Community Pulmonary Program
In 2006, a group of physicians, mid level providers, nurses, case managers, respiratory therapists and rehabilitation therapists began looking at ways to improve the care provided to patients in our community, living with Chronic Obstructive Pulmonary Disease (COPD). In 2006, COPD was the 4th leading cause of death, had a very high potential for patients to be frequently admitted to the hospital, and cost the U.S. healthcare system nearly $22 billion. By 2010, COPD had risen to the 3rd leading cause of death, surpassing stroke, and costing in excess of $50 billion. (NIH Morbidity and Mortality: 2010 Chartbook on Cardiovascular, Lung and Blood Diseases).
In 2006, staff at Hutchinson Hospital, recognized that the care provided to this group of patients was episodic, lacked standardized protocols and patients had long stays in intensive care and on general units. Patients were cared for in a variety of settings. The group working to make improvements realized that a global approach to care was needed; one that focused on high quality care, was patient-centered, and cost effective.
The group began developing evidence-based treatment protocols for use with all patients; and a plan began for a dedicated pulmonary unit with staff who would receive specialized education in the disease process. A dedicated pulmonary nurse case manager began following the first group of 21 patients in their homes. During the first winter, 3-4 admissions per week were prevented. In March of 2007, the dedicated pulmonary unit was opened. This allowed most patients to be admitted directly to this unit, bypassing a stay in intensive care. Patients received specialized care and the length of hospital stays was reduced.
The pulmonary case manager moved from the hospital to Hospice and HomeCare of Reno County. Licensed through that agency to work in patient’s homes, she could make direct contact with physicians to discuss the patient’s condition and make changes as needed in the patient’s care. Many times, patients were able to stay at home, rather than be hospitalized as they had been in the past.
Health Equip, the medical equipment company in the healthcare system, began using a new home ventilator, called the Trilogy. By utilizing this equipment, patients were able to maintain independence longer than ever before, with dramatic improvements in their quality of life.
Below is data reflecting the experience 6 months prior to the beginning of this program and 6 months following implementation:
- Pre-Program
- Admissions: 137
- Length of Stay: 8.82
- ED visits: 14
- Ambulance calls 51
- Post-Program
- Admissions: 21
- Length of stay: 6.05
- ED visits: 4
- Ambulance calls: 8
Today, at Hutchinson Regional Medical Center, this program continues in full force, with amazing outcomes for patients and their families. The nurse case manager works with patients, families, and the medical providers, keeping patients in their homes longer than ever before, reducing readmissions to the hospital and improving independence and quality of life. In recent years, we have also worked to provide care to patients needing to transition to nursing home care or to hospice, by partnering with various facilities and agencies in the community.
Physician and mid level care providers in our community are also impacted by this innovative program:
- The program slows down the revolving door by keeping patients out of the hospital. This program is a great interface between providers and patients”. –S. Ronsick, M.D.
- “This multidisciplinary program allows us to guide our patients to the best care available to them”. –R. Sourk, M.D.
- “I can see a world of difference in the quality of care and quality of life that our patients experience”. –J. Rodgers, APRN
Quality Measures
The Centers for Medicare and Medicaid Services (CMS) developed an Inpatient Quality Reporting (IQR) program as a result of legislation in 2003.
Through the IQR Program, hospitals submit data using standardized measures of care. For example, best medical practice recommends that patients experiencing a heart attack should receive an aspirin within 24 hours of the time they arrive at the hospital. Data is collected on how many times this happens with all heart attack patients.
This kind of data is collected on many different diagnoses and kinds of treatment. The intent of this program is to help you, as a consumer, make the most informed decisions possible about the options you have for healthcare.
It is also intended to encourage hospitals and clinicians to improve the quality of patient care.
Hospitals maintain their own data for the IQR program, and consumers can access the data on the Hospital Compare website. Links for both of these kinds of reports are provided on this page.
Hutchinson Regional Medical Center Quality Measures
CMS Hospital Compare Website