Healthcare Headlines Blog

What are care management’s best practices at this early stage in its existence? This question was answered by William Mills, MD, Chief Medical Officer for Kindred at Home and Vice President of Medical Affairs for Kindred’s new Division of Care Management, during a break-out session at Kindred’s Fifth Annual Clinical Impact Symposium.

There’s no doubt that readmissions to acute care hospitals are costing the healthcare system a lot of money, and the patients who cost the system the most might fit a profile like this:

Patients like this typically see anywhere from two to ten doctors regularly. They have no home support, so when a crisis arises, 911 is called and the patient is taken to the emergency room, which leads to a hospital stay eight out of ten times, Dr. Mills said. Rehabilitation and a long-term care stay follow, then home care and then the cycle recurs.

For patients like this, wouldn’t it make more sense to deliver care in the home setting?

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Stacey Seggelke, sees patients with diabetes both in and out of the hospital, and shared her experiences at the Kindred Clinical Impact Symposium. She is a member of the inpatient Glucose Management team at the University of Colorado Hospital and has an outpatient diabetes clinic one day per week.

There has been a steady and significant increase in diabetes over the last 30 years. It affects 8 percent of the population, and it is estimated that there are 79 million people who are pre-diabetic. Even when it is not the primary diagnosis, diabetes impacts the care provided to the person, and Seggelke works with her patients from admission to discharge to make sure that the treatments for other medical issues don’t harm the patient or cause problems related to their diabetes.

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Did you know that a pharmacist invented Coca Cola? This was just one interesting fact divulged by Kindred Hospital Division Vice President of Pharmacy James Poullard, who presented this afternoon at Kindred’s Fifth Annual Clinical Impact Symposium.

For Coke lovers, this fact makes pharmacists critical. But more importantly, pharmacists play a crucial role in effective care transitions.

Pharmacy – the science and technique of preparing and dispensing drugs and medicines – has undergone a transformation over the years, according to Poullard.

“We’ve gone from pouring sodas and mixing elixirs to now being the medication expert in retail outlets, and in the inpatient arena,” he said. “There are now post-graduate residency programs and we’ve become an integral part of the patient care team.”

And pharmacists have their work cut out for them.

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As we learn more about the pathophysiology of diabetes mellitus, we find that there is more yet to be discovered. Diabetes mellitus is a syndrome with disordered metabolism and inappropriate hyperglycemia due to either a deficiency of insulin secretion or to a combination of insulin resistance and inadequate insulin secretion to compensate. Type 1 diabetes is due to pancreatic islet B cell destruction predominantly by an autoimmune process, and these persons are prone to ketoacidosis. While type 2 diabetes is the more prevalent form and results from insulin resistance with a defect in compensatory insulin secretion. Diabetes can lead to serious complications, resulting in multiple diseases or disorders that affect multiple systems that may result in premature death.

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The Elder Justice Act is designed to provide federal resources to prevent, detect, treat, understand, intervene in and, where appropriate, prosecute elder abuse, neglect and exploitation. The Elder Justice Act is a comprehensive elder abuse prevention law which was enacted as part of the Patient Protection and Affordable Care Act on March 23, 2010. Before The Elder Justice Act was enacted, federal funding for programs and justice regulations was not available. Now, education, awareness programs, training and other services are available to millions of seniors across the U.S.

 

Elder abuse refers to the actions or lack of actions that harm an older adult or place them at risk of harm or within harm’s way. The harm may be physical, mental, emotional and/or financial. True prevalence is unknown primarily due to lack of consensus regarding definition. Clinicians caring for older adults are integral and crucial to the prevention, intervention and treatment of elder abuse.

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Ever wonder what Kindred is doing to take a lead in confronting issues that affect hospitals all over the country, such as alarm fatigue, which happens when too many beeps and buzzes become like background noise to caregivers? The Hospital Division’s Respiratory Care Council is addressing this healthcare challenge as well as others like it. Meeting every other month, the Council’s 21 members – representing each of the regions in which Kindred delivers care, as well as the Support Center in Louisville – strive to identify and share best practices and standardize systems and procedures across the division. They are also working with colleagues from Kindred’s other divisions to achieve enterprise-wide standardization when appropriate.

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October 20-26 is Infection Prevention Week. The goal of the event is to raise awareness of the role infection prevention plays to improve patient safety. Kindred's Hospital Division has numerous Infection Prevention Initiatives in place to prevent the spread of infection and protect the health of patients.

The best way to prevent the spread of germs is for healthcare workers to wash their hands frequently, to properly disinfect hospital surfaces and to take other precautions, such as wearing gowns and gloves when working with people infected with resistant bacteria. Patients, family members and visitors also play a role in infection prevention and can help by properly washing their hands and wearing protective coverings as needed.

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I once heard a quote from Confucius, and it has stuck with me throughout my career as a case manager at Kindred: “The will to win, the desire to succeed, the urge to reach your full potential…these are the keys that will unlock the door to personal excellence.” I tweaked it a little, as people sometimes do, so it really applied to my own life; that desire to succeed is not only for me personally, but also on behalf of the patients I work with each day.

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When someone suffers a traumatic brain trauma — whether it’s from an automobile accident, severe stroke or other injury — he or she is initially admitted to an Intensive Care Unit. After patients are medically stable, it may be necessary to transfer them to a long-term acute care or transitional care facility before an acute rehabilitation or subacute rehabilitation facility.

According to Terry Eberly, a speech pathologist at Kindred Hospital Denver, two assessment methods are used to determine the extent of the injury and issues that need to be addressed:

Based on the results of the evaluation, a plan is customized to the needs of the individual, encompassing and integrating therapies to treat respiratory, speech, motor, visual, orthopedic and other identified issues.

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Kindred’s Transitional Care Hospitals play a vital role in the recovery process for the sickest and most medically complex patients who require aggressive medical care and rehabilitation over a longer period of time. For patients who have complex ventilator needs, multi-organ system failure or complicated medical problems that are very difficult to treat, transitional care hospitals may represent the first important step necessary to make recovery and return home possible.

These hospitals are licensed as general acute hospitals, often featuring such familiar elements as Intensive Care Units (ICUs), operating rooms and on-site laboratory and radiology services, but they also are distinguished by an additional Medicare certification that recognizes the need for extended recovery periods.

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