keeping patients with chronic conditions out of the hospital : perspectives from a hospital and a...

44
Keeping Patients with Chronic Conditions Out of the Hospital: Perspectives from a Hospital and a Public Health Agency Zosia Stanley, JD, MHA, Policy Analyst, WSHA Eileen Branscome, RN, COO, Mason General Hospital, Shelton Joan Brewster, MPA, Director, Grays Harbor County Public Health and Social Services Department

Upload: john-harper

Post on 23-Dec-2015

216 views

Category:

Documents


1 download

TRANSCRIPT

Page 1: Keeping Patients with Chronic Conditions Out of the Hospital : Perspectives from a Hospital and a Public Health Agency Zosia Stanley, JD, MHA, Policy Analyst,

Keeping Patients with Chronic Conditions Out of the Hospital:

Perspectives from a Hospital and a Public Health Agency

• Zosia Stanley, JD, MHA, Policy Analyst, WSHA• Eileen Branscome, RN, COO, Mason General Hospital, Shelton• Joan Brewster, MPA, Director, Grays Harbor County Public

Health and Social Services Department

Page 2: Keeping Patients with Chronic Conditions Out of the Hospital : Perspectives from a Hospital and a Public Health Agency Zosia Stanley, JD, MHA, Policy Analyst,

• Impact and cost of chronic disease• Zosia Stanley, JD, MHA, Policy Analyst, WSHA

• Hospital perspective• Eileen Branscome, RN, COO, Mason General Hospital, Shelton

• Public health perspective• Joan Brewster, MPA, Director, Grays Harbor County Public Health

and Social Services Department

Speakers

Page 3: Keeping Patients with Chronic Conditions Out of the Hospital : Perspectives from a Hospital and a Public Health Agency Zosia Stanley, JD, MHA, Policy Analyst,

• Chronic diseases – such as heart disease, stroke, cancer, and diabetes – are among the most prevalent, costly, and preventable of all health problems

• About half of all US adults—125 million people—have one or more chronic health conditions. One in four has two or more chronic health conditions.

• Seven of the top ten causes of death in 2010 were chronic diseases. • Two of these chronic diseases—heart disease and cancer—together accounted for nearly 48%

of all deaths.

• 84% of all health care spending in 2006 was for the 50% of the population who have one or more chronic medical conditions.

The impact and cost of chronic diseases

CDC, Chronic Disease Control and Prevention, May 2014; AHRQ, March 2014.

Page 4: Keeping Patients with Chronic Conditions Out of the Hospital : Perspectives from a Hospital and a Public Health Agency Zosia Stanley, JD, MHA, Policy Analyst,

Chronic diseases influence overall health

Page 5: Keeping Patients with Chronic Conditions Out of the Hospital : Perspectives from a Hospital and a Public Health Agency Zosia Stanley, JD, MHA, Policy Analyst,

Chronic disease at a county level

Washington Department of Health, Chronic Disease Profiles by County, 2014

• One in 8 adults have asthma.• One in 6 adults have diabetes.• One in 12 adults have heart disease

• One in 12 adults have asthma.• One in 11 adults have diabetes.• One in 11 adults have heart disease.

Page 6: Keeping Patients with Chronic Conditions Out of the Hospital : Perspectives from a Hospital and a Public Health Agency Zosia Stanley, JD, MHA, Policy Analyst,

Rising rates of chronic diseases

Page 7: Keeping Patients with Chronic Conditions Out of the Hospital : Perspectives from a Hospital and a Public Health Agency Zosia Stanley, JD, MHA, Policy Analyst,

Population Health PerspectivePreventionPartnershipsPreservation

Eileen T. Branscome, COO

Mason General Hospital and Family of Clinics

June 2014

Page 8: Keeping Patients with Chronic Conditions Out of the Hospital : Perspectives from a Hospital and a Public Health Agency Zosia Stanley, JD, MHA, Policy Analyst,

EQUITY

Prevention Management Promotion Medical Care

Page 9: Keeping Patients with Chronic Conditions Out of the Hospital : Perspectives from a Hospital and a Public Health Agency Zosia Stanley, JD, MHA, Policy Analyst,

Prevention & Promotion

SocialEconomic

Environment

LifestyleBehaviorsResilience

GeneticsPhysiological

Interventions

Page 10: Keeping Patients with Chronic Conditions Out of the Hospital : Perspectives from a Hospital and a Public Health Agency Zosia Stanley, JD, MHA, Policy Analyst,

Management & Medical Care

QualityHealth Status

Intermediate

Outcomes

Disease & Injury

Interventions

Health & Functionality

Well Being

Better Health

Progression & End of Life

Care Coordination

Care ManagementA Good Death

Page 11: Keeping Patients with Chronic Conditions Out of the Hospital : Perspectives from a Hospital and a Public Health Agency Zosia Stanley, JD, MHA, Policy Analyst,

Shared Responsibility

•Interventions & Outcomes▫Public health▫Health care delivery▫School systems▫Social services▫Employers▫Individual behaviors and choices

Page 12: Keeping Patients with Chronic Conditions Out of the Hospital : Perspectives from a Hospital and a Public Health Agency Zosia Stanley, JD, MHA, Policy Analyst,

Better Health

Better Care

Lower Cost

Page 13: Keeping Patients with Chronic Conditions Out of the Hospital : Perspectives from a Hospital and a Public Health Agency Zosia Stanley, JD, MHA, Policy Analyst,

Break the Vicious Cycle

Health deteriorates

Emergency Services

Acute Hospitalizati

onDischar

ge

Environment Social Economic

No Access

Provider Coverage Resources

Page 14: Keeping Patients with Chronic Conditions Out of the Hospital : Perspectives from a Hospital and a Public Health Agency Zosia Stanley, JD, MHA, Policy Analyst,

Prevention & Management Diabetes

Pre-Diabetes Clinic• Education

▫ Benefits of walking (30” five days/week)▫ How the body breaks down sugar▫ Reduces risk: T2DM,stroke, MI, stress▫ Lowers BP & HDL▫ Increases circulation, energy▫ Improves sleep

• Monitoring – A1C, health status, lifestyle, nutrition, activity

Diabetes Wellness Center• Living well with diabetes• Simple to complex care coordination• Education – Support – Monitoring – Interventions - Advocacy

Page 15: Keeping Patients with Chronic Conditions Out of the Hospital : Perspectives from a Hospital and a Public Health Agency Zosia Stanley, JD, MHA, Policy Analyst,

Employee

Wellness

Chronic

Disease

Managemen

t

Self care and

family health

Active

Lifestyl

e

Preventio

n/ Annual

check up

with PCP

Referred to

DWC

AIC (labs

) high

Child – N

ot Diabetic

Prevention

/ Annual

check up with

MVW

C

Information Sharing

Spouse - Diabetic

Patient’s Story

High Blood

Pressure

Diabetes Education Class

Hypertension Education

Stress Management

Pre-diabetic

Assessment

Active Lifestyle

Active Lifestyle

Nutrition/Diet

Changes

Nutrition/Diet

Changes

Page 16: Keeping Patients with Chronic Conditions Out of the Hospital : Perspectives from a Hospital and a Public Health Agency Zosia Stanley, JD, MHA, Policy Analyst,

Outcomes• Improved Health

▫A1C from 9 4▫BP 168/81 130/78

• Reduced Stress• Improved Well Being

• Small significant lifestyle changes• Move more, eat healthier

• Environmental change• Room to roam and play• A family affair

• Improved nutrition- weight loss [child & parent] Reduced rice and fast food intake Increased vegetable intake

Page 17: Keeping Patients with Chronic Conditions Out of the Hospital : Perspectives from a Hospital and a Public Health Agency Zosia Stanley, JD, MHA, Policy Analyst,

Complex Diabetic PatientMultiple Chronic Disease Processes

•Care Coordination▫Internal and external providers and teams▫Community resources▫Advocacy- needs not covered by health plan ▫MGHFC intervention-equipment & supplies

starting June 16, 2014

Page 18: Keeping Patients with Chronic Conditions Out of the Hospital : Perspectives from a Hospital and a Public Health Agency Zosia Stanley, JD, MHA, Policy Analyst,

2013 Admissions

Emergency OnlyER to ObsER to Obs to Inpt.ER to Inpt.Planned Admits

2014 Admissions through June 4, 2014

Emergency OnlyER to ObsER to Obs to Inpt.ER to Inpt.Planned Admit Obs

Page 19: Keeping Patients with Chronic Conditions Out of the Hospital : Perspectives from a Hospital and a Public Health Agency Zosia Stanley, JD, MHA, Policy Analyst,

Stroke Prevention – TIA Clinic• Access to services in our local community• Telemedicine & early interventions• Collaboration with tertiary stroke center• Care Coordination: Primary care and specialists• Personal connection & education

• Preliminary Outcomes▫Small lifestyle changes – diet, activity, smoking▫Positive personal experience-caring & concern▫Health Status – No progression to stroke in 12 of

13 individuals

Page 20: Keeping Patients with Chronic Conditions Out of the Hospital : Perspectives from a Hospital and a Public Health Agency Zosia Stanley, JD, MHA, Policy Analyst,

Chronic DiseasesCare Coordination & Care Transitions• Risk assessment • Coordination

▫ Follow up medical care and plan• Coaching

▫ Treatment plan, health status, medication management, support

• Care Transitions▫ Warm hand over

• Communication▫ Electronic health record

• Community resources • Coverage by health plan• After-hours access to clinics

Page 21: Keeping Patients with Chronic Conditions Out of the Hospital : Perspectives from a Hospital and a Public Health Agency Zosia Stanley, JD, MHA, Policy Analyst,

Oct Nov Dec Jan Feb0

2

4

6

8

10

12

14

16

18

Readmission Comparison

201220132014

Page 22: Keeping Patients with Chronic Conditions Out of the Hospital : Perspectives from a Hospital and a Public Health Agency Zosia Stanley, JD, MHA, Policy Analyst,

ED Care Coordination Project• ED, clinics, coordinators, providers, community• EDIE – emergency department information

exchange▫Care guidelines, pain management contracts▫ Intervention, narcotic and visit history▫Behavioral health connection▫Connection, communication, primary care follow up▫Education, information sharing▫Coordination with health plan and MGH

coordinators▫Re-direct to clinic after triage▫Community resource connections

Page 23: Keeping Patients with Chronic Conditions Out of the Hospital : Perspectives from a Hospital and a Public Health Agency Zosia Stanley, JD, MHA, Policy Analyst,

Mental Health• Tele-psychiatry pilot – non-urgent patients

▫Familiar private setting – primary provider team ▫Timely access▫ Integrated treatment plan ▫Combine with other resources [chemical

dependency, BHR (limited services), others]• Results so far

▫30 patients ▫4.1 overall satisfied (five point scale)▫Medication management▫Spread to other primary care locations

Page 24: Keeping Patients with Chronic Conditions Out of the Hospital : Perspectives from a Hospital and a Public Health Agency Zosia Stanley, JD, MHA, Policy Analyst,

MGHFC Approach• Align vision and priorities with Community Needs Assessment

▫ Access to Primary Care and coverage [Apple Health, QHP, Health Plans]▫ Communication [Electronic Health Record]▫ Connectivity [personal connection-caring, concern, compassion]▫ Relationships

• Patients First-Always▫ Caring for our community in our community

Coordination Specialist referrals Telemedicine Expanded hours and services

• Community Partners ▫ Mason Matters▫ Health Department▫ School System ▫ Sub-Acute settings▫ Local employers

Outcome: Community Health Ranking improved from 39th in 2005 to 35th in 2013

Page 25: Keeping Patients with Chronic Conditions Out of the Hospital : Perspectives from a Hospital and a Public Health Agency Zosia Stanley, JD, MHA, Policy Analyst,

Contact Information and References

Contact Information:Eileen T Branscome, COO

[email protected]

References:• Population Health in the Affordable Care Act Era, Michael A. Soto,

Ph.D., AcademyHealth, February 2013• IHI Innovations Series 2012• IHI Triple Aim, 2013• Center for Medicare and Medicaid Innovation• County Health Rankings• Beating Diabetes with Exercise, Catherine McHugh, ARNP

Page 26: Keeping Patients with Chronic Conditions Out of the Hospital : Perspectives from a Hospital and a Public Health Agency Zosia Stanley, JD, MHA, Policy Analyst,

Chronic Disease Self-Management

Strategies for Building a Community-wide Program

Joan Brewster, MPADirector, Grays Harbor County Public

Health and Social Services [email protected]

360-500-4062

Page 27: Keeping Patients with Chronic Conditions Out of the Hospital : Perspectives from a Hospital and a Public Health Agency Zosia Stanley, JD, MHA, Policy Analyst,

27

What is “CDSM”?

• Evidenced-based Course– Stanford Patient Education Research Center.

Kate Lorig, et. al.

• 6 weekly classes, 2.5 hours• Standard Curriculum

– “Lay Leaders”, Licensed

• General, Diabetes, or Pain

“The class was the best one I have been to…”

“Helps you to learn how to help yourself do better”

Page 28: Keeping Patients with Chronic Conditions Out of the Hospital : Perspectives from a Hospital and a Public Health Agency Zosia Stanley, JD, MHA, Policy Analyst,

28

Value For Hospitals

• Discharge planning• Care coordination• Reduce readmissions• Community Benefit• Reduce extra ER visits• Patient engagement • Provider support

Self- managing for

Better Health

Page 29: Keeping Patients with Chronic Conditions Out of the Hospital : Perspectives from a Hospital and a Public Health Agency Zosia Stanley, JD, MHA, Policy Analyst,

29

• A coalition of five community agencies

• A commitment to: – Coordinate Efforts – Share the Load – Sustain Over Time

• Mutual effort to seek a revenue source and sustain the program

Agency on Aging Health Department

Hospital Community Action Program

Community Health Clinic

About Our Program

Page 30: Keeping Patients with Chronic Conditions Out of the Hospital : Perspectives from a Hospital and a Public Health Agency Zosia Stanley, JD, MHA, Policy Analyst,

30

Our Motivation

If we bring this program to scale, can we change this picture?

• Worst health status statewide

• Hospitalization and death rates are high

• Huge and costly burden of chronic disease

Page 31: Keeping Patients with Chronic Conditions Out of the Hospital : Perspectives from a Hospital and a Public Health Agency Zosia Stanley, JD, MHA, Policy Analyst,

31

Our Aims

Create and sustain a community condition in which:1. CDSM Programs are

commonplace 2. Access is easy; no cost to

the participant3. Health providers routinely

refer participants

Page 32: Keeping Patients with Chronic Conditions Out of the Hospital : Perspectives from a Hospital and a Public Health Agency Zosia Stanley, JD, MHA, Policy Analyst,

32

Strategy 1: Get Organized

Creating a Coalition made this work more powerful than separate, disconnected efforts.

– Joint marketing, brochure, media, newsletters– One registration phone line – Coordinated training for Lay Leaders, Master Trainers and

special topic courses (diabetes, pain, Tomando.)

Page 33: Keeping Patients with Chronic Conditions Out of the Hospital : Perspectives from a Hospital and a Public Health Agency Zosia Stanley, JD, MHA, Policy Analyst,

33

Strategy 2: Year-Long Calendar • Advance commitment

means people can count on us.

• Primarily for providers, but worked great for all others.

• Each brochure has a long shelf life.

Posters and tear off cards also used. (Not prescription pads or stamps.)

Page 34: Keeping Patients with Chronic Conditions Out of the Hospital : Perspectives from a Hospital and a Public Health Agency Zosia Stanley, JD, MHA, Policy Analyst,

34

Strategy 3: Provider OutreachWe have used all of the following. CDC materials were very helpful, saved time.

– Blast fax– Brochures delivered in person– Request posters be placed in exam,

waiting rooms– Letter from Health Officer– Cards in MD boxes at hospital

Limited success: Necessary, but not sufficient

Best results: – Stand up meetings with MDs before

practice opens– Accompanying drug reps, taking lunch– Repeat, repeat, repeat…

Grays Harbor Community Hospital Staff are Leaders and Master Trainers

Page 35: Keeping Patients with Chronic Conditions Out of the Hospital : Perspectives from a Hospital and a Public Health Agency Zosia Stanley, JD, MHA, Policy Analyst,

35

Strategy 4: Participants as ‘Marketeers’

Direct Marketing to Providers – with a twist:• Participants inform their

providers, take materials, write and deliver letters

• Providers listen well to patients, peers

• Personal stories carry the most weight

“My personal physician…suggested I join the

workshop and I will be forever indebted to her for

doing so…”

Page 36: Keeping Patients with Chronic Conditions Out of the Hospital : Perspectives from a Hospital and a Public Health Agency Zosia Stanley, JD, MHA, Policy Analyst,

36

Strategy 5: Involve Health Plans

Invited Medicaid Health Plans to attend a Coalition Meeting

All 4 Plans gave a short summary of their services: Individual support. Disease management and case management, using telephone contact. No group contact. No local contact.

Health plan staff were unaware of the availability and efficacy of community based classes.

Page 37: Keeping Patients with Chronic Conditions Out of the Hospital : Perspectives from a Hospital and a Public Health Agency Zosia Stanley, JD, MHA, Policy Analyst,

37

Strategy 5 - Plans: It’s working…• Agreed with Plans that we could

maximize impact by:– Learning how to coordinate

individual case management with community offerings

– Having Plans influence providers through marketing, reporting requirements, data point feedback

• Future? Direct marketing to enrollees by Plans

• Funding from Plans? Reduces enrollee health care costs

“…to submit a written proposal along with an

invoice, to Coordinated Care for

sponsorship…”

May 14, 2014 email:

Page 38: Keeping Patients with Chronic Conditions Out of the Hospital : Perspectives from a Hospital and a Public Health Agency Zosia Stanley, JD, MHA, Policy Analyst,

38

Additional Strategies

• Purchased news ads• Free “Senior” columns• Radio shows • Senior meal sites• Civic group talks• Five agency leaders and

staff talking about CDSMP-- always have brochures in hand.

• Next: Faith communities, behavioral health centers

Page 39: Keeping Patients with Chronic Conditions Out of the Hospital : Perspectives from a Hospital and a Public Health Agency Zosia Stanley, JD, MHA, Policy Analyst,

39

Results Year Workshops Participants: 280

2011 5 75

2012 10 69

2013 8 95

2014 12 (41 by May)

Facilitators Trained :

41 (2011- present)

Year MD Referrals

# MDs

2012 5 3

2013 8 3

2014 14 5

Workshop Types:

Regular, Diabetes, Pain Management

Special classes for Behavioral Health clients

Page 40: Keeping Patients with Chronic Conditions Out of the Hospital : Perspectives from a Hospital and a Public Health Agency Zosia Stanley, JD, MHA, Policy Analyst,

40

Results – Typical Post Class Surveys

In general, how effective have you found this program in helping you manageyour chronic condition? Excellent 100%

I found the approach used to present “Living Well With Chronic Conditions” extremely effective and interesting.Strongly Agree 100%

I would recommend this program to others:YES 100%

Page 41: Keeping Patients with Chronic Conditions Out of the Hospital : Perspectives from a Hospital and a Public Health Agency Zosia Stanley, JD, MHA, Policy Analyst,

41

Typical Post Class Comments “I lost weight, have more energy”

“Helped me to manage & learn about my Diabetes”

“Very informative” “Excellent information”

“It is very beneficial and I learned a lot”

“Because it tells true feelings of what Diabetes is”

“Active, laugh, positive thinking, slow down, ways to be optimistic”

“Get more walking and completing more of my projects”

“Action plans and goal setting; weight loss”

“Better eating, better confidence, worthiness”

Page 42: Keeping Patients with Chronic Conditions Out of the Hospital : Perspectives from a Hospital and a Public Health Agency Zosia Stanley, JD, MHA, Policy Analyst,

42

Thank You For follow up: Joan Brewster

[email protected]

Page 43: Keeping Patients with Chronic Conditions Out of the Hospital : Perspectives from a Hospital and a Public Health Agency Zosia Stanley, JD, MHA, Policy Analyst,

Questions?

Page 44: Keeping Patients with Chronic Conditions Out of the Hospital : Perspectives from a Hospital and a Public Health Agency Zosia Stanley, JD, MHA, Policy Analyst,

Thank you!