list.”
Mark has added several custom features to the CNS mailing
list over the years. One of the most significant was a development that enabled the nurses to send attachments to each other
without being flagged by hospitals’ security firewalls. Because of
the high level of privacy and the critical nature of computerized
information at hospitals, security protocols have to be tight. They
often misidentify harmless e-mail attachments, like PDF files, as
potential threats and prevent the e-mail from entering the hospital’s computer system.
Mark’s solution was to program the list platform to remove
attachments from members’ e-mail, post the attachment online
and insert a link to the document before sending the e-mail on to
“Mark is a problem
solver. I wish all
of our IT folks could
be like him — a really creative person
who is always pushing
the envelope to find a
better solution to do
what we need to do,”
—
Dr. Lisa Hopp, NACNS List Moderator
other members. The solution ensured delivery of those e-mail and
made it easy for members who want to view an e-mailed document to do so easily.
Since developing this work-around for the
CNS group, Mark has also implemented the feature for other list
groups with high security issues.
Other custom features, like the option to receive weekly digests of popular
discussions, enable members to be more selective about the messages they receive,
avoiding the hassle of receiving irrelevant e-mail or becoming bogged down with
e-mail at
inconvenient times. Recently, Mark added the capability for members to “like”
particular questions and responses and assign tags
to conversations. These modifications allow members to be even
more selective about what e-mail they read and receive so they
can address topics they specialize in or follow issues they are
concerned about.
“Mark is a problem solver. I wish all of our IT folks could be
like him — a really creative person who is always pushing the
envelope to find a better solution to do what we need to do,” said
Dr. Hopp. “Mark is somebody who really creates something and is
looking ahead and anticipating the next issue, the next problem,
the next better solution. That is what it seems like he is doing
down there in Texas.”
Helping Non-profits Achieve More
— Through Email
For busy clinical nurses doing critical work at hospitals across
the nation, The CNS mailing list hosted and serviced by Mail-list.
com has proven to be an effective, dependable means of sharing
knowledge across a broad array of specialists, staying informed
on important issues, and improving patient care and experience
“Mark is somebody
who really creates
something and is looking ahead and anticipating the next issue,
the next problem, the
next better solution.”
— Dr. Lisa Hopp,
NACNS List Moderator
as a result. But the NACNS isn’t the only organization that has
found Mail-list.com e-mail discussion groups to be a convenient
and efficient way to keep communication lines open. More than
500 non-profit and professional organizations, from the Children’s
Environmental Health Network and the Sanford Consortium of Regenerative Medicine to the Global Hospitality Educators and MIDI
Manufacturers Association, enlist Mail-list.com to keep members
informed and connected.
“At Mail-list.com, we’re proud to serve these excellent organizations and help
them find solutions to their needs as communities,” said Mark McCreary. “KISS, Push and Mobile First Formatting are the keys to a vibrant online community.”
“KISS, Push and Mobile First Formatting are the keys to a vibrant online community.”
— Mark McCreary, Mail-list.com

For more information about Mail-List.com
and how an e-mail discussion group can keep
your non-profit organization or other community
connected with 100% deliverability and securityfriendly e-mail backed by pro-active support and
a powerful framework, please visit:
www.Mail-List.com
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