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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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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Kindred offers all levels of post-acute care, and in our Integrated Care Markets, where we offer all levels of care in one geographic area, we can help patients transition through the full continuum of Kindred care, from the long-term acute care hospital all the way to home. With that ability to transition patients through many levels of care comes the opportunity and challenge of ensuring that those transitions are done well.

Approximately 60 percent of medication errors occur during transitions of care. In addition, 50 percent of all hospital-related medication errors are linked to poor communication at transitions of care and data shows that patients tend to miss one to two doses of their medication during transitions. These were some of the takeaway messages from a presentation titled "Medication Management and Polypharmacy across the Continuum," delivered by Justin Kullgren, PharmD,  CPE, South College School of Pharmacy, at this year's Clinical Impact Symposium. 

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In the last presentation of the 2013 Kindred Clinical Impact Symposium, Ronald Leopold, MD, MBA, MPH, Senior Vice President, National Practice Leader, Health and Productivity for Wells Fargo Insurance Services, talked about the business value of a healthy workforce.

People are remaining in the workforce longer than ever before, and perhaps longer than they had planned, Leopold said.

“Your ability to earn a living is your biggest financial asset,” he said.

And companies, in turn, are well-served to encourage a healthy workforce.

“It’s in [companies’] best interest to get their workforces healthier and more importantly, it’s in your own best interest,” Leopold said.

How can individuals do that? First, they can pick realistic goals and stick with them. Have a healthy lifestyle – move around, eat well, consider behavior changes – what are you doing that you shouldn’t be doing and vice versa?

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Last month I spent an evening with a dedicated group of physicians at Kindred Transitional Care and Rehabilitation Milwaukee, one of the largest skilled nursing facilities (SNFs) in the country. During his introductions, Executive Director Michael Thomas spoke passionately about the importance of communication – between physicians; physicians and nurses; nurses and nursing assistants; staff and administration and, perhaps most importantly for healthcare reform, between the acute and post-acute care settings. I could not help but think about this year’s American Medical Directors Association (AMDA) Annual Meeting in Washington D.C.

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Representing the commitment to pursuing improved quality and the innovations that enable better patient care in our nation’s skilled nursing facilities, the Alliance for Quality Nursing Home Care (the Alliance) published its 2013 Quality Report on Skilled Nursing Facility Care. The stated goal of which “is to provide an objective national overview of Skilled Nursing Facility (SNF) patient care quality, pertinent quality trends, specific improvements, and areas of care requiring continued attention.” The report relies on publicly reported data as well as expert third-party experts to provide an effective assessment.

The release of the report is timely as legislators in Washington, DC, prepare to consider Medicare payment reforms for post-acute care – especially in light of the wide recognition that nursing facilities are a cost-effective and important element in the care continuum.

Some of the top line findings of this report include:

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On Tuesday I had the privilege of listening to a presentation by Dr. Bill Crounse, Microsoft’s Senior Director of Worldwide Health.A former family medicine doc with a background in broadcasting, Dr. Crounse started his talk by showing a cartoon depicting what people in 1925 predicted telemedicine would look like fifty years into the future. He then shared his own experience with his “Dr. Goodwell” program, which he used in the late 1990s to connect patients to their doctor via computer in order to discuss symptoms and begin the process of diagnosis and treatment. In sharing these blasts from the past, Dr. Crounse pointed out that while consumers and physicians were not ready in 1975 or even in the late ‘90s for new technology to play a real role in health care delivery, we are now living in a time that is ripe with opportunities for technology to greatly improve the way we do our work.

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“Do you have an advance directive?” This is one of the first questions a patient is asked when admitted to a Kindred facility. “The goal of an advance directive is to make sure that patients are making informed decisions and that we’re following their wishes,” says Kathee Paradowski, Clinical Informaticist Consultant in Kindred’s Hospital Division. All patients who do not have an advance directive are educated/counseled on the importance of creating one. They are also encouraged to designate a power of attorney for health care who can speak for them if they become so sick they are unable to speak for themselves.

Advance directives discussions, like the one pictured above, are vital to providing the proper care while keeping the patient's wishes a priority.

 

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ProTouch, Kindred’s proprietary electronic medical record (EMR) system, helps clinicians paperlessly access and manage important patient information including vital signs, medications, progress notes and lab and radiology results. ProTouch monitors in patient rooms are continually updated as needed, and interface with a patient’s ventilator in order to provide real-time respiration information. Recent enhancements to the system include documentation and display of multi drug-resistant organisms with flagged alerts, and improvements to the searchability of transcribed reports including display by date, report type, dictator and signature status.

The next big thing? ProTouch will soon be available as an app for the iPad, allowing our clinicians to access and update important patient information even more efficiently.

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“We’re a health care organization and this is a health care issue, so we believe we should support our staff by offering this service at no cost.” The free vaccinations are available from October 1 through March 31 each year.

According to Silliman, staff is the most likely source for bringing the flu virus from the community to the Kindred facilities. “Our patients are at high risk,” she says. “Many of them are immunosuppressed. Many have comorbidities. It’s easy for them to catch the flu. If a staff member’s child comes home with the flu and the staff member hasn’t been vaccinated, that staff member can catch it and spread those germs to our patients before they realize they are sick. Staff members who aren’t vaccinated can also catch the flu from patients or other non-vaccinated employees and take it home to their families. By getting as many people vaccinated as possible, we’re decreasing the risk of more people spreading the flu and getting sick.”

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