For the eighth time, Kindred Healthcare has been named by Fortune as one of the World's Most Admired Healthcare Companies. Each year, Fortune partners with Korn Ferry Hay group, a global organizational advisory group.

 

Together they survey top industry minds and leaders, including executives, directors and securities analysts. These industry elites span 680 of the world's highest-revenue companies in 28 countries and across more than 51 industries. Additionally, each company's score must be in the top 50% of the industry survey in order to be listed.

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An intervention known as noninvasive ventilation is being increasingly studied and used in patients with chronic respiratory failure. An article in a recent issue of the journal Respiratory Care, which followed a national symposium dedicated to the care of the chronically critically ill patient, examined its use in several patient populations. Noninvasive ventilation, or NIV, does not require an artificial airway, in contrast to tracheostomy (surgical creation of an airway through the neck) or the placement of a breathing tube through the nose or mouth. NIV is achieved most often through the delivery of pressure and flow to the normal airway through the nose and/or mouth.

The benefits of NIV therapy include reduced re-hospitalizations of out-patients and a reduction in potential complications such as infection that can occur with invasive ventilation techniques.

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Chronically critically ill patients, a population whose needs and challenges were the sole subject of a recent issue of the journal Respiratory Care, have a very high mortality rate, and survivors among the group suffer with severe impairments and functional dependence. For the caregivers of these patients, the effect can be devastating. According to one article in the journal, “it is difficult to imagine a group of patients with greater need for high-quality palliative care.”

This article points out that early integration of palliative care for these patients can be highly beneficial, particularly in helping patients and families define goals for care and manage the emotional issues that arise when a patient is chronically critically ill.

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The publication of the June 2012 issue of the journal Respiratory Care followed a national symposium dedicated to the “chronically critically ill patient,” the patient with ongoing costly medical interventions, risk for medical complications and death, and the need for extensive post-acute care services.  One article and subsequent discussion was devoted to the topic of liberating patients on prolonged mechanical ventilation, or PMV patients, from their need for this ongoing treatment. PMV is defined, in this article, as mechanical ventilation needed for at least 21 days.

We know there are barriers to weaning patients from PMV, but it can be argued that we haven’t formally studied them enough to know how to overcome them. The barriers may include age, identifying windows of opportunity for weaning, a concurrent condition known as critical illness neuromyopathy (CINM) and cardiac issues.

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Many important questions were raised by information published in the June 2012 issue of the journal Respiratory Care. This issue followed a national symposium dedicated to the “chronically critically ill patient,” the patient with ongoing costly medical interventions, risk for medical complications and death, and the need for extensive post-acute care services.

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Once a year, DaVita Inc., a leading provider of kidney care who delivers dialysis services to patients with chronic kidney failure and end stage renal disease, recognizes one of its partners with its Hospital Partnership Award. Kindred Healthcare is the recipient for 2012; the award was given at DaVita’s Hospital National Meeting on July 25.

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Many of you are probably already aware that May is Better Hearing and Speech Month. Since one of the goals of Better Hearing and Speech Month is to raise awareness about communication impairments and the professionals who treat them, this seems like a good time to share some information about Kindred’s speech and language pathologists (SLPs), and what they do for our patients.

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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.

“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.

 

 

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Congestive heart failure is a very common reason for hospitalization, with over 1 million congestive heart failure (CHF) admissions per year; readmission rates are 30% at 30-60 days. Identifying methods to reduce the frequency of hospitalization and the associated costs are critically important.

Early exercise training may be useful in reducing morbidity and mortality in CHF. Aerobic and strength training are both key as muscle strength is a key predictor of long term survival, better than peak VO2.

The 6 min walk test is commonly used to measure functional capacity.  A result under 300 meters is associated with increased mortality.  The test is sensitive to changes in cardiac function, and a difference of 99 feet is considered the minimal improvement of clinical  importance according to Ethel Frese.

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