"We've talked about pain, pain management and how pain is treated. Now we turn toward our relationships and interactions with patients," said Dr. Marc Rothman, Kindred's Chief Medical Officer, in his introduction to the next presentation during the 2016 Clinical Impact Symposium.

Rothman then introduced Dr. VJ (Vicente) Velez - MD, FACP, FHM, Internal Medicine Hospitalist at the Cleveland Clinic and Institute Experience Officer for the Department of Medicine Institute.

Dr. Ed Covington is the former director of the Cleveland Clinic Chronic Pain Rehabilitation Program and his career has largely centered on understanding and treating pain. He is quick to note that there is no "one right way" to treat pain, but emphasizes that "success comes only from addressing the whole person."

At the beginning of his presentation, he asked one question: "Why talk about pain?" It turns out the simple answer is because it needs to be talked about. We don't know enough and some of what we believe, or have been taught, is simply wrong. 

The University of Kentucky's College of Health Sciences presented this morning to kick off day two of Kindred's Clinical Impact Symposium. "How do we keep patients progressing at the expected rate, and what gets in the way of that?" asked Art Nitz, PhD, PT, ECS, OCS. How do we keep pain from getting in the way of that?

Pain, and sometimes our very best efforts, have unintended consequences. We have a shared responsibility to develop approaches that are more efficient, more accessible, more effective and do no harm. He began by discussing how the understanding and articulation of pain also has changed over time.

It's often been said that no one can or could give a facility tour like Paul Diaz. Paul was CEO of Kindred Healthcare for 10 years and is now a board member. Paul made a great impact on families and employees alike, which is why every year Kindred honors outstanding employees for going above and beyond with this special award in his name.

This year, there were 110 nominations from all Kindred divisions across the country. It's a long and challenging task to go through 110 applications, but at today's Clinical Impact Symposium, that list was narrowed down to two individuals. 

Speaker Dr. Ronald Crossno, Chief Medical Officer of Kindred at Home, opened his presentation with a poll asking the audience several questions, including how many of them are dealing with chronic pain. The answer was 30%, which is very similar to the percentage of people in the general population who are affected.

He then asked how many people in the audience know someone who has an opioid misuse disorder. The number went up to 75%. These responses reflect what Dr. Crossno calls “the crises of pain management.” Specifically, that we do not manage pain well--whether it’s acute or chronic—and that with opioid prescriptions nearly tripling between 1999 and 2011, we are facing an epidemic of opioid misuse.

Presentation by Scott Strassels, PharmD, PhD. A clinical pharmacist with Optum Hospice Pharmacy Services, a partner of Kindred  

Medications, while prescribed to promote healing and symptom relief, often have unintended effects that can hinder care goals. All clinicians must be able to recognize medication-related problems and reach out to pharmacists as necessary.

In Scott's presentation, he sought to help the audience understand the roles of pharmacists in pain and palliative practice and understand how analgesics are chosen based on type and severity of pain.

Kindred Healthcare's 2016 Annual Clinical Impact Symposium kicked off on Tuesday, November 8. And in true Kentucky fashion, Steve Buttleman, the official bugler of Churchill Downs, played "My Old Kentucky Home" and the "call to the post" that is most often associated with the Kentucky Derby.

Afterward, Buttleman added, "Use this call-to-the-post to get out of the gates when you get back home like they do at the Derby. How you start the race is often a determination of the final results." 

Kent Wallace, Chief Operating Officer, took the stage to speak about the current state of Kindred. He opened with a slide that answers the question "Who is Kindred" with one sentence:

Kindred is 102,200 dedicated teammates taking care of approximately 1,040,000 patients and residents in more than 2700 locations in 46 states.

In many ways, the number of people Kindred employees care for is the most important number of all, and Wallace paid tribute to all Kindred employees who provide care and touch so many lives every day.

With fall upon us and Halloween fast approaching, we need to be aware of the potential for a number of unique accidents that can require a quick trip to the ER. Yes, it's that time of year when all of the spooks and spirits come out to play. And sometimes they get hurt.

Luckily, in 2015, the most recent revision of the International Statistical Classification of Diseases and Related Health Problems (ICD) was released by the World Health Organization (WHO). The updated lists holds more than 14,000 codes, and 16,000 with optional sub-classifications of diseases, symptoms, complaints and external causes of injury or disease.

We have narrowed this down to the top eight potential codes that our clinicians may need to know during the month of October, particularly on the 31st.

For physicians practicing or anticipating involvement as hospice medical directors, the Hospice Medical Director Manual (HMDM) is the go-to reference. Recently the third edition was released. Not only does it have twice the content of the previous edition, it also has a Kindred touch.

Two Kindred at Home physician leaders contributed to the new edition: Lyla Correoso-Thomas, MD, Kindred at Home Southeast Region National Medical Director is co-editor, and John Manfredonia, DO, Kindred at Home West Region National Medical Director, is also a contributor.