•  Stacey Seggelke, MS, RN, CNS, CDE, BC-ADM Stacey Seggelke, MS, RN, CNS, CDE, BC-ADM

    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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  • Case Managers Will Be More Important Than Ever in the Changing Healthcare and Political Environment

    By Wendy De Vreugd, RN, BSN, PHN, FNP, CCDS, MBA

    Entitlement reform is a hot topic in this election season and no matter your political position or ideas about it, for post-acute providers this brings to light the issue of payment models and the question of how long the current volume-based payment system (the current revenue model) will continue.

    Entitlement reform may fail, in which case the existing fee-for-service systems will continue. It may be enacted, with implementation expected over the next decade, but with reforms for post-acute care beginning as early as five years post-enactment. Either way, payment pressures will continue; pay-for-performance and value-based purchasing models will likely be implemented; private payers will continue to move toward integrated care and integrated payment models; and single site providers will be at the greatest risk while non-institutional providers such as home care will be favored.

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  • Kindred Healthcare’s fourth annual Clinical Impact Symposium, “Care Transitions Across the Continuum,” will be held in Louisville from November 12-15.

    This year’s symposium will offer the latest evidence-based information from some of the most widely respected experts in the nation as well as interactive conference style offerings, hands-on skills demonstrations and trade show exhibits.

    The audience for the symposium is made up of caregivers from all four Kindred divisions – Hospital Division, Nursing Center Division, RehabCare and Homecare and Hospice. The goal is to enhance clinical practice in the post-acute continuum and maintain Kindred as a leader in clinical excellence.

    Speakers at the symposium will include:

    Come back to this blog throughout the conference as we will cover the conference live with interactive blog posts, pictures, and video.

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  • National Hospital Week, a celebration of hospital history, technology and staff, is May 6-12. So this seems like the perfect time to recognize some of the Kindred Healthcare Hospital Division’s recent successes.

    Honoring National Hospital Week by Noting Recent Successes Over the last several years, Kindred’s Hospital Division has been working diligently to reduce acute care hospital readmissions. “Once patients have been transferred to one of our facilities, it’s our goal to provide them with all of the diagnostic and therapeutic modalities that will take them through to the next level of care, which is hopefully home,” says Jeffrey Winter, President, Kindred Healthcare Hospital Division. “There’s always a risk involved with transitions of care, so the more we can provide for our patients without sending them back to an acute care hospital, the better.”

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  • Healthcare in 2012 and beyond has given all of us great challenges and opportunities to meet the needs of our population. Knowing that the fastest growing industry sector in the United States is healthcare at 2.3% per year (Bureau of Labor Statistics), we must continue to enhance our processes and outcomes. This growth can be further broken down into segments with home healthcare services forecasting a 3.9% yearly growth followed close behind by offices outside the traditional hospital setting at 3.0%, nursing and residential care at 1.9% and hospitals at a 1.1% yearly rate. Statistics from 2011 have shown us that 69% of the job growth in 2011 was in the ambulatory service area. According to Bloomberg News in February 2012, healthcare will add more than 5.6 million employees to be the biggest job gainer by 2020.

    Captured 2-23-12 from: http://www.census.gov/prod/cen2010/briefs/c2010br-09.pdf

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  • The 2011 Clinical Impact Symposium Cardio-Pulmonary Rehabilitation Across the Continuum, held December 6-8 in Louisville, Ky., offered some great information on providing patients the highest level of care.

    Cardio-Pulmonary Clinical Impact Symposium “The clinical guidelines for long-term care and rehabilitation have evolved gradually and changed considerably over the last several years,” he says. “Skilled nursing facilities have sometimes lagged behind. Dr. Pandya provided some easy-to-follow instructions and tools that will help those facilities to better manage their patients with diabetes.”

    Sean Muldoon, M.D., Chief Medical Officer and Senior Vice President, Hospital Division, Kindred Healthcare, says that the “hazards of immobility that lead to polymyoneuropathy” theme was a common one during several of the sessions. “This validates the Kindred model of integrated restorative services, which will lead staff to update these findings with renewed determination into hospital care models,” he says.


    Daniel Forman, MD, FACC, FAHADaniel Forman, MD, FACC, FAHA


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  • There has always been a struggle in the management of patients with diabetes. How do we reach A1c goals of less than 7% and at the same time avoid hypoglycemia? Are we allowing fear of hypoglycemia let us get too comfortable with hyperglycemia? Most protocols for managing high blood sugars require contacting prescribers when glucose levels exceed 300 or even 400mg/dl. Since symptomatic hyperglycemia starts at glucose levels of 180mg/dl, allowing blood sugars to elevate to such levels proves the point that we are too comfortable with hyperglycemia. On the other hand, no one would suggest a prescriber be contacted every time blood sugars are above 180mg/dl.

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  • Cardiodiabesity

    By Ryan Squire

    CardiodiabesityVisceral adipose tissue or VAT fat was the target of Sharon Himmelstein's opening remarks, and for good reason: VAT fat releases chemicals that enter the liver and lead to diabetes and cardiovascular disease. Himmelstein explained that the amount of VAT is an indicator for diabetes.

    The leading reasons for the spike in VAT in the world population is the change in eating habits over the last few decades. Convenience, advertising, erratic eating, and over eating have lead to VAT levels to shoot up.

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  • Diabetes: Risk for Cardio-Pulmonary Disease

    By Ryan Squire
    Naushira Pandya, MD, CMDNaushira Pandya, MD, CMD

    Dr. Pandya outlined identified the objectives of her talk to review the goals of glycemic control: One size does not fit all, review the current guidelines from several national organizations for cardiovascular risk, and review best practices for diabetes management.

    Diabetes is a head to toe disease: Retinal disease, stroke, nephropathy, neuropathy, large and small vessel disease of the extremities and  this emphasizes the range of diabetes impact.

    There are many potential barriers to improved management of diabetes: Institutional challenges, staff/practitioner resistance, and complexity of medication regimens and all may negatively impact diabetic control. Yet, there are several basic principles that apply to diabetes management, and must involve an inter professional clinical team:

    Maintaining functional status is the over arching goal of all interventions applicable to diabetes management.

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