For Polly Moore, MD, FACC, helping patients live and die well with heart failure is not just a job, it’s a passion. One that started 25 years ago when she began her career as a nurse and found satisfaction working with heart patients in the emergency room.
Dr. Moore, now a cardiologist with Franciscan Physician Network Indiana Heart Physicians, is director of the practice’s Heart Failure Care Clinic and works with Kindred as a consultant, rounding on cardiac patients at Kindred Hospital – Indianapolis South, and providing clinician education there on the heart disease process.
“I was drawn in particular to the heart failure patients, primarily because of the way heart failure impacts their whole lives,” she said. “I try to teach the patients and their families how to get the heart failure under control so they can live well with it.”
In honor of National Cardiac Rehabilitation Week, we are highlighting a unique monitoring system that ensures that any change in a patient’s condition triggers the appropriate medical response.
Because the care of a cardiovascular patient can be extremely complex, Pamela Zanes, District Director of Clinical Operations, recently implemented simple-to-use, but very effective, systems for monitoring the condition of each patient. Congestive Heart Failure Zone management uses information about breathing, swelling, weight gain, chest pain, and activity level to determine when a physician should be called. The Stop and Watch Early Warning Tool encourages anyone in the room to observe and report changes in patient behavior.
“Someone might notice something different, such as the patient is less talkative than the day before or a sudden weight gain that might be a sign of edema. Heart failure is a long-term condition with symptoms that can begin suddenly,” Zanes says.
Many diners tell Ronnie Barker, Head Chef and Foodservice Director at Kindred Hospital Sacramento, that they feel like they’re on vacation rather than at work. He takes this as “a great compliment to me and my amazing team,” including his assistant, Tifiny Andersen.
“Most people only have 30 to 60 minutes to eat. Tifiny and I want them to come here, relax and have a first-class experience,” says Barker.
Instead of frozen food and bland ingredients, Barker uses fresh produce purchased from local vendors, and specialty items like Persian cucumbers and Japanese eggplant.
On Monday the Centers for Medicare and Medicaid Services (CMS) reported that 14 organizations – including Kindred Healthcare – have been selected to participate in Model 3 of their Bundled Payments for Care Improvements (BPCI) initiative. The BPCI initiative seeks to evaluate the total cost of care for 60 days following an acute care hospitalization, and to have the quality of care improve while bringing down the overall cost. That includes care delivered in multiple settings: home health, skilled nursing facilities, LTACH’s, and any time spent back in the acute care hospital if needed.
On Tuesday I had the privilege of listening to a presentation by Dr. Bill Crounse, Microsoft’s Senior Director of Worldwide Health.A former family medicine doc with a background in broadcasting, Dr. Crounse started his talk by showing a cartoon depicting what people in 1925 predicted telemedicine would look like fifty years into the future. He then shared his own experience with his “Dr. Goodwell” program, which he used in the late 1990s to connect patients to their doctor via computer in order to discuss symptoms and begin the process of diagnosis and treatment. In sharing these blasts from the past, Dr. Crounse pointed out that while consumers and physicians were not ready in 1975 or even in the late ‘90s for new technology to play a real role in health care delivery, we are now living in a time that is ripe with opportunities for technology to greatly improve the way we do our work.
According to Dr. Crounse:
, of the most successful home care providers in the United States.
“The HomeCare Elite is published annually to recognize the top 25 percent of home care agencies based on publicly available performance measures,” says Scott Smith, Director of Marketing, National Research Corporation. “We also further distinguish the top 100 and top 500 agencies. The list recognizes those agencies that are doing more to improve performance and outcomes for their patients.”
Performance measures used to determine the 2012 HomeCare Elite included quality of care, quality improvement, patient experience (HHCAHPS), process measure implementation, and financial performance. The analysis used to develop the list is drawn from information that is publicly available via CMS cost reports and Home Health Compare.
is an excellent time for facilities to get the word out to the community, to residents and even to employees about what activity professionals do,” he says.
All Kindred facilities provide physical, psychosocial, spiritual and religious activities to residents. “The more people stay active and participate in life, the better their outcomes will be,” says Charnock. “We offer a variety of activities, such as church services, exercise programs, Tai Chi and laugh therapy. We also offer culinary programs, such as cooking demos and in-house lunches that the residents prepare themselves.”
The Methodist Hospital in Houston, Texas operates one of the largest lung transplant programs in the country; in 2012, the hospital performed 143 lung transplants and boasts excellent outcomes with a 30-day survival rate of 95 percent, one-year survival rate of 83 percent and five-year survival rate of 55 percent.
“Our outcomes are on par or slightly above the national average,” said Director of the Lung Transplant Program Harish Seethamraju, MD.
Many of those lung transplant patients are seamlessly discharged from Methodist to Kindred Hospital-Houston Medical Center, where Dr. Seethamraju and his team oversee their care as they continue their recovery.
“Do you have an advance directive?” This is one of the first questions a patient is asked when admitted to a Kindred facility. “The goal of an advance directive is to make sure that patients are making informed decisions and that we’re following their wishes,” says Kathee Paradowski, Clinical Informaticist Consultant in Kindred’s Hospital Division. All patients who do not have an advance directive are educated/counseled on the importance of creating one. They are also encouraged to designate a power of attorney for health care who can speak for them if they become so sick they are unable to speak for themselves.
I found this article about staffing issues in Home Health to be quite interesting for several reasons:
1.) Their definitions of home health vs. home care. We look at “homecare” as being an umbrella term to capture medical home health and non-medical home care, but we may need to rethink this.
2.) How we are differentiated by many of our competitors due to the background checks and drug screenings that our employees undergo?
3.) Also how we are differentiated by our certification and accreditation?
Editor's Note: Leigh White is Kindred Healthcare's Senior Director of Communications for the PeopleFirst Homecare and Hospice Division.
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