This past fall, neither Marlene Coon nor her mother Darlene Mack was initially concerned when Darlene began experiencing breathing problems. At first, the mother-daughter duo who live together in a house near Smithland chalked up the symptoms to allergies, or at most, a minor case of the flu.
When the situation suddenly turned dire and Darlene was rushed to UnityPoint Health – St. Luke’s, questions arose not just about Darlene’s health but about her daughter Marlene’s future as well. With her mother and long-time caretaker in the hospital, Marlene faced a long list of questions. Where would she live? How would she travel from home to Sioux City to visit her mother?
“The outlook for my mom didn’t look good at the time, but I knew my prayers would be answered and everything would work out,” recalls Marlene.
As doctors diagnosed Darlene with an infected hernia and prepared her for the first of several life-saving surgeries, St. Luke’s staff took Marlene under their wings. They gave her a room in the Levitt Guest Center, just steps away from her mother’s room in intensive care, where she could have some quiet moments to herself to rest or work on her poetry. Staff also introduced her to the hospital’s chaplains who invited her to use the chapel whenever she needed. Eating many meals in St. Luke’s cafeteria, Marlene got to know St. Luke’s food and nutrition employees on a first-name basis.
In many ways, St. Luke’s became Marlene’s “home away from home.”
As days led into weeks and Darlene’s health declined, Marlene called her sister Laura in California to let her know their mother was failing. Laura quickly planned a trip and arrived in Sioux City with her family soon after.
“When I first arrived, the staff made sure that my family had our own room in the Levitt Guest Center. They went out of their way to accommodate our needs,” says Laura. “It was a very humbling experience to know that people genuinely cared about my family.”
When their mother opened her eyes the next day, the Mack family celebrated and began the process of planning the future for not only Darlene but Marlene as well. Through conversations with St. Luke’s care coordinator Mary Shook, the family expressed their concerns about finding a place for both Darlene to recover and Marlene to live during her mother’s recovery.
“It was very important to the family that Marlene and Darlene be kept together at discharge. This was important for the patient’s overall successful recovery as well as to the daughter’s mental health,” explains Shook. “I have no doubt that Darlene would have been hospitalized for quite some time if we would have been unable to find a discharge plan that was satisfactory to the patient and her family.”
On a mission to keep mother and daughter together, Shook explored several options before calling Select Specialty in Omaha, a facility that could accommodate the patient and family’s needs. Most importantly, Marlene and Darlene would be able to live together at the Omaha facility while Darlene recovered.
“It was amazing to hear there was a place for both my mom and my sister. St. Luke’s really took our family’s situation into consideration, and they were able to come up with a great solution for mom’s discharge,” adds Laura.
St. Luke’s care coordinators work on a patient’s discharge planning throughout their admission says Shook. As part of the process, a number of factors are reviewed including the patient’s financial situation, family support, location of a facility and how that facility can best meet the patient’s mental and physical needs.
“If a patient is going home, we need to determine services that will best meet their needs at home. Our goal is to develop a plan at discharge that will assist patients and their families in understanding the patient’s illness, meet their goals for care and ensure the patient’s successful recovery after they leave the hospital. By developing a solid discharge plan, we also hope to prevent readmissions,” notes Shook.
Care coordination led to a positive outcome for the Mack family, who hopes to someday bring Darlene and Marlene back home to Smithland once Darlene finishes her recovery in Omaha.
“Everyone at St. Luke’s was so personable. They didn’t treat my mother as just another patient…staff cared for her like she was a family member,” says Laura.
The 127 hospitals participating in the Iowa-based Hospital Engagement Network (HEN) prevented potential harm to more than 4,300 patients in 2013 and reduced health care costs by more than $51 million, according to data released today by the Iowa Healthcare Collaborative (IHC), which administers the network.
Among other improvements, participating hospitals reduced early elective baby deliveries (which can increase complications) by 90 percent; catheter associated urinary tract infections by 44 percent; adverse drug events by 28 percent; central line-associated blood stream infections in intensive care by 24 percent; surgical site infections by 24 percent; patient falls by 23 percent; and avoidable re-admissions by 11 percent.
This work has taken place as part of the federal Partnership for Patients initiative, with the goals of reducing harm by 40 percent and hospital readmissions by 20 percent. The program has helped the hospitals develop the infrastructure, expertise and organizational culture that will support further improvements for years to come. The Iowa HEN, which includes12 hospitals in Illinois and Nebraska, has accelerated improvement across the state and patients are benefiting every day from the spread and implementation of best practices.
In addition to reducing costs, the Iowa HEN reduced the time that patients spent in the participating hospitals by 17,758 days. It’s estimated that at least 32 lives were saved because of the HEN.
“Through the HEN program, Iowa hospitals and their 71,000 employees are ensuring that patients are safer when they are in the hospital and less likely to return to the hospital, all of which reduces the cost of care,” explained Tom Evans, M.D., IHC CEO. “In many ways, Iowa was already a leader in these measurements, but our hospitals have taken up the challenge to do even better – and they are succeeding.”
“Iowa physicians and hospitals are committed to raising the quality and safety bar in all parts of the state,” said IHC Board Chair Jeff Maire, D.O., of Mercy Surgical Affiliates in Des Moines. “Through that commitment we are increasing value and bending the cost curve for all health care consumers.”
The story goes that Andrew Jackson, as the nation’s seventh president, once set out a huge block of cheese to encourage ordinary Americans to visit and interact with the White House. As folklore, the story is mostly homage to Jackson’s down-home, populist image: raised in the Carolina backwoods; self-taught country lawyer; first elected representative of Tennessee to the U.S. House; national hero who defeated the British at New Orleans during the War of 1812.
There is some truth to the cheese story. In 1835, a wheel of cheese four feet in diameter and two feet thick was created by a New York dairy farmer, part of a collection displayed at a local patriotic gathering, which culminated with the largest wheels being shipped to leaders in Washington, D.C. The biggest, weighing some 1,400 pounds, found its way to the White House.
President Jackson supposedly distributed some of the cheese to friends and colleagues, but by 1837 the wheel was largely intact and still in the White House. Two years of aging and the accompanying odor pushed Jackson and his staff toward a solution, which led to a public reception where, reportedly, 10,000 visitors devoured the cheese in two hours.
The big block of cheese story, then, is more about symbolism than actual history. In addition to bringing even more color to Jackson’s already flamboyant personal story, the idea of inviting and feeding thousands of citizens inside the walls of the world’s most powerful residence reinforces how we, as Americans, view our relationship with those who govern – “of the people, by the people, for the people.”
For IHA, that relationship is put into action daily through continual advocacy efforts and comes to a head each year at our Legislative Day. For more than 20 years, IHA has invited hospital leaders and advocates to come to Des Moines, learn about the issues affecting their hospitals and share their concerns with legislators at the seat of state government, the Iowa Capitol.
Far from being merely symbolic, these personal interactions are truly affective in advancing the Iowa community hospital agenda. One-on-one conversations with legislators by hospital representatives who have come from all corners of the state make a real impression – and they make a real difference.
Time and again during last year’s Medicaid expansion debate, legislators from both sides were heard to say, “This is what my hospital is telling me.” Obviously, much of what legislators were hearing was communicated via e-mails, letters and phone messages, so imagine the impact of a face-to-face conversation, particularly if it takes place on their legislative turf.
Make no mistake, however, perception does matter. The fact that IHA, year after year, is able to bring hundreds of voters representing every state Senate and House district to Legislative Day does not go unnoticed. The sight of busloads of hospital advocates pulling up to the Capitol serves as urgent notice to rookie legislators and a stark reminder to veterans: there are real people behind those e-mails, they care about their hospitals and they are a force to be reckoned with.
That force must be re-energized and reorganized each year. For that to happen, hospital leadership is needed. IHA is known and respected “on the hill” because behind our expert lobbyists are thousands of hospital leaders, employees, trustees and volunteers ready to spring into action.
On Wednesday, IHA will be asking hospital advocates to bring their passion to Des Moines. Be heard. Make a difference. And who knows, there may even be cheese…
Iowa’s community hospitals generate nearly 120,000 jobs that add more than $6 billion to the state’s economy, according to the Iowa Hospital Association’s latest Iowa hospital economic impact report. In addition, Iowa hospital employees by themselves spend more than $1.6 billion on retail sales and contribute nearly $99 million in state sales tax revenue.
“People are often unaware of the contributions that hospitals make to their local economies, including the number of people they employ, the significance of hospital purchases with local businesses and the impact of their employees’ spending and tax support for an entire region,” said Kirk Norris, IHA president/CEO. “Just as no one provides the services and community benefits found at community hospitals, there is also no substitute for the jobs and business hospitals provide and create.”
The IHA study examined the jobs, income, retail sales and sales tax produced by hospitals and the rest of the state’s health care sector. The study was compiled from hospital-submitted data on the American Hospital Association’s Annual Survey of Hospitals and with software that other industries have used to determine their economic impact.
The study found that Iowa hospitals directly employ 71,437 people and create another 48,553 jobs outside the hospital sector. As an income source, hospitals provide $4.2 billion in salaries and benefits and generate another $1.8 billion through other jobs that depend on hospitals.
In all, Iowa’s health care sector, which includes employed clinicians, long-term care services and assisted living centers, pharmacies and other medical and health services, directly and indirectly provides 307,402 Iowa jobs, or about one-fifth of the state’s total non-farm employment.
Complete information from the study, including economic impact data for each of Iowa’s hospitals, is available on the IHA website at www.ihaonline.org.
UnityPoint Health – St. Luke’s Hospital in Cedar Rapids has donated three automated external defibrillators (AEDs) to the Cedar Rapids Public Library and Linn County Fair. The donations are possible through the hospital’s Heart Safe Community program, which has donated more than 70 AEDs to various public locations throughout Linn County since 2002.
According to the American Heart Association (AHA), more than 383,000 Americans experience sudden cardiac arrest outside of a hospital each year. CPR and early defibrillation with an AED more than doubles a victim’s chance of survival. AHA’s latest statistics show that 23 percent of out-of-hospital cardiac arrests are “shockable” arrhythmias or those that respond to a shock from an AED, making AEDs in public locations very important.
Sudden cardiac arrest is usually caused by an electrical malfunction of the heart called ventricular fibrillation. The heart muscle quivers and is unable to pump blood through the body. Once the blood stops circulating, a person quickly loses consciousness and the ability to breathe. Defibrillation is the only effective treatment for ventricular fibrillation.
In 2002, as part of its Heart Safe Community program, St. Luke’s donated 20 AEDs to some of Cedar Rapids’ largest public facilities. In 2010, the hospital’s foundation donated 50 AEDs to the Cedar Rapids Police Department, making it possible for every squad car to be equipped with an AED.
“Many of these deaths are preventable,” said Dr. Ryan Sundermann, medical director of St. Luke’s Emergency Department. “For every minute that ticks by without CPR and defibrillation, chances of survival decrease. With these AED donations we continue to make Cedar Rapids a Heart Safe Community by building a cardiac safety net.”
“We are grateful to St. Luke’s for its donation of two AEDs,” said Bob Pasicznyuk, Cedar Rapids Library director. “The hospital also provided training for our staff on how to use the equipment – so this is a very generous donation. Many people use the library on a daily basis and it gives us a peace of mind knowing we have this life-saving equipment on hand.”
Unlike the models of defibrillators intended for use by health care professionals, AEDs do not require extensive medical knowledge to understand or operate. The expertise needed to analyze the heart’s electrical function is programmed into the device, enabling non-medical professionals to respond to cardiac emergencies.
AEDs provide clear voice prompts and screen displays that instruct the user to attach electrodes and then stand away while the device analyzes the patient’s heart rhythm. If the AED’s computer determines the patient’s heart is in a shockable rhythm, the rescuer is again prompted to remain clear of the patient while defibrillation shock is delivered.