Identifying preventable readmissions is a major focus of K-HEN
and also of the current status of transitions of care.
sure patients have had their prescriptions filled, asking if they’ve
seen their doctor again, are they feeling better, etc.
“You have some patients who fall through the cracks, an at-risk
population who, on top of everything else, may not be able to make
it to their doctors’ appointments,” said Ms. Meador, pointing out that
Baptist Health in LaGrange, Ky., and Baptist Health in Louisville are
both operating transitional clinics. Patients come one day per week
for four weeks and meet with pharmacists, dieticians and more to
go over everything they’ll need to better take care of themselves.
K-HEN works with more than 75 hospitals across Kentucky,
and Meador said that collaboration will be the key to becoming
more efficient. “What practices out there are we not doing? What
resources can we take advantage of? In quality improvement work,
you’re doing little mini-tests of chance. You’re saying, ‘Let’s try this
and see if it works.’ You’re testing the waters.”
Meador says it is important that hospitals share information with
each other. This openness can make a tremendous difference on the
quality of the work being done. “Hospitals haven’t always been open
with each other. There’s a level of competition. But, when it comes
to patient care and quality, we shouldn’t be competing,” she said.
Another area which can make a difference, according to Ms.
Meador, is educating the patient as soon as they enter the process of
getting well. “I can remember the days when a patient is discharged
and you quickly run through their information. You ask if they
understand, and they nod their head. That’s not at all the best way
to do things. We’re now starting education shortly after admission.
Throughout the patients’ stay, they’re provided with information,
and being asked if they understand.” Meador says hospitals are also
working harder to follow up discharges with phone calls, making
While the end result of near-perfect transitions of care may still
be far away, the growing number of doctors, nurses and administrators who realize the importance of the practice is a reassuring
sign of things to come.
“The hope is to have 100 percent complete transfers where you’re
doing everything correctly in a reproducible way for every patient,”
said Dr. Alagia. “It largely comes down to the people sending and
receiving these transfers of care. They have to understand that this
is just as important as getting the blood pressure right, as getting
the pulse right, as getting the person’s temperature right. Now it’s
just a matter of focusing our lens on that particular area so we all
get it right.” LM
Note: Aaron Burch is the communications specialist for the Greater
Louisville Medical Society.
August 2014
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