Great isn’t Good Enough

Evansville’s award-winning hospitals offer top-notch patient care
Janet Raisor of St. Mary’s Health System, instructs Sheila Santacana, a senior nursing student at USI.

Evansville already has nationally ranked hospitals: Deaconess has earned a Solucient 100 Top Hospitals award for cardiac and orthopedic services and a US News and World Report Best Hospitals ranking for hormonal disease services, while St. Mary’s has achieved ranking for fastest heart attack care and a Magnet designation for nursing, which only 6.74 percent of registered hospitals nationwide have achieved. More importantly, neither hospital is completely satisfied and both are planning to offer updates that address technology, patient rooms, obesity, and readmission rates.

St. Mary’s is scheduled to complete their emergency department (ED) expansion project later this year. The project adds 16 beds and a CT scan to the emergency room (ER). While the main focus of the project is the ER, it also will affect general patients, providing more private rooms and space for treatment, according to St. Mary’s Media Relations Coordinator Laura Forbes. A major service target for 2012 is to reduce readmission rates. Janet Raisor, executive director of case management, community outreach, and rehabilitation, says this is a goal for many hospitals nationally. Minimizing the need to return to the hospital is not only better for the patients’ health; it also reduces health care costs. Raisor says Medicare spends approximately $17 billion annually on readmissions (one out of every five Medicare patients is readmitted within 30 days of discharge), and beginning this year, hospitals will be issued financial penalties for readmissions.

St. Mary’s is urging its doctors and nurses to take basic steps to avoid readmission, such as early discharge planning and understanding patient barriers to home recovery (mobility, finances, and cognition). These actions help prevent common mistakes that could lead to relapse — taking medications incorrectly, failing to follow up with a primary care physician, not knowing symptoms that might indicate a need to return to the doctor.

In this effort, St. Mary’s is encouraging their doctors and nurses to use the “teach-back” methodology, where the caregiver who explains the discharge program to the patient asks the patient to explain it back to them, to avoid misunderstanding and to internalize the information. The teach-back method also addresses any recovery issues the patient might face at home. It’s a time for the patient to ask questions, and for the health professional and the patient to have a discussion. The goal is eventually for all St. Mary’s doctors and nurses to use the program.

As another part of the readmission-reduction initiative, St. Mary’s began a courtesy prescription delivery service during summer 2011, which brings a patient’s first set of prescriptions to his or her bedside to assist with the transition from the hospital. Geriatric and family practitioners, David and Evelyn Bose have recently committed themselves exclusively to their post-acute care model, in which all of their approximately 500 patients are nursing home residents. The couple essentially are traveling doctors with no in-office practice.


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