A new report from the Dartmouth Atlas Project shows that Iowa hospitals continue to set a national standard for providing high-value, patient-centered care. Focusing on chronically ill Medicare patients at the end of life, the report examines measures such as time spent in the hospital and in the intensive care unit (ICU), the number of physicians engaged, hospice enrollment and the likelihood of dying in the hospital.
In all of these measures, Iowa hospitals are among the best in the nation, reflecting a statewide culture that prioritizes providing appropriate care that aligns with each patient’s wishes. For example, within the study group, the rate of deaths occurring in the hospital averaged 25 percent across the U.S. compared to only 18.5 percent in Iowa (fourth lowest in the nation). Similarly, nearly 17 percent of these deaths nationally were associated with an ICU admission, while in Iowa this occurred less than 11 percent of the time (fifth lowest in the nation).
The report’s authors noted that between 2007 and 2010, which is the latest data available, the nation has improved overall on these measures. “The growing use of hospice care and decrease of hospital use at the end of life are promising trends that may reflect attempts to provide care that aligns more closely with patients’ preferences,” said David Goodman, M.D., one of the principal investigators for the project.
However, the study also notes that Medicare spending for chronically ill patients in the last two years of life increased about 15 percent between 2007 ($60,694) and 2010 ($69,947). Iowa remains one of the lowest-spending states at $53,081, which is 27 percent less than the national average and 47 percent less than what is spent on average in California ($86,605), the highest amount in the nation.
Regional and hospital-specific data associated with the new report are available at the Dartmouth Atlas Project website.
Pella Regional Health Center can add “get me to the church on time” to its list of medical services. At least that’s the experience for recent groom Nathen Deppe of Kellogg, who married Pella native Jenna DeJong in November.
Deppe experienced stomach pain on Friday during rehearsal but believed it was just nerves. The pain became progressively worse during the night and at 4 a.m., about 12 hours before the ceremony, he drove himself to Pella Regional’s emergency room. A short time later, Dr. Matt Doty announced an unexpected wedding gift: acute appendicitis.
When Deppe explained that it was his wedding day, Dr. Doty set plans in motion to assure the best medical care and to meet the groom’s desire to walk down the aisle that afternoon. Dr. Doty contacted surgeon Timothy Breon in Oskaloosa, who performed the emergency appendectomy at 9 a.m.
“Everyone worked together to help this patient get to his wedding,” said Dr. Breon. “Fortunately, everything fell into place, and it was special to know that we could help him.”
Following surgery and recovery, Drs. Breon and Doty assured Deppe and his family that they would do all they could medically for his timely discharge, providing he made continued improvement. As the bride and wedding party readied for the ceremony, Deppe received expert and expedient care from Registered Nurse Jodi Wilson, who noted that his was one of the fastest in (patient) and out (patient) processes she’d ever been a part of.
Once he’d received the necessary intravenous fluids, antibiotics and pain medications, Deppe carefully slipped out of his hospital gown and into a tuxedo, with local photographer Jeff Bokhoven documenting everything. Minutes later, Deppe’s parents chauffeured the groom to the church, where he arrived with a half hour to spare.
Because of the compassionate, team-oriented and timely care from emergency room, operating room and floor staff at Pella Regional, the ceremony was a beautiful celebration and demonstration of Nathen’s commitment to Jenna.
“I just can’t say enough about the care and concern I received from Dr. Doty, Dr. Breon, Jodi and all of the other great staff at the Pella hospital,” Deppe said. “They really made our big day possible with their quick decisions, compassion and expertise. We are very, very grateful to everyone at Pella Regional who helped us on our wedding day.”
The mother traveled nearly 1,000 miles from Alabama to Iowa to meet the people who cared for her daughter.
It wasn’t the first time she had come to Iowa. She and her daughter tackled the 15-hour drive together once before because her daughter’s husband had taken a wind farm job and he had to start only a few days after being hired.
So mother and daughter packed up the house and the couple’s little boy, the toddler who brought them home from Texas to Alabama because “it was time to be with momma.” But then it was time to go to Iowa for a new job, a new adventure.
Of course the mother helped the daughter get started – she couldn’t let her go all that way alone. They were close, as mothers and daughters often become when wedding bells ring and grandchildren enter the picture. As her only child, this pair was even closer.
But she was also her daddy’s little girl – well, little tom girl. Between cheer leading and softball, they fished, hunted and bounded around on four-wheelers. He had prepared her well for life in rural Iowa.
Then it was time for more grandchildren and the desire to be close to family renewed itself. This time they would be heading from Iowa back to Texas, home of the son in-law’s family but also closer to Alabama.
The mother didn’t need to help with this move, she thought. This young but experienced family could handle it, so she stayed home.
Five days before Christmas, the young family loaded their car and turned southward. Not far into the trip, that December day turned treacherous with slick pavement and poor visibility.
Brake lights appeared from nowhere – too late. A chain reaction accident on an interstate highway with pre-Christmas traffic. More than 30 vehicles, with the young family caught in the middle, taking hits from every direction.
First responders were there instantly. With great efficiency, the young family was rescued and ambulances raced to the hospital. For the husband and little boy, minor injuries. But for the daughter, much worse.
The trauma team worked valiantly, just like in the drills, but the damage was too great. The daughter could not be saved, nor the twins she carried inside her.
So the daughter came home to Alabama, where now she would stay forever.
When spring came, the mother headed again for Iowa. Not to relive a tragedy, but to help turn the final pages on a young, beautiful woman’s life. And to be a mother one last time.
You see, she had to be where her daughter had been. She had to find the people who were with her, who tried so desperately to give her one more chance, who held her hand and stroked her hair as that chance slipped away. Who loved her, she hoped, like she would have.
And in that Iowa town, she found them. Among the firefighters, paramedics and law enforcement members, she found them. At the hospital, in that trauma room, among the nurses, physicians, staff and volunteers, she found them – the people who fought and cared for her daughter, who comforted her son in-law, who rocked and fed her grandson. She felt their passion and their compassion, how they wanted as much for her daughter as the mother ever had.
She came a long way to that Iowa hospital and found everything she had hoped for and more. She found love, hope and healing, and she brought it all back to Alabama with her.
What more could a mother ask?
As Nurses Week comes to a close, we want to share some of the words of thanks and appreciation sent from Iowa hospital leaders to their nurses. Iowa hospitals are deeply blessed with thousands of truly professional nurses!
The job of a nurse is sometime a thankless job, putting in long hours to make us feel better while at the same time forgetting to maintain their own sanity. I thank our nursing staff for a job well-done and for giving our patients comfort and care and a smiling face… Each of you has the capacity, the knowledge, the fortitude and the compassion for great things. Just as Florence Nightingale advanced the health care system of yesterday, you too are advancing our health care system through the implementation of health care reform and meaningful use, laying the groundwork for generations to come.
– Michael O’Neal, CEO, George C. Grape Community Hospital, Hamburg
Often described as an art and a science, nursing is a profession that embraces dedicated people with varied interests, strengths and passions because of the many opportunities the profession offers. As nurses, we have many roles – from staff nurse to educator to nurse practitioner – and serve all of them with passion for the profession and with a strong commitment to patient safety. Nurses in today’s health care environment are successful at “Delivering Quality and Innovation in Patient Care.”
– Linda Klimesh, Chief Nursing Officer, Winneshiek Medical Center, Decorah
I want to thank all of the nurses for the added TLC that they are so known for giving to each and every patient that uses our facility. The difference that you make in a patient’s life is sometimes difficult to measure but to that person it can change their life in a positive way. Thank you to all of nursing for what you do on a daily basis, 365 days a year…I want to express my appreciation to all of you for your GREAT SERVICE to the people that we serve on a daily basis. We truly have an opportunity every day to make someone’s life more pleasurable under some of the most stressful situations that they will encounter in their life. The spirit of treating others with that extra TLC by everyone on our staff is the No. 1 reason that I’m most proud of what we do on a daily basis. We must never lose sight that we need to earn the trust of each and every person that we touch to accomplish our mission. Thank you for treating others how you would want your loved ones treated.
– Allen Pohren, Administrator, Montgomery County Memorial Hospital, Red Oak
We pay tribute to all the nurses in the nation, state and particularly our community who deliver quality care in a variety of settings. Florence Nightingale was credited as the woman who started nursing; she was devoted to her calling and committed to patient dignity. As one reflects on the life and work of this woman it is with pride that her values are demonstrated in nurses today with their unwavering focus on the patient. Health care today has many challenges and the opportunity to continue to increase the standards of performance for all patients. All nurses should be proud of their work, proud of their profession, proud of their organization and proud of themselves. Join me in saluting the outstanding nursing professionals in our community who are extremely devoted to their calling of providing the best care and compassion to the patients they serve.
– Donna Vandehaar, Chief Clinical Officer, Dallas County Hospital, Perry
Our blessing of the hands reminds us that as nurses and all hospital staff, our hands and our compassion are part of the healing process for our patients. As a faith-based hospital system, we are examples of the healing ministry of Jesus Christ and to work with all people from all walks of life. When we attend to their needs of body, mind and spirit, we are doing His good work.
– Kathy Peckham, Chief Nurse Executive, Alegent Creighton Health Mercy Hospital Corning
Nurses Week helps remind us all to stop and say thank you to our amazing nurses for the care they provide our patients and families. As a nurse, it’s easy to take the special compassion you provide for granted; but remember, what you think is routine is extraordinary to those in your care. You truly impact lives – whether by a healing touch or a compassionate conversation – each and every day. Take time this week to stop for a minute and think about how special you are because you’re a nurse. Thank you not only for all you do this week, but every week!
– Carl Behne, CEO, Greene County Medical Center, Jefferson
IHA’s Iowa Hospital Education and Research Foundation (IHERF) has awarded $96,000 in scholarships to 32 college students from all parts of Iowa. The students, who are all studying in health care fields, will each receive $3,000 for the upcoming academic year and each is eligible for up to $6,000 in assistance from IHERF over two years.
One of the recipients is Jessica Nees, who group up in Rockwell City and is working on becoming a physician assistant.
“By helping to reduce financial burdens, this award will prove to be extremely valuable to the successful completion of my program,” Nees said. “I look forward to giving back to my community upon completion of my graduate school program as a quality health care provider in a local, Iowa hospital.”
IHA established the IHERF Health Care Careers Scholarship Program in 2004 to help address the ongoing shortage of health care professionals and encourage young Iowans to remain in the state as they establish their careers. The first scholarships were awarded in 2005 and now 267 students have benefited from the program.
In exchange for financial support, scholarship-receiving students agree to work one year in an Iowa hospital for each year they receive an award. Including these latest awards, the scholarship program has provided $801,000 in direct support to students since its inception.
IHA staff, the IHERF Board, hospital leaders and IHA Auxilian/Volunteer Board members from throughout the state evaluated scholarship applications from more than 115 students, who were judged on grade-point average, a written personal statement, letters of reference, and extracurricular, community and health care-related activities.
This year’s recipients include nurses seeking both graduate and undergraduate degrees as well as students in respiratory therapy, physical therapy, occupational therapy and pharmacy programs.