Location, Location, Location May Impact Hospital Readmission Rates

The socio-economic status of patients in a given community may explain some of the variation in hospital 30-day readmission rates. Read More

At the Hospital, Better Responses to Those Beeping Alarms

In hospitals, alarms on patient-monitoring devices create a cacophony of noise day and night-beeping, pinging and ringing so often that doctors and nurses ignore them, turn them off or just stop hearing them. Read More

It's the time of snow and ice, trees and tinsel, naughty and nice. Yes, the holiday season has arrived, and with it, a unique set of accidents and hospital visits. The most recent revision of the International Statistical Classification of Diseases and Related Health Problems (ICD) was recently released by the World Health Organization (WHO). 

The updated lists holds more than 14,000 codes, 16,000 with optional sub-classifications, of diseases, symptoms, complaints and external causes of injury or disease. But we have narrowed this down to the top ten potential codes that our clinicians may need to know during the holiday and winter months.

Matt Maloney was shoveling snow when he started experiencing chest pains. With a family history of coronary artery disease, his primary care physician sent him in for a stress test. Matt was diagnosed with sudden Myocardial Infarction and was rushed into surgery for emergency coronary bypass grafting. During that procedure, he developed pulmonary edema, an excess of fluid in the lungs.

Matt had developed acute respiratory distress syndrome, and now required prolonged mechanical ventilation and a tracheostomy. When he left the ICU, he was transferred to Kindred Hospital Heritage Valley where he could be successfully weaned from the ventilator while also monitoring his kidney dialysis.    

After Ashley came home from her freshman year in college, she made a trip to the doctor. A high cortisol level led to more testing, which led to the discovery of a tumor on her pituitary gland. This was found to be the cause of her high cortisol levels, and she was officially diagnosed with Cushing’s disease. Ashley soon went in for surgery to remove the tumor, which was successful, but with a cost. 

During the surgery, a blood clot formed that eventually made its way to her lungs. She developed respiratory failure, sepsis, and pneumonia along with ARDS, a severe inflammation of the lungs, according to Sarmad Ashfaq, MD, of Kindred Hospital Heritage Valley, where Ashley was transferred to after surgery for long-term acute care.

Josephine is originally from the East Coast. She and her husband moved to California where they raised their son, who gave them two grandchildren to share their love. Josephine was a very successful registered nurse and became the director over a large nursing agency covering Los Angeles and Orange County. 

Prior to being admitted to Kindred Hospital Brea, Josephine lived in an assisted living facility with her husband.  Sadly, her husband passed but Josephine still lovingly refers to him as being her “biggest supporter”. 

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.  

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.

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.

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

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.