Chronically critically ill patients, a population whose needs and challenges were the sole subject of a recent issue of the journal Respiratory Care, have a very high mortality rate, and survivors among the group suffer with severe impairments and functional dependence. For the caregivers of these patients, the effect can be devastating. According to one article in the journal, “it is difficult to imagine a group of patients with greater need for high-quality palliative care.”
This article points out that early integration of palliative care for these patients can be highly beneficial, particularly in helping patients and families define goals for care and manage the emotional issues that arise when a patient is chronically critically ill.
[caption id="attachment_538" align="alignleft" width="210"] Ms. Opdyke leaves Kindred Hospital with a smile and new appreciation for her extended lease on life.[/caption]
Aubrey Opdyke, a 27-year-old wife and mother came to Kindred Hospital – The Palm Beaches after a two-month battle for her life at a local sub acute hospital against Public Enemy No. 1; swine flu. Ms. Opdyke had spent five weeks in a coma, suffered six collapsed lungs, a near-fatal seizure and worst of all, lost the child she was carrying. The young mother had been six months pregnant with her second child when she contracted H1N1 that July. In spite of every possible effort, her baby girl could not be saved. Once her condition had stabilized, Ms. Opdyke was transferred to Kindred Hospital having lost two months of her life and the life of her child during the medically induced coma that had saved her life.
National Case Management Week, observed Oct. 14-20 this year, recognizes case managers for their hard work, dedication and advocacy for their patients, and also educates others about what they do.
The Palliative Care Summit for PeopleFirst Homecare and Hospice was held in Snowbird, Utah on September 15, 2012, following the Rocky Mountain Geriatric Conference. The leadership team in attendance represented over 1400 employees of the PeopleFirst Homecare and Hospice Division of Kindred Healthcare, Inc. Jim McDonald, Vice President of Western Region for Homecare and Hospice, and Ed Seiler, Senior Director of Hospice and Home Health Operations hosted the summit as a way to bring the western branches together and to give an overview of the BridgePoint Palliative Care program. There were commanding presentations, sharing ideas and best practices on the implementation and maintenance of a successful palliative care program. You can learn more about PeopleFirst Homecare and Hospice's palliative care program here.
What is Palliative Care?
Last week was National Healthcare Foodservice Workers Week, a time set aside to honor healthcare food and nutrition professionals. Thousands of patients and residents are admitted to Kindred facilities every year, and our staff has an amazing ability to keep up with all of their dietary needs and restrictions.
The publication of the June 2012 issue of the journal Respiratory Care followed a national symposium dedicated to the “chronically critically ill patient,” the patient with ongoing costly medical interventions, risk for medical complications and death, and the need for extensive post-acute care services. One article and subsequent discussion was devoted to the topic of liberating patients on prolonged mechanical ventilation, or PMV patients, from their need for this ongoing treatment. PMV is defined, in this article, as mechanical ventilation needed for at least 21 days.
We know there are barriers to weaning patients from PMV, but it can be argued that we haven’t formally studied them enough to know how to overcome them. The barriers may include age, identifying windows of opportunity for weaning, a concurrent condition known as critical illness neuromyopathy (CINM) and cardiac issues.
Soon after Barbara Baylis came to Kindred in late 2002, she began an effort to develop consistent policies and procedures within the company’s nursing centers – more than 200 of them.
“A small group of us got together to clearly outline the care we were expected to deliver, based on evidence-based standards,” said Baylis, the Nursing Center Division’s Senior Vice President of Clinical and Residential Services. “And some people out in the field said, ‘Well, this is voluntary, right?’ And I said. ‘No. They didn’t voluntarily hire me. These are the standards we will begin striving for.’ ”
Many important questions were raised by information published in the June 2012 issue of the journal Respiratory Care. This issue followed a national symposium dedicated to the “chronically critically ill patient,” the patient with ongoing costly medical interventions, risk for medical complications and death, and the need for extensive post-acute care services.
In an effort to improve employee safety, Kindred has developed and implemented a number of safety measures over the last few years. “We started a campaign called ‘Safety Never Hurts,’ in 2011, and are continuing it in 2012,” says Greg Laird, Director of Loss Prevention, Kindred Healthcare. “Some of our earliest efforts were visual promotions like posters and banners. We also provided facilities with digital counters to record injury-free days. There are contests between facilities to see who can make it through the most days without an injury. We have one facility right now in Texas that’s close to 400 days.”
As part of the campaign, each Kindred facility was asked to assign a Worker’s Compensation Champion. “The champions are employees who were already working in the facilities,” says Laird. “Their job is to keep track of injuries and make sure the CEO or director is aware of those injuries so they can work to resolve any ongoing issues.”
National Rehab Awareness Week is Sept. 16-22, which makes this an ideal time to highlight the impact that Kindred’s RehabCare Division has on our patients. The country’s largest provider of rehab services, RehabCare offers physical therapy, occupational therapy, and speech-language therapy to more than 2,100 facilities in 46 states. “Many of our patients are critically ill and are on ventilators or have trachs [tracheostomies],” says Vienna Lafrenz, OTR/L, CLT, Director of Clinical Operations - West Region, RehabCare. “We also treat a lot of medically complex patients who have multiple diagnoses or conditions.”
Kindred Healthcare680 South Fourth StreetLouisville, KY 40202Phone: 502.596.7300Toll Free: 1.800.545.0749
Copyright © 2014 Kindred Healthcare, Inc., EOE