Jeanine Hess is an 86 year old woman who was referred by her Primary Care Physician to Gentiva Home Health due to generalized decline in lower extremity strength and functional mobility. She was evaluated by physical therapy and was placed in our 'Safe Strides' balance program.

 

She was also evaluated by occupational therapy. During the evaluation, Jeanine disclosed that she missed her dog terribly.  Her family had taken the dog out of her apartment as they felt that Jeanine was at a risk of falling.  Each morning Jeanine would take her dog outside to do it's 'business' and was often rushing to accomplish this task.  

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Pete Gregg woke up to his wife, Johna Gregg, 23, screaming. Once he turned on the light, it became apparent she was having a grand mal seizure. The first hospital the Greggs visited claimed Johna was having an anxiety attack due to a mental breakdown and transferred Johna to a mental hospital. Upon arrival at the mental facility, the medical professionals realized there was indeed more to her story, and Johna was once again transferred - this time 80 miles away from home.

Johna's health had deteriorated, and by the time she arrived at Ruby Memorial she was in a coma. After another treacherous grand mal seizure, she coded and was intubated. When Johna was diagnosed with Anti-NMDA receptor encephalitis, Pete became worried he may lose her and was saddened by the moments his wife was missing at home, like their son's first steps. Johna woke up from her coma after two months and was transferred to Kindred Hospital Pittsburgh, 150 miles away from home, to continue her recovery.

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As part of an ongoing effort to provide input to the Centers for Medicare & Medicaid Services (CMS) and its contractors and help shape value-based care, Dr. Marc Rothman, MD, Kindred's Chief Medical Officer recently commented on efforts to develop potentially preventable readmission measures for all post-acute providers. As a provider of health care services and supports across the entire post-acute continuum, Kindred has a unique perspective about the value of each setting, actual success in reducing re-hospitalizations across all post-acute settings, and certain pitfalls to avoid in quality measure creation.

Within its comments, Kindred pointed out that it supports the development of measures to promote the delivery of high quality care to patients, and appreciates the opportunity to comment on measures that are a proxy for quality in health care delivery.  This is consistent with Kindred's endorsement of the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014 , which set the foundation for the establishment of cross-setting quality measures and served as an important foundation to pursuing step-wise reforms necessary for value-based post-acute care reforms.

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The seventh annual Kindred Clinical Impact Symposium has officially come to a close. Luckily, we live-blogged the whole event, so you can always find that content right here on the Kindred Continuum. Here's a look at each of the speakers, panels and breakout sessions in order:

Clinical Impact Symposium 2015 Pre-Conference

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Tori Murden McClure does everything backwards. As a rower, it just comes naturally. She went to divinity school and then to law school, while most people might presume you need divinity school AFTER law instead of before. At Kindred Healthcare's 2015 Clinical Impact Symposium, she began explaining her incredible life story by reading the last page of her book first.

Now the president of Spalding University, McClure has too many accolades to count. She holds a Master's in Divinity from Harvard Divinity School, a Juris Doctorate from the University Of Louisville - Brandeis School Of Law and a Master's of Fine Arts in writing from Spalding University. Previously, she has worked as a hospital chaplain, a mayoral policy assistant and a director of a shelter for homeless women.

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At the 2015 Clinical Impact Symposium, many case studies were examined through poster presentations. Lisa Orsino is a registered nurse at Kindred Hospital Sahara in Las Vegas. Her case study on a traumatic brain injury patient stood out to us because of the joined efforts of so many different levels of care.

John, a 33 year-old gentleman, was injured in a motor vehicle accident that left him with severe brain injuries and multiple fractures and wounds. Upon arrival at Kindred, John was not responsive and was both physically and chemically restrained. However, within only a month, his care was progressing so well that he was able to be de-cannulated. 

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While there can be a divide between what matters to the average American and what matters to politicians, in recent years, healthcare has been on the minds of both. Ray Sierpina, Senior Vice President, Public Policy and Government Affairs for Kindred Healthcare, said the 2016 presidential race will continue the ongoing discussion about healthcare and healthcare reform. He added, though, that although 10,000 Baby boomers qualify for Medicare every day, candidates have yet to have a meaningful conversation about the future healthcare needs of this constituency.

Sierpina also noted the 2016 field is one of the most diverse - racially, culturally, geographically and economically - for both the Democrats and Republicans. He cited self-described democratic-socialist Bernie Sanders and real estate developer/reality TV star Donald Trump as noted examples from both sides. 

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Two years ago, after the close of the 2013 Clinical Impact Symposium, the clinicians from Kindred's Dallas/Fort Worth Integrated Care Market returned home with the intent to delve further into deep training on cognitive care. They pulled together clinicians from all over their market and decided where to start - developing a training program that was workable within the hospital environment.

 

The team, headed by Jane Dailey, Vice President of Clinical Operations for the hospital division in the east and southeast regions, piloted the program and studied the results. Initially, the plan was to integrate the program into the hospital division's new cognitive care training program before it was spread out into the other fields. 

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Imagine a world where a patient is able to access pre acute care rather than just post acute care; a world where there is a more central role for post acute care. At the end of the 2015 Clinical Impact Symposium's second full day, the clinicians were treated to a dinner where William Altman, Executive Vice President for Strategy, Policy and Integrated Care provided insights into Kindred's current position in the world, as well as where we are headed.

Altman spoke to how we, as a company, are figuring out how to reposition ourselves in this new world, where healthcare is patient-centric.

"I don't know what is going to happen," Altman said. "But I do know that our country has reached a tipping point when it comes to integrated care."

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The assignment in the medical management breakout session Wednesday seemed straightforward: Review information on a patient's medications, create a Medication Action Plan to identify any potential issues and place the patient's daily medications in a pill organizer divided into days of the week. 

No problem for an audience filled with nurses, physicians, pharmacists and other clinicians, right?

The reality was somewhat different, but the big payoff was in a deeper understanding (and appreciation) of the medication management challenges faced every day by healthcare providers across the Kindred continuum and the opportunity to brainstorm on how to better address those challenges. 

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